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The rising demand for child care is putting a strain on parents of children with autism spectrum disorder (ASD), particularly the mothers. This study investigated Chinese mothers of children with ASD and examined the factors associated with maternal mental health. An online national survey was completed by the parents of 5077 ASD children and adolescents aged 0‍‒‍17 years. A total of 28.0% of the mothers reported poor mental health status. Mothers with children aged 10‍‒‍13 years had a lower chance of having poor mental health status than mothers with children aged 0‒2 years (odds ratio (OR) 0.63, 95% confidence interval (CI) 0.43‍‒‍0.91). Mothers of children with high-functioning autism were less likely to have poor mental health status than those of children with low-functioning autism (OR 0.76, 95% CI 0.62‍‒‍0.94). Having children with comorbidities was related with a higher risk of poor mental status (OR 1.56, 95% CI 1.35‒1.81), as were having conflicts with other family members (OR 1.44, 95% CI 1.22‍‒‍1.70) and providing full-time care (OR 1.22, CI 1.06‍‒‍1.41). A higher-than-average family income was associated with lower risk of having poor mental health status (OR 0.70, 95% CI 0.58‍‒‍0.82). Factors related to the children and family, and providing full-time care, have a significant effect on mothers' mental health status. Reducing obstacles to work and social interaction, as well as tackling the financial burden of raising an ASD child, may help improve the well-being of mothers.

Evidence suggests that improved health outcomes and reducing the hospital length of stay of individuals with autism require working in partnership between parents and health care professionals. Parents' ability to cope in their daily caregiving responsibilities to their child with autism and assessment of their hospital experience can have an impact on their participation with the care team. Nurses working in the inpatient setting can provide support to parents during their encounter with them. This article presented some of the helpful approaches that can help in building positive relationships with parents that may help facilitate addressing the needs of their child with autism. Suggestions that nurses can implement to support the parents cope with their daily challenges are presented. The approaches were discussed in relation to literature and suggestions from parents of individuals with autism spectrum disorder.

Objective: This study explores the health information needs of individuals with autism spectrum disorder (ASD) and their caregivers in the post-COVID-19 era by analyzing discussions from Reddit, a popular social media platform. Methods: Utilizing a mixed-method approach that integrates qualitative content analysis with quantitative sentiment analysis, we analyzed user-generated content from the "r/autism" subreddit to identify recurring themes and sentiments. Results: The qualitative analysis uncovered key themes, including symptoms, diagnostic challenges, caregiver experiences, treatment options, and stigma, reflecting the diverse concerns within the ASD community. The quantitative sentiment analysis revealed a predominance of positive sentiment across discussions, although significant instances of neutral and negative sentiments were also present, indicating varied experiences and perspectives among community members. Among the machine learning models used for sentiment classification, the Bi-directional Long Short-Term Memory (Bi-LSTM) model achieved the highest performance, demonstrating a validation accuracy of 95.74%. Conclusions: The findings highlight the need for improved digital platforms and community resources to address the specific health information needs of the ASD community, particularly in enhancing access to reliable information and fostering supportive environments. These insights can guide future interventions and policies aimed at improving the well-being of autistic persons and their caregivers. [ABSTRACT FROM AUTHOR]

Objectives: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that includes abnormal communication, repetitive and limiting interests, and social dysfunction. This study aimed to identify the experiences of parents in raising children with ADS in Iran. Methods: A total of 18 parents of children with ASD were selected by purposive and convenient... [ABSTRACT FROM AUTHOR]

