Stress prediction and management in parents of children diagnosed with Autism

    Abstract

This paper is aimed at understanding the research conducted on the stress and stressors involved in the daily life of parents of children who have Autism. Parenting a child who has been diagnosed with Autism can be a challenge without a good support system, special parenting techniques and in some cases without a proper diagnosis. Parents of Autistic children face social, personal, financial conditions that can be daunting. Such situations for any person can be a source of stress and give rise to stressors that need proper management. If these stressors are not handled with the right means, then they can take a toll on the parents mental and then eventually physical health as well. This paper suggests some techniques and strategies that would benefit this population in particular. These strategies are used and designed considering the specific situation faced by these parents with a child who suffers from Autism.

Target Population- Parents of Children having Autism

The number of children diagnosed today with Autism, medically known as Autism Spectrum Disorders (ASD) is much more than it was until few years ago. The CDC reports that today 1 out of 88 children is identified with ASD, where as in 2007 it was 1 out of 150 children (www.cdc.gov) and looking at data from previous years, it shows that the diagnosis has increased by 23 % every year.

This means that today the number of parents with children with Autism is also higher than it was few years. What is Autism? Autism is defined by APA as ‘the most severe developmental disability’. It appears ‘within the first three years of life, autism involves impairments in social interaction’ (Encyclopedia of Psychology, APA). The symptoms and behavior for people with autism can vary from not being aware of other people’s feelings to hurting themselves, from unusual eating, sleeping habits to have trouble communicating. Baird et al (2003) in their study on diagnosis of Autism defined Autism as ‘behaviorally defined disorder that’s the end point of several organic aetiologies’. At first Autism was linked to many prenatal exposure to chronic conditions, and then their study connected Autism to neurobiological disorder. They also add that the diagnosis of Autism typically happens between the ages of 2 and 3 years of age, which is conflict with some other researches, but their point on surveillance of the child’s behavior make it a valid age for diagnosis. This brings us to the age that Autism is mostly diagnosed is early child hood years and preschool age. Ostreling & Dawson (1994) did a study to understand the

Stress prediction ad management in parents of children diagnosed with Autism.

right age for diagnosing Autistic children, and their study said that though Autism is not usually diagnosed until age 4, but parents of these children report observing something unusual even before age one. They talk about using ‘retrospective’ technique to diagnose Autism in children younger than age four and having involvement by parents in reporting, observing to help with diagnosis. This study and the general idea that Autistic children show signs of their condition at a young age and that it has genetic factors related to it, makes it understandable what the parents of these children go through. It makes it more significant that the lives of parents with children having Autism can be stressed.  

Wolf et al (1996) reported in their study that parents of Autistic children tend to have a higher stress level than parents of children with Down syndrome or parents of developmentally average children. They added that parents of Autistic children had a compromise on their well being due to many reasons that include the unpredictable and the uncertain nature of Autism. Parenting to toddlers and young children can require lots of patience, understanding and organization to make it a stress free experience and successful. When the same experience changes for a bigger challenge and the children are facing disabilities like Autism, the stress for the parents can increase. This stress can be due to the parenting needs of the child, and for many other reasons as well that can act as stressors.  Dumas et al (1991) studied stress faced while parenting by parents of children diagnosed with Autism, Down syndrome and behavior disorders. Their results clearly showed that parents of children with Autism faced much higher levels of stress due to behavioral difficulties.

Common Stressors for this population and related health issues

There are some stressors that are common among the population of parents of Autistic children because of some specific challenges that these parents face due to the disability suffered by their child. This can include parenting challenges and other conditions like social support, financial constraints and family structure as well. Parents of more than one child may face stress when they observe the effects of their Autistic child on other siblings. Smith & Perry (2005) report that siblings of Autistic children feel neglected and pressured to excel and take household responsibilities. Finding the balance between all children can be a major stressor for these parents as the Autistic child may demand and require more attention that their siblings.

Parents feel stress in their marriage as well and mothers report to have facing more stress than fathers of Autistic children due to being more involved in parenting and caring for the child.

Dunn et al (2001) study shows that parents of Autistic children face more marital strain and dissatisfaction, lack of marital intimacy as compared to parents of normal kids. The parents of Autistic children can get effects of the parenting challenge of the Autistic child on their own relationship which can act as a stressor when trying to run a functional family and work as partners.  

The role of parents is major in an Autistic child’s life as they run the day to day life of the child. The behavioral symptoms may vary in every child, but the lack of understanding, social skills and inability to communicate and showing unusual is very common (mayoclinic.com).

