The interplay between behavioral differences presented by autistic males and females, and gender norms might influence caregivers' behavior perceptions, contributing to the later identification of autistic females.

Our study aims to investigate differences in mothers' and fathers' perceptions of children's behaviors typically associated with autism. Further, we aim to analyze parental perception of children's behaviors in relation to their offspring's sex. Second, our objective is to examine differences in the perception of behaviors of males and females to better understand females' phenotypes and potential reasons for their underdiagnosis METHODS: The sample consisted of 40 children and adolescents (M chronological age = 8.75 years, SD = 1.10, Range = 4-16.75), 20 males and 20 females, with their mothers and fathers. Parental perceptions are studied through the Social Responsiveness Scale, a quantitative report instrument that assesses autistic characteristics.

Mothers and fathers reported similar profiles of their children. However, females presented better abilities in relation to Social Communication and fewer Mannerisms than males. However, clinicians' observations scores related to the ADOS-2 did not show evidence of differences in behavioural characteristics typically associated with autism.

These mechanisms should be further explored as they might partly determine females' later diagnosis. Children's age plays a significant role, as older individuals present more severe behaviors associated with autism in the dimensions previously mentioned and Social Motivation. Hence, a late diagnosis can exacerbate behavioral presentation of autism.

The purpose of this project was to investigate potential correlates of family life impairment in families of young autistic children. This project incorporated measures of specific child and parent challenges in addition to a commonly used unidimensional measure of autism characteristics. In this way, we could assess whether such challenges explain variance in family life impairment, and whether their inclusion diminish associations between autism characteristics and family life impairment. Cross-sectional data were collected from 564 parents of autistic children aged 2 to 5 years who participated in a larger online study. Participants completed measures on child characteristics (autism characteristics, emotion dysregulation, speaking ability, flexibility, and sleep problems), parent depression, and family life impairment, using the Family Life Impairment Scale (FLIS). Multiple linear regression models were generated to examine whether any of the independent variables were associated with the four domains of the FLIS. Models controlled for child age and sex, parent education, and single-parent homes. All independent variables were associated with impairment in one or more FLIS domains. None of the primary independent variables were significantly associated with positive growth. More overt characteristics and behaviors (e.g., autism characteristics, reactivity, speaking ability, and flexibility) were associated with impairment in domains that reflected a family's ability to navigate the community. However, sleep challenges and parent and child emotional difficulties were most strongly associated with parent impairment. Findings suggests that families may have different needs across contexts and provide new avenues through which they might be better supported.

Eating disorders in children with autism spectrum disorder (ASD) are multifactorial and complex, and impair their quality of life. The link between eating difficulties and ASD is still controversial, and few studies have focused on very young children with ASD.

Our objectives were: 1) to characterize the eating disorders of ASD children under 4 years; 2) to study the links between these eating disorders and the characteristics of the child (symptoms and severity of ASD, level of development).

33 ASD children (18 months to 4 years) were included. Their developmental level was assessed by the Brunet-Lézine Revised test (BL-R) and characteristics of ASD by the Autism Diagnosis Interview-Revised (ADI-R). We used a new questionnaire on eating disorders of children between 9 months and 6 years of age that covered 4 dimensions: eating behavior, oro-motor skills, oral and bodily sensory characteristics, and parental impacts and strategies.

70 % of parents declared eating disorders in their child, with an early frequent onset beyond 12 months of age. These disorders caused significant parental suffering and worries about the future in two-thirds of parents, and more than half of the parents implemented strategies to handle them. We found two striking results: 1) No statistical link was observed between the severity of an eating disorder and the severity of ASD symptoms or the child's developmental level; 2) Children with better communication and socialization levels had more eating disorders.

These results show that eating disorders in our population are probably linked with the relational nature of the act of eating.