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties with language, cognition, and social interaction. The diagnostic and statistical manual of mental disorder, fifth edition used "spectrum" to show the variability in etiology and phenotypic levels. This study aims to compare nonverbal communication skills in normally developing and autistic children in Karbala City, Iraq. Materials and Methods: This was a cross-sectional study. Two sets of children (ASD and normal) were matched in terms of age and socioeconomic state. A total of 50 individuals were recruited with 25 ASD and 25 normally developing children without any history of psychological abnormalities. The child's parent/caregiver provided all the demographic information and medical history. The information was gathered from 10-min videos separately recorded for each child, regular contact with them, and continuous interviews with their parents and caregivers. The researchers developed a pre-designed data collection questionnaire according to the non-verbal skills of 3-5-year-olds, including body language, eye contact, and facial expressions. The questionnaire was filled out by the first author. Finally, the gathered data were analyzed by the SPSS software, version 25 (IBM Corp, Armonk, NY). Results: Comparing the total scores revealed a significant difference between the ASD and normal group in gestures (P=0.001), phonetics (P=0.001), body language (P=0.001), and artifacts (P=0.001). Normally developed children scored significantly higher than ASD children in all 4 variables. However, in the maladaptive behavior (P=0.001), the significant scores were for ASD children compared to normal children. Conclusion: The results showed that ASD children experience difficulty in nonverbal communication skills. They also have maladaptive behaviors. The main reason for this behavior is their inability to communicate non-verbally. [ABSTRACT FROM AUTHOR]

Introduction: Concerns about the quality of life (QoL) of parents of children with autism spectrum disorder have been raised by previous study. Policy decision-makers and healthcare professionals can be better informed about the environmental factors associated with parental QoL, which will enhance outcomes for both parents and children. The objective of this review is to perform a comprehensive review that assesses the environmental relevant factors associated with quality of life (QoL) of parents of ASD children (under 18 years old). Methods: To identify the environmental factors associated with parental QoL, a scoping review was conducted using the Arksey and O'Malley original and enhanced framework. Three electronic database (PubMed, Scopus & WOS) and reference list checks were used in the search. Results: Social support, family support, residential condition, and access to services were all factors linked to the parental quality of life in this group. Conclusions: The review highlighted environmental factors as one of the variables that have an association with parental QoL. The results of this analysis also highlighted potential areas of support that have implications on future policy and practices. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) affects children and their families. We investigated the family environment of children with ASD in Brazil. Twenty-one families participated. Outcome measures administered to parents included the Strengths and Difficulties Questionnaire, Questionnaire on Resources and Stress—Short Form, and the Family Environment Scale. All families reported a number of difficulties, including social interactions and peer relationships, stress levels, and communication difficulties. Families also reported great concern for their child's future. Brazil is a developing country, yet there are few national resources and studies related to ASD. The challenges continue from diagnosis through treatment. Our results emphasize the need to understand the family environment of children with autism and their parents' apprehensions to develop effective coping programs. [ABSTRACT FROM AUTHOR]

Parents of children with autism spectrum disorder and other disabilities report high levels of distress, but systematically evaluated interventions are few. This study aimed to evaluate the feasibility of a novel, manualized Acceptance and Commitment Therapy group intervention (Navigator ACT) in a sample of 94 parents of children with disabilities. Feasibility was measured by treatment completion, credibility, and satisfaction, and preliminary outcomes by using self-rating scales administered at the baseline, post-intervention, and follow-up. The results imply the intervention is feasible in the context of Swedish outpatient habilitation services. A preliminary analysis of the outcome measures suggests that parents experienced significant improvements in well-being. The results indicate that the treatment is feasible and should be evaluated in a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Objectives: Research shows that stigma has an adverse psychological impact on parents of children with autism spectrum disorder (ASD). However, there are very few studies examining the potential protective factors that may buffer the adverse impact. The present study investigated the longitudinal associations of experienced discrimination and anticipated discrimination with detrimental cognitive consequences (i.e., self-stigma content and self-stigma process) and affective consequences (i.e., parenting stress and depressive symptoms) for parents of children with ASD and tested whether these associations would be moderated by nonattachment. Methods: At two time points separated by 24 months, 381 Hong Kong parents of children with ASD completed standardized questionnaires to provide data on experienced discrimination, anticipated discrimination, nonattachment, self-stigma content, self-stigma process, parenting stress, and depressive symptoms. Results: Hierarchical regressions showed that experienced discrimination and anticipated discrimination had significant interactions with nonattachment at baseline in predicting adverse psychological consequences (i.e., self-stigma content, self-stigma process, parenting stress, and depressive symptoms) at follow-up. In addition, simple slope analyses showed that the associations of experienced discrimination and anticipated discrimination with the adverse psychological consequences were weaker in parents with high nonattachment than in parents with low nonattachment. Conclusions: Our findings indicate the longitudinal associations of experienced discrimination and anticipated discrimination with detrimental cognitive consequences and affective consequences for parents of children with ASD, and highlight the protective effects of nonattachment against such associations. These findings suggest the importance of supporting parents of children with ASD to increase nonattachment in order to cope with discrimination and improve psychological well-being. [ABSTRACT FROM AUTHOR]