 This was concluded by White et al (2009) as well when their study results showed that anxiety is very common among children with Autism Spectrum disorder (ASD) and these children do not show anxiety that would be considered age appropriate.

For parents of Autistic children, managing small to major tasks in daily life can actually turn in chronic stress (a form of stress that you get used to because it is so often in your life) that can eventually start effecting their own health.  

Depression and isolation are some general health issues that can develop among parents of Autistic children as result of chronic stress.

Polawsky et al (2013) while looking at the parental reaction to diagnosis of their child with Autism found that these parents went into isolation, depression and negative feelings towards their spouses. This was found more common among mothers who admitted to being stressed.

 Parents are also capable of neglecting their own physical and mental health when caring for their Autistic children. It takes a lot of time and effort to learn your child’s specific symptoms, how to handle them and help your child. In the mean time without a good support system around, it’s not improbable that parents may be unable to attend to their own health needs.

Stress management strategies

 1. Social support is most important

 Social support can be formal or informal, it can come from family, friends, child’s school or neighbors. Zablotsky et al (2012) report that social support from neighborhood seems to have significant effect on the quality of life and stress faced by parents of children with ASD. They also add that social support can be ‘diverse’ coming from whomever the parents feel a connection with which can make a big difference.

A good communication and mutual efforts with the child’s educators is also very important. Social challenges for the children are mainly faced at schools and a bad experience can create a high level of stress for parents. This can be prevented if there is good and effective communication with the teachers, school of the child especially if the child has been diagnosed with less than sever symptoms of Autism and is able to attend school with normal kids.

2. Physical activity as a family

Lang et al (2010) report that physical activity actually benefits children and individuals with ASD if it is specifically designed to be carried out by them. This can be a great coping technique for the parents where after advice from the caretaker of the child, they can get involved in some form of physical activity with their child. This will benefit their health as well as their child.

3.Marriage therapy and family therapy

When you have a child with special needs in the family then they effects of that is felt by the parents as well as other siblings. Marital therapy can be a very good tool to help with the day to day stress that the parents relationship has on it. The best of partners can be affected by a stressful situation like raising a child with development disabilities. Added to that can be the situation of other siblings as well who maybe feeling neglected and lost in the scenario. Family therapy can be helpful to reconnect, bond and develop strong communication about how to deal with daily situations.

  

                                                                 References:

Autism and Developmental Disabilities Monitoring (ADDM) Network, United States, 2012. WWW.CDC.GOV.

Article on Autism, adapted from Encyclopedia of Psychology. www.apa.org

Baird, G., Cass, H., & Slonims, V. (2003). Diagnosis of autism. BMJ: British Medical Journal, 327(7413), 488.

Dumas, J. E., Wolf, L. C., Fisman, S. N., & Culligan, A. (1991). Parenting stress, child behavior problems, and dysphoria in parents of children with autism, Down syndrome, behavior disorders, and normal development. Exceptionality: A Special Education Journal, 2(2), 97-110.

Dunn, M. E., Burbine, T., Bowers, C. A., & Tantleff-Dunn, S. (2001). Moderators of stress in parents of children with autism. Community mental health journal,37(1), 39-52.

Lang, R., Koegel, L. K., Ashbaugh, K., Regester, A., Ence, W., & Smith, W. (2010). Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 4(4), 565-576.

Osterling, J., & Dawson, G. (1994). Early recognition of children with autism: A study of first birthday home videotapes. Journal of autism and developmental disorders, 24(3), 247-257.

Mayoclinic staff, Symptoms of Autism. Mayoclinic.com

Poslawsky, I. E., Naber, F. B., Van Daalen, E., & Van Engeland, H. (2013). Parental Reaction to Early Diagnosis of Their Children’s Autism Spectrum Disorder: An Exploratory Study. Child Psychiatry & Human Development, 1-12.

Smith, T., & Perry, A. (2005). A sibling support group for brothers and sisters of children with autism. J Dev Disabil, 11, 77-88.

White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical psychology review, 29(3), 216-229.

Wolf, L. C., Noh, S., Fisman, S. N., & Speechley, M. (1989). Brief report: Psychological effects of parenting stress on parents of autistic children. Journal of autism and developmental disorders, 19(1), 157-166.

Zablotsky, B., Bradshaw, C. P., & Stuart, E. A. (2012). The Association Between Mental Health, Stress, and Coping Supports in Mothers of Children with Autism Spectrum Disorders. Journal of autism and developmental disorders, 1-14.