Elevated levels of parenting stress have been reported in parents raising an Autistic child. Previous studies have identified a multitude of predictors of parenting stress, including both child-related and parent-related factors, though findings across studies are not always in agreement. In the present study we investigate the determinants of parenting stress using a Network Analysis approach, which is then used to inform a subsequent structural equation model. New Zealand parents (n =  490) of a child diagnosed with Autism Spectrum Disorder (ASD) provided data on their Autistic child (e.g., ASD core symptoms, problem behaviours) and themselves (i.e., parenting stress). The analysis revealed that both child and parent demographic factors were poor predictors of parenting stress, while the child's current language and communication ability were correlated with diagnostic age and parenting stress. An earlier diagnostic age, in turn, suggested better behavioural and emotional outcomes for children. Overall, the Network Analysis showed itself to be an informative approach to understanding parenting stress in the ASD context. Findings further advocate for the implementation of ASD-related and language-related interventions as early as possible, and that language delays during early infancy justify prompt clinical assessment.

This study examines the alignment between self-reports and parental reports on adolescents' autism identity, functional autonomy, social participation, and quality of life (QoL), providing insights into the relationships between these factors. Thirty dyads comprising adolescents aged 13 to 18 years and one of their parents participated in the study. Participants completed the Autism Identity Questionnaire, Daily Routine and Autonomy questionnaire, Child and Adolescent Scale of Participation-Youth, and the Pediatric Quality of Life Inventory. The findings indicated moderate agreement between self-reports and parental reports regarding autism identity, functional autonomy, and QoL. Fair agreement was found regarding social participation. Adolescents who reported higher levels of acceptance regarding their autism identity demonstrated greater autonomy and participation, which correlated with a higher QoL. Conversely, those with higher engulfment scores (feeling overwhelmed by the diagnosis) exhibited lower levels of independence, social participation, and emotional and social QoL. These findings suggest that fostering a positive autism identity may enhance autonomy and social participation while addressing feelings of engulfment could improve emotional and social outcomes.

Research shows that caregivers of children with autism can be taught a variety of behavioral strategies, but there is little research on teaching caregivers to prioritize rapport building over skill acquisition during play. The current study evaluated the effects of a digital training package on the rapport-building skills of four caregivers of children with autism. Target skills were derived from parent-child interaction therapy with specific adaptations for children with limited communication and play skills. The intervention package included asynchronous online modules with video models, active response opportunities, and automated feedback as well as synchronous feedback via video chat. All four caregivers demonstrated increases in rapport building skills, and three of four dyads showed increases in interactive play postintervention. Caregivers also rated the intervention favorably. Data on participant and interventionist time to complete the intervention guide a discussion of the efficiency of combining asynchronous and synchronous strategies.

It is recognized that around 25-30% of autistic children do not develop functional speech and remain minimally verbal beyond the age of 5. However, little is known about the clinical characteristics of this group.

We retrospectively examined a sample of 189 autistic children and adolescents classified as minimally verbal (mean age: 7.37 ± 1.51; 152 males, 37 females) and compared them with a group of 184 verbal autistic children and adolescents (mean age: 7.71 ± 2.52; 160 males, 24 females). We considered intellectual functioning, severity of autism, emotional and behavioural problems, and parenting stress.

Children in the minimally verbal group exhibited significantly lower nonverbal Intelligent Quotient and an increase in restricted repetitive behaviours compared to the verbal group. Exploring potential differences in emotional and behavioural problems, the verbally group showed higher levels of anxiety symptoms. In addition, minimally verbal group showed high score of parenting stress.

This study highlights the importance of accurately characterizing minimally verbal autistic children and adolescents to facilitate the identification of specific and individualized interventions based on individual functioning profiles.

Parents of children diagnosed with autism face enormous stressors, which may interfere with achieving personal and family goals. The typical approach for reducing stress is often pathological; the individual attempts to directly eliminate the stress through counseling, behavioral therapy, or medication. As an alternative, the constructional approach builds repertoires for accessing important reinforcers. In this study, a mentoring program based on the constructional approach was used to teach three parents of children diagnosed with autism how to analyze their lives, formulate goals, and implement programs to reach these goals. A mentor's support was gradually reduced until each participant could implement these steps independently. After the implementation of this program, events that each participant wanted to keep as part of their life encompassed a larger proportion of their total weekly events, as compared to before the program. In addition, time spent working on chosen goals increased as each goal was targeted for intervention. This mentoring program offers a promising approach for teaching people to manage their own lives by cultivating skills that help them get what they want, without dwelling on the problems interfering with their happiness.