This paper reported the quality of life (QoL) of 260 Malaysian parents with autism spectrum disorder (ASD) and factors which influencing it. About half of these parents reported to having good QoL. The factors identified in the double ABCX model showed that perceived social support and sense of coherence (SOC) were mediated by coping strategies and had a positive direct and indirect effect on parents' QoL. These finding reiterate the importance of social support, coping skills, and strong SOC reflection skills in influencing the QoL of parents with ASD child. We therefore suggest parents to utilize the widely available social and organization supports to gain good QoL, which is also important for the wellbeing of their child. [ABSTRACT FROM AUTHOR]

Daily living skill deficits commonly co-occur in individuals with autism spectrum disorder (ASD). These deficits in adolescence are associated with poor outcomes, in both employment and independent living skills as adults. Currently, there are no interventions that directly target daily living skill acquisition in adolescents with ASD without an intellectual disability to facilitate a successful transition to adulthood. In this paper, we discuss the development, refinement, and initial efficacy studies of Surviving and Thriving in the Real World (STRW), a 14-session group treatment for both adolescents with ASD and their parent/caregiver that promotes attainment of critical daily living skills. We summarize initial feasibility studies that have been instrumental in the iterative development of STRW. The structure, core treatment elements, and content of STRW are described in detail. Lastly, we discuss the transition of the in-person STRW intervention to STRW-telehealth, which allows for adolescents with ASD to work on daily living skills in their own home with support from a therapist. [ABSTRACT FROM AUTHOR]

Caring for an individual with autism spectrum disorder (ASD) in ideal circumstances can be stressful, and the Coronavirus disease (COVID-19) pandemic created a high degree of disruption to life and stress to families living with an individual with ASD. We conducted an online survey of families in Michigan that revealed higher levels of stress in caregivers of younger individuals with ASD and those with greater severity of ASD symptoms. Stress around therapeutic service disruption, finances, and illness predominated and greater stress was reported for caregivers of individuals receiving greater intensity of services pre-COVID-19. Respondents voiced concerns about receiving respite care during COVID-19, and those expressing interest in respite also reported greater symptom severity in the person with ASD. [ABSTRACT FROM AUTHOR]

Introduction: Identifying the predictors of parenting stress in parents of children with autism spectrum disorder is crucial to provide the best health-care services. Main text: The scoping review was conducted. Search engines (EBSCO, Springer, PubMed, Ovid, Google Scholar, and Science Direct) were used to collate published studies between the years 2009 and 2020. Keywords used were parenting stress, parental stress, predictors of parenting stress, Autism disorder, Autism, and scoping review. Primary screening of the titles and abstracts of 1039 articles was conducted. The secondary screening of 348 articles resulted in 27 articles included in this review. The reviewed articles revealed core symptoms of the disorder, namely, behavior problems, and socio-communication impairments strongly linked with the high level of parenting stress. Conclusion: This scoping review is the initial step toward encouraging future efforts to provide supportive interventions for parents of children with autism spectrum disorder. [ABSTRACT FROM AUTHOR]

Services for children with autism spectrum disorder (ASD) and their families have evolved with the advent of the Medicaid waiver, leading to more family-based coordination of care. Evaluating family involvement, the current investigation compared 230 families of children with ASD receiving Medicaid waiver services to a propensity-score matched group of 230 families who were waiting for such services (i.e., registry families). Compared to the registry, waiver families reported more involvement in service planning tasks, but not activities related to future-planning, managing crisis situations, or searching for and securing funding. Additional analyses characterize waiver families as engaging in high levels of coordinating and delivering behavioral interventions for their child. Implications for family burden and future programming for waiver programs are discussed. [ABSTRACT FROM AUTHOR]

