The Predictors of Parenting Stress in Mothers of Preschoolers with Autism Spectrum Disorders based on the perspective of the International Classification of Functioning, Disability and Health for Children and Youth Framework
Date Issued
2012
Date
2012
Author(s)
Chiou, Tzu-Huang
Abstract
Background: Autism Spectrum Disorders is characterized by qualitative impairments in communication and social interaction, along with restricted, repetitive and stereotyped interests. Besides the core symptoms, children with ASD also have various associated deficits such as atypical sensory processing, impaired intellectual function, behavior problems, and difficulty in self-care skills or participation in family activities, which may have greatly affected parenting stress. Because of the complex nature of problems in children with ASD, employing a holistic framework to identify the factors influencing maternal stress is crucial. The World Health Organization advocates a uniform framework and terminology, the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), for the description of health and health-related states in children and youth population. ICF-CY has changed the previous concept and definition about health. It not only focuses on disability but also on function, and considers the interaction between disease, function, environmental and personal factors. To date, studies examining the predictors of maternal stress in children with ASD only included factors from two or three specific dimensions without taking into account the possible factors from all the dimensions of ICF-CY simultaneously. Moreover, previous studies employed participants with a wide age range (e.g., from preschoolers to adults) such that the results may not be applicable to children in a specific age range, such as preschoolers. Furthermore, using the ICF-CY framework to investigate the predictors of maternal stress in children with ASD is essential for a comprehensive understanding of factors associated with maternal parenting stress.
Purposes: The purpose of this study was to investigate the factors related to the maternal parenting stress in preschoolers with ASD using the ICF-CY framework by considering the potential factors from all dimensions of the ICF-CY.
Methods: Preschoolers with ASD were recruited from developmental centers, pediatric rehabilitation clinics, and child psychiatry and rehabilitation departments of general hospitals in Taiwan. The inclusion criteria included (1) preschool children were diagnosed with autistic disorder, Asperger’s disorder, or PDD-NOS by child psychiatrists based on criteria of the DSM-IV-TR, and (2) children’s mother agreed to participate and give the informed consent. The exclusion criteria were (1) children with sensory limitations such as blindness, deafness, and severe motor limitations which hindered adequate testing, and (2) children’s mother unable to communicate in Mandarin or Taiwanese. The child with informed consent received a one-to-one assessment using the Chinese Psychoeducational Profile-third edition (CPEP-3) by a researcher. Another researcher rated the child’s behaviors using the Childhood Autism Rating Scale. Meanwhile, the child’s mother was interviewed by a third researcher using the Vineland Adaptive Behavior Scale-Chinese classroom edition. After completion of the CPEP-3, a package of questionnaires including a basic information questionnaire, the Behavior Style Questionnaire-Chinese version, the Child Behavior Checklist for Ages 1.5-5 - Chinese version, the Short Sensory Profile-Chinese version, Positive Affect Index, and the Parenting Stress Index-Chinese Short Form were given to the mother.
Statistical analysis: Descriptive analysis and Pearson Product Moment Correlation analysis were conducted for the observed variables in ICF-CY framework. Multiple linear regression models were fitted to identify the significant factors of parenting stress in mothers of preschooler with ASD.
Results: Eighty-nine preschoolers with ASD aged from 3 to 5 years old were recruited. Pearson correlation demonstrated that maternal parenting stress was significantly positively correlated with the severity of symptoms, emotional and behavior problems. But maternal parenting stress was significantly and negatively correlated with mother’s positive affect, child’s rhythmicity, sensory processing, cognitive, expressive language and communication, daily living skills, and socialization. The strongest predictors of parenting stress in mothers of preschoolers with ASD were child’s internalizing problems, high rhythmicity, the severity of symptoms, and mother’s positive affect.
Conclusion: This is the first study investigating the parenting stress in mothers of preschoolers with ASD adopting the conceptual framework of the ICF-CY. Findings suggest that early diagnosis and interventions, coping strategies and social support should be provided to mothers of preschooler with ASD to assist their stress relief and psychological adjustment.
Subjects
Autism spectrum disorders
parenting stress
ICF-CY
preschooler
predictor
Type
thesis
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