Child care problems and employment among families with preschool-aged children with autism in the United States

Department of Pediatrics, University of Rochester, Rochester, New York, United States
PEDIATRICS (Impact Factor: 5.47). 08/2008; 122(1):e202-8. DOI: 10.1542/peds.2007-3037
Source: PubMed


The impact of childhood autism on parental employment is largely unknown.
The purpose of this work was to describe the child care arrangements of children with autism and to determine whether families of preschool-aged children with autism are more likely to report that child care arrangements affected employment compared with typically developing children and children at high risk for developmental problems. METHODS. Parents of 16282 preschool-aged children were surveyed by the National Survey of Children's Health. An autism spectrum disorder was defined as an affirmative response to the question, "Has a doctor or health professional ever told you that [child] has any of the following conditions? Autism?" There were 82 children with autism spectrum disorder in the sample, and 1955 children at high risk on the basis of the Parent's Evaluation of Developmental Status. We used chi(2) and multivariate logistic regression analyses.
Ninety-seven percent of preschool-aged children diagnosed with autism spectrum disorder were cared for in community settings, particularly preschool and Head Start, with only 3% in exclusive parental care. Thirty-nine percent of the parents of children with autism spectrum disorder reported that child care problems had greatly affected their employment decisions, compared with 16% of the children at high risk and 9% of those who were typically developing. In multivariate analyses, families with a child with autism spectrum disorder were 7 times more likely to state that child care problems affected employment than other families, after controlling for household and child covariates. This effect was 3 times larger than the effect of poverty.
Developmental problems and autism spectrum disorder are associated with higher use of child care services and higher probability that child care problems will greatly affect employment. These findings warrant evaluation of the community resources available to families with children with special needs.

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    • "However, stressors can come from a variety of sources for parents of children with ASD: it can be related directly to parenting a child with ASD (parenting stress), or form the range of additional life stressors that such parents may experience (see Osborne and Reed 2009b, for a discussion). It is certainly the case that issues such as employment (Hill et al. 2014; Montes and Halterman 2008), financial issues (Knapp et al. 2009), and relationships and divorce (Hartley et al. 2010) are important potentially disruptive factors in lives of parents of individuals with ASD, and each of these can impact on health and its physiological correlates (see Barrington et al. 2014; Marmot and Bell 2012; Repetti et al. 1989). Given that it is currently unclear whether parenting stress or general life stressors associated with being a parent of a child with ASD are more directly related to health issues for this group of parents, the current report sought to establish the relationship between levels of both general stress, and stress particular to parenting, with the health-related QoL and health status for this group. "
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    ABSTRACT: The current study explore the relationship between various forms of experienced stress (general stress and parenting stress) and both health-related quality of life (QoL) and reported physical health symptoms. One hundred and twenty-two mothers of children with autism spectrum disorder responded to an online survey included questionnaires on general stress, parenting stress, health-related QoL, and physical symptoms. The results suggested that perceived general stress as associated with both a reduced health-related QoL and more physical symptoms. However, parenting stress was only associated with a reduced health-related QoL, and not with physical health. These results are discussed in relation to the complex impact of prolonged and predictable parenting stress on the cortisol response and immune system.
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    • "Prior studies have documented gender differences and lack of involvement from fathers in caregiving of children with ASD (Gray, 2003). Similarly, studies have documented that in families of children with ASD, mothers often reduce their workload or leave their employment entirely to manage their child's needs (Cidav, Marcus, & Mandell, 2012; Montes & Halterman, 2008), and the care of the child with ASD often results in social isolation (Myers, Mackintosh, & Goin-Kochel, 2009; Woodgate, Ateah, & Secco, 2008). "
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    ABSTRACT: Objective: Prior research has documented caregiving difficulties in families of children with autism spectrum disorder (ASD). However, Latino families may encounter unique challenges. The purpose of this study was to understand the caregiving experiences of Latino families with children with ASD, including daily activities, coping strategies, and service utilization. Method: Fifteen Latino parents of children with ASD were interviewed. The interviews were transcribed for analysis to identify themes of experiences unique to this population. Results: Latino families of children with ASD encounter many similar issues as non-Latino families but also unique issues that affect service utilization. Four themes were identified: dealing with the diagnosis, dealing with stigma and isolation from family and community, understanding the role of mothers in changing family routines, and utilizing services. Conclusion: To meet the unique needs of Latino families, services need to be provided in culturally sensitive context that address children's needs within family units.
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    • "In addition to the negative impact of ASD on the child, the condition has also been associated with major stressors on the family unit, often more so than among families with children with other developmental disabilities (e.g., Down syndrome; Brown et al. 2006). Research has consistently demonstrated a link between child behavior problems and decreased family well-being (e.g., Eisenhower and Blacher 2006; Turnbull et al. 2007), as well as between ASD and decreased family productivity (e.g., parental employment; Kogan et al. 2008; Montes and Halterman 2008). The rise in documented prevalence of ASD over the last couple of decades has dramatically increased the financial burden of caring for individuals with ASD. "
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    ABSTRACT: State-specific 1915(c) Medicaid Home and Community-Based Services waiver programs have become central in the provision of services specifically tailored to children with autism spectrum disorders (ASD). Using propensity score matching, 130 families receiving waiver services for a child with ASD were matched with and compared to 130 families waiting on the registry (i.e., control group). Results indicate that participants in the waiver group reported more improvement in independent living skills and family quality of life over the last year compared to those on the registry. More frequent intensive individual support services and therapeutic integration were statistically predictive of improvement in a variety of domains. The results suggest that the waiver program may be promising for improving child and family functioning.
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