Researchers commonly report that families of children with autism spectrum disorder (ASD) experience more parenting stress than families of typically developing (TD) children or those diagnosed with other disabilities [e.g., Down syndrome (DS), cerebral palsy, intellectual disability]. The authors reexamined the research using comparison groups to investigate parenting stress and conducted a meta-analysis to pool results across studies. The experience of stress in families of children with ASD versus families of TD children resulted in a large effect size. Comparisons between families of children of ASD and families with other disabilities also generated a large effect size however, this result should be interpreted with caution as it may be associated with the specific experience of parenting a child with DS.

The impact of parenting stress: a meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder.

Background The purpose of this study was to examine the correlates of caregiver stress in a large sample of young people with autism spectrum disorders (ASDs). Two main objectives were to: (  ) disentangle the effects of behaviour problems and level of functioning on caregiver stress; and (  ) measure the stability of behaviour problems and caregiver stress. Methods Parents or teachers of  young people with ASDs completed measures of stress, behaviour problems and social competence. Parents also completed an adaptive behaviour scale. Eighty-one young people were rated twice at a  -year interval. Results Parents and teachers did not perfectly agree on the nature and severity of behaviour problems. However, both sets of ratings indicated that behaviour problems were strongly associated with stress. Conduct problems in particular were significant predictors of stress. Adaptive skills were not significantly associated with caregiver stress. Parental reports of behaviour problems and stress were quite stable over the  -year interval, much more so than teacher reports. Parent ratings suggested that behaviour problems and stress exacerbated each other over time. This transactional model did not fit the teacher data. Conclusion Results of this study suggested that it is a specific group of externalized behaviours that are the most strongly associated with both parent and teacher stress. Results were discussed from methodological and conceptual perspectives.

The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders.

Elevated parenting stress is observed among mothers of older children with autism spectrum disorders (ASD), but little is known about parents of young newly-diagnosed children. Associations between child behavior and parenting stress were examined in mothers and fathers of 54 toddlers with ASD (mean age = 26.9 months). Parents reported elevated parenting stress. Deficits/delays in children's social relatedness were associated with overall parenting stress, parent-child relationship problems, and distress for mothers and fathers. Regulatory problems were associated with maternal stress, whereas externalizing behaviors were associated with paternal stress. Cognitive functioning, communication deficits, and atypical behaviors were not uniquely associated with parenting stress. Clinical assessment of parental stress, acknowledging differences in parenting experiences for mothers and fathers of young children with ASD, is needed.

Parenting Stress in Mothers and Fathers of Toddlers with Autism Spectrum Disorders: Associations with Child Characteristics

Pediatricians have an important role not only in early recognition and evaluation of autism spectrum disorders but also in chronic management of these disorders. The primary goals of treatment are to maximize the child's ultimate functional independence and quality of life by minimizing the core autism spectrum disorder features, facilitating development and learning, promoting socialization, reducing maladaptive behaviors, and educating and supporting families. To assist pediatricians in educating families and guiding them toward empirically supported interventions for their children, this report reviews the educational strategies and associated therapies that are the primary treatments for children with autism spectrum disorders. Optimization of health care is likely to have a positive effect on habilitative progress, functional outcome, and quality of life; therefore, important issues, such as management of associated medical problems, pharmacologic and nonpharmacologic intervention for challenging behaviors or coexisting mental health conditions, and use of complementary and alternative medical treatments, are also addressed.

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Management of Children With Autism Spectrum Disorders

https://www.hal.inserm.fr/inserm-00549873/document

Etiological heterogeneity in autism spectrum disorders: More than 100 genetic and genomic disorders and still counting

Affect regulation (AR) and temperament were examined in children with Autism Spectrum Disorder (ASD). To determine AR, children were exposed to a mildly frustrating situation. Temperament was assessed by the Children's Behavior Questionnaire (CBQ). Children with ASD showed greater variability in AR and used less effective AR strategies compared to controls. Lower academic ability was associated with less effective AR strategies for the ASD while for the controls older age predicted more effective AR strategies. Those with ASD were lower than controls in Attention Focusing, Inhibitory Control, and Soothability. Of the three overarching temperament factors of the CBQ, only Effortful Control but not Negative Affectivity and Surgency/Extraversion distinguished those with ASD from controls. For the ASD group, higher academic ability predicted higher Negative Affectivity. Fewer symptoms and older chronological age predicted higher Effortful Control.