Previous literature has indicated that perceptions of social support (PSS) may be an important predictor of parental stress levels, particularly for parents of children diagnosed with autism spectrum disorders (ASD). The current study implemented structural equation modelling to further investigate the relationship between PSS and parental stress in a sample of 454 parents of children diagnosed with ASD. Results indicate that PSS derived from friends was the most important factor in protecting against stress, with PSS from both a significant other and family appearing to be less pervasive in this regard. In addition, the importance of PSS was further underlined by the finding that it remained a significant predictor of parental stress after controlling for the absence/presence of professional support. [ABSTRACT FROM AUTHOR]

Parents of children with Autism experience high levels of stress. Resiliency is the ability to cope and adapt when faced with stressful events. This randomized, waitlist controlled pilot trial examines the feasibility, acceptability, and preliminary efficacy of an adapted virtual mind–body group intervention for parents of children with ASD. The intervention was feasible and acceptable. The immediate treatment group showed no difference in distress and greater improvement in resiliency and stress reactivity/coping relative to the delayed treatment group, (M difference 5.78; p =.038 and M difference 7.78; p =.001 respectively). Findings showed promising feasibility, acceptability, and preliminary efficacy for parents of children with ASD. [ABSTRACT FROM AUTHOR]

Objectives: Families caring for children and adolescents with autism spectrum disorder (ASD) have a unique parenting experience and often report high stress. Resilience factors such as coping and social support are linked to positive family outcomes and protect against stress. The Family Adjustment Measure (FAM) was developed as a screener for both parental stress and coping, and in the current study, we validated its use for ASD-affected families. Methods: With data from parents of children and adolescents with rigorously-confirmed ASD diagnoses (n = 362), we also used receiver-operating characteristics (ROC) analyses to identify cut-off scores, sensitivity, and specificity for the FAM's four subscales, which differed for parents of children versus parents of adolescents. Results: For parents of children, FAM subscale cut-off scores were: Parental Distress = 16.5 (78% sensitivity, 64% specificity); Social Support = 30.5 (70% sensitivity, 52% specificity); Family-Based Support = 27.5 (73% sensitivity, 57% specificity); and Positive Coping = 24.5 (58% sensitivity, 54% specificity). For parents of adolescents, FAM subscale cut-points were: Parental Distress = 18.5 (83% sensitivity, 82% specificity); Social Support = 30.5 (73% sensitivity, 51% specificity); Family-Based Support = 28.5 (80% sensitivity, 62% specificity); and Positive Coping = 22.5 (70% sensitivity, 50% specificity). Conclusions: Results support the validity of using the FAM subscales to predict clinically-significant stress within families of both children and adolescents with ASD, though the differing cut-off scores underscore the need for age-related considerations when working with ASD-affected families. Findings suggest potential clinical utility of using the FAM to identify unique risk and protective factors of families raising children and adolescents. [ABSTRACT FROM AUTHOR]