The online version contains supplementary material available at 10.1007/s40617-024-00944-y.

The present study investigated the effects of a short-term synergic growth mindset intervention towards abilities and towards stress on reducing parental stress and promoting stress-related growth (SRG) among Arab parents of children diagnosed with Autistic Spectrum Disorder (ASD). One hundred and seven parents (70 mothers, 37 fathers) of male children with ASD, completed several questionnaires, including a demographic questionnaire; the Childhood Autism Rating Scale, the Parenting Stress Index-Short Form, the revised Stress- Related Growth Scale, The Implicit Self-Theories Scale, and the Stress Mindset Scale. Seventy- two parents were randomly assigned to an "intervention group", and 35 to a comparison group. Members of the intervention group participated in a short synergic growth mindset intervention, created especially for this research. Six months after the intervention, all participants re-completed the same questionnaires. The intervention significantly increased growth mindset and SRG and decreased parental stress. This study demonstrates the effectiveness of a short-term intervention in promoting growth mindsets, reducing parental stress, and fostering SRG among parents of children with a chronic disorder. These findings are particularly important since many parents of children with chronic disorders often exhibit fixed mindset patterns due to their children's slow progress in various developmental domains.

The literature highlights the importance of parental involvement in autism treatment. However, much research has predominantly focused on child outcomes and cognitive dimensions. This study explores the impact of an early intensive intervention with parental involvement, focusing on changes in parents' affective exchanges. Notably, given the paucity of studies on fathers in the intervention context, this study examines the comparative trajectory of change considering both caregivers.

Twenty autistic preschoolers were monitored for one year during a parental-based intervention. Child-mother and child-father play interactions were coded with the Emotional Availability Scales at baseline and at 12 months. Repeated measures linear mixed-effect models were employed to investigate time and caregiver effects and their interaction.

Results highlighted both similarities and differences in change trajectories between caregivers. Parental sensitivity, structuring, and non-intrusiveness significantly increased for both parents with fathers showing more prominent gains in structuring the interaction while being non-intrusive. Child responsiveness and involvement significantly increased, showing similar trajectories with both caregivers. Children were generally more involved while interacting with their fathers.

Parent-child interactions with caregivers evolved toward more adaptive exchanges regarding emotional availability for children's and parents' dimensions. Fathers appeared to be particularly receptive regarding acquiring structuring abilities and non-intrusive behaviors. Our results underscore the importance of investigating parental features as well as the importance of actively involving caregivers to support distal outcomes and generalization.

The presence of a child with Autism Spectrum Disorder (ASD) in the family can have a negative impact on parental Quality of Life (QoL), but evidence on how treatments for children with ASD can affect parental QoL is currently limited. In this qualitative study, we develop a semi-structured interview in order to investigate the impact of ASD on the QoL of mothers and fathers from a subjective perspective, as well as the effect of the intervention on their QoL and adjustment process. The sample consisted of 31 parents of children with ASD severity 2 or 3, aged 5 to 11 years, undergoing a multidisciplinary intervention. In order to identify emerging themes from the interview transcripts, a Thematic Analysis was conducted using a bottom-up approach. We identified three main themes relating to parental QoL (ASD impact on QoL, useful external resources, QoL improvement-related factors) and five themes relating to parents' views on the intervention (positive impact on parent, dissatisfaction with previous interventions, parental involvement, useful features, critical issues). The results provide indications of the process of parental adaptation and the components of interventions that foster an improvement in their QoL. In conclusion, living with a child with ASD can have a significant influence on a parents' QoL, not just physically and emotionally, but also in terms of general goals, family structure, and social interactions.

