Stress is a major concern for parents of autistic kids

Parenting may be the most rewarding job you'll ever have, but most people would agree that it can be stressful. New research shows that mothers of some of the neediest kids show increased levels of stress, worry, and depressive symptoms. In a study published in the July issue of the journal Autism, Annette Estes and her colleagues from the University of Washington examined the stress levels of mothers whose preschool-aged children were diagnosed with autism, and compared them to the moms of kids who were developmentally delayed but not autistic. By matching the autistic kids to developmentally delayed children with similar cognitive profiles, Estes was able to determine the difficulties specific to autism that link to maternal stress. Although some research on autistic kids is complicated by the diverse range of difficulties experienced by children with the diagnosis, Estes was careful to ensure accurate diagnoses as well as detailed information about behavioural functioning and the daily living skills of the participants.

Although the children in the two groups were matched on measures of nonverbal intelligence, children with autism had higher ratings of problem behaviour and lower daily living skills. Perhaps unsurprisingly, mothers of the children in the study reported high levels of stress. But an examination of the data indicated that stress wasn't linked to the child's diagnosis. Instead, maternal stress and psychological distress was related to higher levels of problem behaviours, regardless of whether the child was autistic or developmentally delayed. Estes proposed that the findings supported what she called a "transactional model," in which child behaviour leads to increased parental stress, which interferes with parenting, resulting in a further increase in negative behaviour.

An important finding by Estes' team concerned the adaptive functioning of the children in the studies. Adaptive behaviours are the abilities necessary for age-appropriate independence; for example, kindergarten-aged kids learn to fasten buttons and zippers on their own. Both the autistic and non-autistic children in the study demonstrated delays in adaptive skills, but although the children in the study required more direct supervision and care than other kids do, adaptive delays were not linked to increased stress. The researchers proposed that mothers of preschool-aged kids may be resilient to the burdens of caring for children requiring support in the adaptive area.

Since the findings were consistent across the diagnostic groups examined in the study, the results may have implications for parents of children with behaviour problems; if stress related to those difficulties increases anxiety and depressive symptoms, interfering with parenting, the problems are likely to get worse before they get better. Family therapists believe that a change in the behaviour or functioning of one family member can have ripple effects throughout the home. This study supports this notion with regard to the impact of negative behaviour, but positive changes can also have an impact. Estes and her colleagues recommended treatment to address the behavioural concerns of developmentally delayed and autistic children. I agree that this is important, not just for children with those disorders, but for any child who engages in ongoing negative behaviours that interfere with his or her relationships or other areas of functioning. I'd add, however, that parents also need to look after themselves in order to provide the best care for their kids. So if your child's behaviour is a problem, you shouldn't only look for help for him or her, but find support for yourself as well!

You can read Estes' study here.

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