Objectives: We examined associations between parent-reported stress on the Parenting Stress Index (PSI) and clinical characteristics in children with autism spectrum disorder (ASD) and serious behavioral problems. Methods: The 298 children (259 males, 39 females; mean age 5.8 ± 2.2 years) were participants in one of two multisite randomized trials. The pre-treatment evaluation included standardized assessments of cognitive and adaptive functioning (Vineland Adaptive Behavior Scales) and parent ratings such as the Aberrant Behavior Checklist (ABC). Results: Parents of children above the median on disruptive behavior (ABC Irritability) and social disability (ABC Social Withdrawal) reported higher levels on PSI Parent–Child Interaction than children below the median (Irritability 33.0 ± 7.7 vs 28.4 ± 7.3; Social Withdrawal 33.4 ± 7.5 vs 27.9 ± 7.2, p <.05). Similar findings were observed for the PSI Difficult Child subscale. Bivariate logistic regression identified that these measures as well as greater adaptive functioning deficits (≤median on Vineland Daily Living) predicted parental membership in the upper quartile on the PSI. Stepwise logistic regression models showed that greater severity on ABC Social Withdrawal and greater deficits on Vineland Daily Living uniquely predicted parental membership in the highest quartile on the Parent–Child Interaction PSI subscale (ABC Social Withdrawal odds ratio = 3.4 (95% CI 1.82–6.32); p <.001; Vineland Daily Living odds ratio = 2.6 (95% CI = 1.34–4.87; p <.001). Conclusions: In addition to disruptive behavior, higher levels of social disability and lower levels of adaptive functioning are associated with parental stress on the PSI. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the current study was to evaluate the feasibility and initial efficacy of a large-group, time-limited Parent Child Interaction Therapy (PCIT) adaptation for parents of children with autism spectrum disorder (ASD) and externalizing behavior problems (EBP). Methods: Participants included parents of 37 preschoolers (Mage = 4.80, 87% Male, 73% Hispanic/Latino) with ASD and comorbid EBP. Parents reported on their positive and negative parenting practices and parenting stress at a pre-and-post treatment assessment as well as at a 6-month follow-up assessment. Positive and negative parenting skills were observed and coded during a parent-child interaction. Additionally, parents were objectively assessed on their knowledge of principles learned in treatment at pre-and-post-treatment. Results: The treatment was delivered with a high level of fidelity and was well received and attended by families. At post-treatment, parents reported improved parenting stress and parenting practices. Parents were also rated as engaging in more positive parenting skills and less negative parenting skills during play. Lastly, parents increased their knowledge of principles presented in treatment. Improvements in positive parenting practices were also maintained at a 6-month follow-up assessment. Conclusions: Findings highlight the initial efficacy and transdiagnostic nature of group PCIT for improving outcomes for children with ASD and comorbid EBP. [ABSTRACT FROM AUTHOR]

Despite the higher prevalence of autism spectrum disorder (ASD) in children born preterm, valid screening tools for use in preterm populations are lacking. We aimed to evaluate the screening accuracy of the Brief Infant Toddler Social-Emotional Assessment (BITSEA) and to compare it to the Pervasive Developmental Disorders Screening Test-II, Stage 2, Developmental Clinic Screener (PDDST-II-DCS) in identifying ASD diagnosis in toddlers born at < 30 weeks' gestation. Caregivers (94% mothers) of 555 children completed questionnaires (BITSEA, PDDST-II-DCS, socio-demographics) when the children (58% male) were 18-36 months. Medical charts were abstracted 3.5 years later and showed that 4% (n = 24) of children had an ASD diagnosis. BITSEA competence (sensitivity = .74; specificity = .76) and ASD (sensitivity = .70; specificity = .73) subscales demonstrated better accuracy in identifying ASD compared to the recommended PDDST-II-DCS cut-score (sensitivity = .73; specificity = .64), specifically as it related to specificity. Additional studies are needed in other preterm populations to replicate these findings. [ABSTRACT FROM AUTHOR]

Somatic disorders occur more often in adult psychiatric patients than in the general adult population. However, in child and adolescent psychiatry this association is unclear, mainly due to a lack of integration of existing data. To address this issue, we here present a systematic review on medical comorbidity in the two major developmental disorders autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) and formulate clinical recommendations. The literature was searched using the PubMed and PsycINFO databases (2000-1 May 2016) with the keywords "[((child and adolescent) AND (Autism OR Attention Deficit Hyperactivity Disorder* OR ADHD)) AND ("Cardiovascular Diseases" [Mesh] OR "Endocrine System Diseases" [Mesh] OR "Immune System Diseases" [Mesh] OR "Neurobehavioral Manifestations" [Mesh] OR "Gastrointestinal Disorders" [Mesh] OR Somatic OR Autoimmune disease OR Nervous system disease OR Infection OR Infectious disease)]. Two raters independently assessed the quality of the eligible studies. The initial search identified 5278 articles. Based on inclusion and exclusion criteria 104 papers were selected and subsequently subjected to a quality control. This quality was assessed according to a standardized and validated set of criteria and yielded 29 studies for inclusion. This thorough literature search provides an overview of relevant articles on medical comorbidity in ADHD and/or ASD, and shows that medical disorders in these children and adolescents appear to be widespread. Those who work with children with ASD and/or ADHD should be well aware of this and actively promote routine medical assessment. Additionally, case-control studies and population-based studies are needed to provide reliable prevalence estimates. Future studies should furthermore focus on a broader evaluation of medical disorders in children and adolescents with ADHD and/or ASD to improve treatment algorithm in this vulnerable group. [ABSTRACT FROM AUTHOR]