Parents of children with autism spectrum disorder (ASD) report increased distress relative to parents of children with neurotypical development. Parent well-being is generally considered a key determinant of parenting behavior, thus increased distress may spill over into less optimal parenting in families of children with ASD. However, evidence is mixed regarding the degree to which parenting is actually compromised in this population, suggesting the possibility of buffering, wherein the parenting of children with ASD may be robust against spillover from increased parental distress. The current study tested competing spillover and buffering models with regard to relations among child ASD status, parental distress, and parenting behavior. Parents of preschoolers with (n = 73) and without (n = 55) ASD completed self-report measures of parenting stress, depressive symptoms, and emotion dysregulation, as well as of positive and negative parenting behaviors. Families of preschoolers with ASD reported higher distress and negative parenting, and lower positive parenting than did their counterparts. Findings supported the spillover model for negative parenting such that increased parental distress accounted for status-group differences in negative parenting. In contrast, potential buffering was observed for positive parenting in that an inverse association between distress and parenting was observed for parents of children with neurotypical development only. Findings highlight the potential benefit of intervention to reduce parental distress in families of children with ASD, but also suggest some existing ability of these families to buffer certain parenting behaviors from deleterious effects of parent distress.

Emotion dysregulation (ED) is common and severe in older autistic youth, but is rarely the focus of early autism screening or intervention. Moreover, research characterizing ED in the preschool years (when autism is typically diagnosed) is limited. This study aimed to characterize ED in autistic children by examining (1) prevalence and severity of ED as compared to children without an autism diagnosis; and (2) correlates of ED in autistic children. A sample of 1864 parents (Mean child age = 4.21 years, SD = 1.16 years; 37% female) of 2-5 year-old children with (1) autism; (2) developmental concerns, but no autism; and (3) no developmental concerns or autism completed measures via an online questionnaire. ED was measured using the Emotion Dysregulation Inventory-Young Child, a parent report measure characterizing ED across two dimensions: Reactivity (fast, intense emotional reactions) and dysphoria (low positive affect, sadness, unease). Autistic preschoolers, compared to peers without developmental concerns, had more severe ED (+1.12 SD for reactivity; +0.60 SD for dysphoria) and were nearly four and three times more likely to have clinically significant reactivity and dysphoria, respectively. Autistic traits, sleep problems, speaking ability, and parent depression were the strongest correlates of ED in the autism sample. While more work is needed to establish the prevalence, severity, and correlates of ED in young autistic children, this study represents an important first step. Results highlight a critical need for more high-quality research in this area as well as the potential value of screening and intervention for ED in young autistic children.

Autism Spectrum Disorder (ASD) impacts not only diagnosed individuals, but also significantly affects the quality of life of both primary and secondary caregivers. These effects are particularly pronounced when compared to caregivers of individuals with other neurodevelopmental disorders. The emotional and physical demands of caring for someone with ASD can profoundly alter family dynamics and interpersonal relationships, creating challenges that require a comprehensive approach to be understood and addressed.

The methodological design is a narrative review study, based on a search conducted during May, June, July, and August 2024 in the Scopus, Dialnet, and WoS databases concerning the object of study. As a result, a total of 197 articles were qualitatively analyzed. Of these, 36 articles were selected for a more detailed qualitative analysis, leading to a final sample of 14 documents. The selected studies were examined through qualitative content analysis. The inclusion criteria for this selection were as follows: empirical studies or research published in English or Spanish; open access via the Internet; categories limited to "education/educational research" relevant to the proposed objectives; and specific documents related to students with Autism Spectrum Disorder (ASD).

The care of individuals with Autism Spectrum Disorder (ASD) has a significant and multifaceted impact on family life, deeply affecting the mental health of caregivers. These effects manifest in the form of chronic stress, anxiety, and interpersonal difficulties, altering family dynamics. The quality of life of caregivers varies depending on the coping strategies they employ, which are crucial for their emotional well-being.

Understanding and optimizing these strategies is essential to mitigate the negative effects of caregiving and improving the overall well-being of families living with ASD.