Affect Regulation and Temperament in Children with Autism Spectrum Disorder

Data on 14 males with autism and 14 with schizophrenia were collected to examine symptom overlap. The Structured Clinical Interview (SCID), the schedule for positive symptoms (SAPS) and the schedule for negative symptoms (SANS) of schizophrenia, the Childhood Autism Rating Scale (CARS), and the DSM-III-R were administered. On the SCID, none of the men with paranoid schizophrenia met criteria for autism while 7 of those with autism met criteria for schizophrenia, disorganized type, showing negative symptoms. In addition, 5 showed positive symptoms on the SAPS and 6 negative symptoms on the SANS. As the difference in measured nonverbal intelligence was not significant, the effects could not be attributed to it. Although the findings continue to support the differentiation of autism and schizophrenia, they are also consistent with a comorbidity of the two disorders, mainly in those diagnosed with autism.

Autistic disorder and schizophrenia: diagnostic overlaps.

Parents of 44 autistic children rated their children's symptom severity and their own stress on a 14-item symptom scale Thirteen child and family characteristics were also examined to assess how they affected symptom perception and stress Preschoolers were rated less symptomatic by their parents than by clinicians Lower functioning, nonverbal, odd-looking, self-abusive, seizuring and hyperirritable children were rated more symptomatic than their peers Best predictor of stress for both parents was a child's self-abuse; for mothers hyperirritability and older age were also associated with elevated stress scores Compared with parents of matched normal children, mothers of autistic children reported the most aggravations and expressed the need for additional support from their spouses

Assessing Child Symptom Severity and Stress in Parents of Autistic Children

This study assessed the impact of various individual symptoms of autism on mothers and fathers, and professionals' accuracy in estimating parents' perceived stress levels. Mothers and fathers of 20 autistic children, and 20 therapists working with those children, independently rated the severity of common symptoms of autism in their child, and how stressful they found each symptom; therapists estimated parental stress. The autistic child's language and cognitive impairment were judged by all raters as most severe and stressful. In contrast with other studies, individual parents agreed on both symptom severity and degree of stress. Parents of older children judged symptom severity to be lower, but fathers reported a continued high level of stress. Professionals judged families as more stressed by the child symptoms than did families themselves. Implications for intervention and casework are discussed.

Parent and professional evaluations of family stress associated with characteristics of autism

Thirty-one individuals, 15 with autistic disorder and 16 with developmental delay, male and female, were asked to select from a series of drawings depicting sexually relevant activities and to define them. In addition they were asked to describe their sexual experiences, attitudes, and interests, using a semistructured interview format. Ability to select through pointing out sexually relevant body parts or activities was not different by level of functioning, group, or gender. There were differences in providing a sociosexual label, however, with better performance for those with developmental delay and for the higher functioning. No differences were evident for sexual experiences, likely because of the considerable variability across subjects and types of activity, with some individuals reporting very many and others very few. As to attitudes, individuals with autistic disorder endorsed more sexual activities than those with developmental delay. Higher knowledge of sexuality terms and activities was inversely related to their endorsement. Literalness and perseveration were evident in the responses of some, primarily those with autistic disorder. Results are discussed for their relevance to the reliability and validity of information on sexual awareness among the developmentally disabled. Suggestions for future research are offered.

M. Mary Konstantareas

Papers

Affect Regulation and Temperament in Children with Autism Spectrum Disorder

Autistic disorder and schizophrenia: diagnostic overlaps.

Assessing Child Symptom Severity and Stress in Parents of Autistic Children

Parent and professional evaluations of family stress associated with characteristics of autism

Sociosexual Knowledge, Experience, Attitudes, and Interests of Individuals with Autistic Disorder and Developmental Delay