This study examined the longitudinal associations between child behavior problems, coping strategies, social resources, and parenting stress in mothers of young children with autism spectrum disorder. Participants were 283 mothers who completed self- and child-report measures at the time of diagnosis and 2 years later. Hierarchical multiple regression was conducted to predict overall parenting stress. At diagnosis, the final model indicated that high levels of social support and mothers' use of active engaged coping strategies were associated with lower levels of parenting stress. Conversely, high levels of child externalizing behavior problems, family dysfunction, and mothers' use of disengaged coping strategies were associated with higher parenting stress. Two years later, high levels of parenting stress at diagnosis predicted increased parenting stress. In addition, high or increasing levels of social support predicted a decrease in parenting stress, while high or increasing levels of family dysfunction predicted increased stress. Finally, increased use of disengaged coping strategies and decreased use of active coping strategies over time predicted higher levels of parenting stress. Results are discussed in terms of their implications for the provision of targeted supports that are designed to enhance the personal and social resources available to mothers of children with autism spectrum disorder. [ABSTRACT FROM AUTHOR]

Objective: Differences between the self-image of persons with typical development and the image they have of their brother or sister with disabilities have been hypothesized in literature, but no specific patterns have been detected with reference to intellectual disability associated or not with Autism Spectrum Disorder (ASD). The aim of the study was to address this specific issue. Method: Two Semantic Differentials on self-image vs brother/sister's image were administered to 93 individuals with typical development divided into three groups, matched by age, according to the sibling's condition: Autism with Intellectual Disability, Intellectual Disability without Autism, Typical Development. Severity of impairment and levels of adaptation of disabled brothers/sisters were also taken into account. Results and conclusions: Siblings of individuals with disability perceived the disabled brother/sister as less active and less emotionally stable than themselves, but not demonstrating any significant difference in showing affects and feelings. In future research, specific behaviors associated with ASD need to be controlled in order to better address the differences between the aforementioned groups. [ABSTRACT FROM AUTHOR]

Background: Siblings of children with chronic illness and disabilities are at increased risk of negative psychological effects. Support groups enable them to access psycho-education and social support. Barriers to this can include the distance they have to travel to meet face-to-face. Audio-conferencing, whereby three or more people can connect by telephone in different locations, is an efficient means of groups meeting and warrants exploration in this healthcare context. This study explored the feasibility of audio-conferencing as a method of facilitating sibling support groups Methods: A longitudinal design was adopted. Participants were six siblings (aged eight to thirteen years) and parents of children with complex neurodevelopmental disorders attending the Centre for Interventional Paediatric Psychopharmacology (CIPP). Four of the eight one-hour weekly sessions were held face-to-face and the other four using audio-conferencing. Pre- and post-intervention questionnaires and interviews were completed and three to six month follow-up interviews were carried out. The sessions were audio-recorded, transcribed and thematic analysis was undertaken. Results: Audio-conferencing as a form of telemedicine was acceptable to all six participants and was effective in facilitating sibling support groups. Audio-conferencing can overcome geographical barriers to children being able to receive group therapeutic healthcare interventions such as social support and psycho-education. Psychopathology ratings increased post-intervention in some participants. Siblings reported that communication between siblings and their family members increased and siblings' social network widened. Conclusions: Audio-conferencing is an acceptable, feasible and effective method of facilitating sibling support groups. Siblings' clear accounts of neuropsychiatric symptoms render them reliable informants. Systematic assessment of siblings' needs and strengthened links between Child and Adolescent Mental Health Services, school counsellors and young carers groups are warranted. [ABSTRACT FROM AUTHOR]