Caregivers of children with autism spectrum disorder (ASD) often report higher rates of depression and the related negative thought patterns that may precede a clinical diagnosis. These negative thought patterns are referred to as depressive cognitions. Depressive cognitions are exacerbated by child problem behaviors (CPB) but may be impacted by parental resilience. The current study examines relations between CPB and depressive cognitions and the role of resilience as a moderator among caregivers of children with ASD (n = 287) and a sample of caregivers of children who are typically developing (n = 207). Significant positive associations were found between CPB and depressive cognitions for caregivers of children with ASD and who are typically developing. A moderation analysis revealed that, among the ASD sample, the model accounted for 33% of the variance in caregiver depressive cognitions (R2 = 0.33, SE = 35.52, p < 0.001). The interaction of child problem behaviors and caregiver resilience on caregiver depressive cognitions was statistically significant (B = - 0.016, SE = 0.007, p = 0.037), thus resilience was a significant moderator, for caregivers of children with ASD. Resilience serves as a protective factor in the relationship between child problem behavior and caregiver depressive cognitions for caregivers of children with ASD only. This finding highlights the importance of assessing and supporting resilience among caregivers of children with ASD. Interventions addressing child behavior would benefit from additional components to bolster caregiver resilience to enhance caregiver mental health and protect against depressive cognitions.

This study evaluated the effectiveness of a 3-session group intervention for parents who had received a diagnosis of autism for their child within the past month. The intervention group (N = 41) was compared to Treatment-as-Usual (N = 40): one meeting with a social worker after the diagnosis feedback meeting. Parental stress was evaluated in both groups within a week and then a month after the diagnosis. The findings indicate an increase in the experienced parental stress for the comparison group on all six indices, while in the intervention group there was an increase only on two indices. That is to say, the intervention reduced stress that occurred in the first month after the diagnosis. Further analyses revealed that parent satisfaction with the group intervention was the single most important variable in predicting stress reduction. We argue that parent support groups immediately after their child's diagnosis are effective and important, and probably superior to a single post-diagnosis meeting.

Children with Autism Spectrum Disorder (ASD) experience increased hospitalizations as compared to the general population, particularly in the context of mental health crises. Given the unique needs of children with ASD and behavioral health needs that can either lead to or emerge during hospitalization, an understanding of hospital experiences is critical. To date, research on caregiver experiences in acute care medical hospital settings is limited. Therefore, the purpose of this qualitative study was to investigate caregiver experiences with inpatient care for children with ASD and behavioral health needs, including factors and practices that impacted or were desirable for care. Two focus groups were conducted with a total of 12 parents of children with ASD admitted to a large pediatric hospital. Data were analyzed using interpretive description. Emerging themes pointed to the child, family, and staff factors and practices that intersect to influence hospitalization experiences. Child factors included the child's communication, sensory, behavioral, medical, and safety needs. Family factors included the family's relationship with the healthcare team, own needs, and advocacy experiences. Staff factors included staff communication practices, comfort, and knowledge when providing care. Overall, this research demonstrates the complexity of factors and practices that impact the behavioral health hospitalization experience for children with ASD and their caregivers. Experiences varied widely and were guided by the unique needs of each child. Findings point to care practices that can be adopted to best meet the needs of all stakeholders during hospitalization and offer implications for future educational initiatives.

Raising an autistic child is associated with increased parenting stress relative to raising typically developing children. Increased parenting stress is associated with lower parent wellbeing, which in turn can negatively impact child wellbeing.

The current study sought to quantify parenting stress and parent health-related quality of life (HRQOL) in the autism context, and further understand the relationship between them by employing a relatively novel statistical method, Network Analysis.

This cross-sectional study involved 476 parents of an autistic child. Parents completed an online survey requesting information on parent and child characteristics, parent's perceptions of their autistic child's symptoms and problem behaviours, and assessed their parenting stress and HRQOL.

Relative to normative data, parent HRQOL was significantly lower in terms of physical health and mental wellbeing. The structure extracted by the Network Analysis indicated that child age and externalising behaviours were the main contributors to parenting stress, and that externalising behaviours, ASD core behavioural symptoms, and parenting stress predicted HRQOL.

Parental responses to child-related factors likely determine parent HRQOL. Findings are discussed in relation to the transactional model, emphasising the importance of both parent and child wellbeing.

The increased prevalence of autism spectrum disorder (ASD) has placed a significant emotional and psychological burden on mothers. We explored the association between the severity of ASD symptoms in children and the mental health of their mothers during the COVID-19 pandemic. Our study included 1,924 mothers of children with ASD, enrolled in a web-based cross-sectional survey over 85 consecutive days to gather clinical and sociodemographic data. The severity of ASD symptoms was obtained according to the children's age. Using the Depression, Anxiety, and Stress Scales (DASS-21) scale, we found that 35.8 percent of mothers experienced both anxiety and depression. A high education level and a high family income reduced the chance of concurrent anxiety and depression. Conversely, unemployment, a child using psychiatric medication, and higher severity of ASD symptoms increased the chance. Notably, the severity of the ASD symptom was the sole predictor of maternal co-occurring anxiety and depression across all age groups (<3 years aOR = 2.04, 95%CI 1.07-3.89; 3-5 years aOR = 2.76, 95%CI 1.67-4.56; ≥ 6 years aOR = 1.61, 95%CI 1.04-2.50). Recognizing the challenges associated with ASD leads to greater acceptance and tailored interventions, ultimately improving the overall well-being of both individuals with ASD and their mothers.

Attention-deficit/hyperactivity disorder (ADHD) symptoms affect 40-60% of autistic children and have been linked to differences in adaptive behavior. It is unclear whether adaptive behavior in autistic youth is directly impacted by co-occurring ADHD symptoms or by another associated feature of both autism and ADHD, such as increased irritability. The current study examined relationships between irritability, ADHD symptoms, and adaptive behavior in 3- to 7-year-old autistic children. Results suggest that, after adjusting for co-occurring ADHD symptoms, higher levels of irritability are associated with differences in social adaptive behavior specifically. Understanding relationships between irritability, ADHD, and adaptive behavior in autistic children is critical because measures of adaptive behavior, such as the Vineland Scales of Adaptive Functioning, are often used as a proxy for global functioning, as well as for developing intervention plans and measuring outcomes as primary endpoints in clinical trials.

The Caregiver Strain Questionnaire assesses the three dimensions of caregiver strain, namely the objective, subjective externalized and subjective internalized strain. It was validated among caregivers of children with Autism Spectrum Disorder (ASD) in the United States and Mainland China with promising psychometric properties.This study aimed to develop and validate the Chinese (traditional script) version of the Caregiver Strain Questionnaire (C-CGSQ) among 198 caregivers of children with ASD in Hong Kong. The C-CGSQ showed excellent internal consistency (α = 0.958) and test-retest reliability (Spearman's r = 0.966). Concurrent, convergent, divergent validity and a three-factor structure (consistent with previous studies) were established. The C-CGSQ demonstrated promising psychometric properties in measuring caregiver strain among caregivers of Chinese ASD children in Hong Kong.

The influence of the environment on different groups of people with disabilities has rarely been studied in the context of neurodevelopmental disabilities, such as autism, in adolescence. This study explored how external responses to autism affect the experiences, outcomes and family relationships of autistic adolescents and their family members, including siblings and parents. This study adds to the knowledge of factors that contribute to the social disadvantage and exclusion autistic adolescents and their families face in their communities. Interviews with 30 participants from families with an autistic adolescent show that external factors greatly impact the well-being of autistic adolescents and their families. The school environment, including sensory overload, bullying and negative interactions with teachers, was found to be a key factor that negatively influenced mental health and family relationships. The study also revealed that isolation and stigma are major concerns for families, indicating the importance of public awareness campaigns to increase understanding of autism. In addition, the lack of adequate support and services presented significant challenges for families. The study emphasises the importance of person-centred approaches to providing services, which involve including autistic individuals and their families in designing and delivering support.

Background/Objectives: Burden Syndrome, also known as Caregiver Syndrome, particularly affects those who serve in the role of informal caregiver in the presence of family members with conditions. The ABCX dual model examines the impact on the caregiver of the diagnosis of autism spectrum disorder (ASD) on the family. This model considers the severity of the stressor (A), the additional demands of life stress (aA), the family's internal resources (B), the family's external resources (bB), the family's assessment of the situation (C), coping strategies (cC), and outcome (X). The purpose of the present study is to investigate the relationships between resilience, guilt, and burden of care in caregivers of children with ASD. Methods: Various assessment instruments were used, including the "Caregiver Burden Inventory" to measure burden, the "Brief Resilience Scale" to assess resilience, the "Guilt Sensitivity Questionnaire" to examine guilt sensitivity, and the "DA.L.I.A." to collect information on parent and child characteristics. A total of 80 parents/caregivers participated in the research, including 53 women (Age M = 41.72; SD = 7.8) and 27 men (Age M = 43.35; SD = 6.29). Results: The findings indicate that individuals' resilience to stressful events correlates negatively with burden, a developmental subtype. However, guilt seems not to play a significant role in the overall perception of burden. In contrast, it was found that the use of informal supports is associated with higher levels of guilt and emotional burden, whereas the use of formal supports is correlated with higher emotional burden, but not higher perceptions of guilt. Conclusions: This study provides important information about the support needed by caregivers and suggests how to address emotional burdens to prevent burnout and support families with children with ASD.

Parents of children on the autism spectrum often face great challenges in the care of their child. Early support tailored to families' individual needs is therefore crucial for the development and quality of life of both children on the autism spectrum and their families. However, to date it is unclear whether the support available meets the parents' needs.

To investigate how the system of care, support, and therapies for children on the autism spectrum is perceived by their parents.

A total of 57 parents of Swiss children on the autism spectrum participated in an online survey, and 20 of them participated in additional semi-structured interviews.

We found that parents of children on the autism spectrum may face substantial challenges and that social support is essential. Two thirds of the participating parents reported a long and difficult diagnostic process as challenging, and 60% expressed their need for closer follow-up after diagnosis and more support. Only one third of the parents stated that they manage their everyday lives well, whereas 17.5% felt exhausted, and more than half of the parents responded that they felt challenged. One fifth indicated that they had poor family support, and half reported substantial financial challenges. At the same time, most families also emphasize how important their neurodivergent children are to the family`s life together.

It is important that primary pediatricians not only initiate the diagnostic process, but also assess the different needs of the different family independent of the diagnosis and, if necessary, initiate adequate measures or guide parents to institutions in charge. Parents who do not actively express their individual needs should nevertheless be advised about support services, including financial counseling. The positive aspects mentioned by families can be emphasized and used as resources to improve their quality of life.

Mothers of autistic children often report poor mental health outcomes. One established risk factor for these outcomes is the child having a medical home. This study examined possible mediating variables (coping, social support) in this relationship in 988 mothers of autistic children from the 2017/2018 National Survey of Children's Health (NSCH). The results of the multiple mediation model suggest the relationship between having a medical home and maternal mental health is largely explained by indirect associations with coping and social support. These findings suggest that clinical interventions for coping and social support provided by the medical home for mothers of autistic children may improve maternal mental health outcomes over and above implementation of a medical home.

Infant hypersensitivity affects daily challenges and parental stress. Although the crucial role of tactile sensation in infants' brain function has been highlighted, hypersensitive infants and their families lack support. Electroencephalography may be useful for understanding hypersensitivity traits. We investigated the relationship between infant perceptual hypersensitivity and parental stress, somatosensory-evoked potential (SEP), and magnitude-squared coherence (MSC) in the general population.

Infants aged 8 months (n = 63) were evaluated for hypersensitivity and parental stress using a questionnaire and for cortical activity using electroencephalography. Vibration stimuli were applied to the infant's left foot. SEP components that peaked around 150 ms (N2) and at 200 ms (P2) after stimulus onset were evaluated by amplitude and latency at the midline electrode (Cz) and MSC between the midline electrodes (C3-C4).

Parental stress was associated with infant hypersensitivity. The latency of Cz was delayed, and C3-C4 delta MSC was high in infants with hypersensitivity.

Increasing inter-hemispheric MSC synchrony in the stimulated condition in infants with hypersensitivity suggested atypical somatosensory cortical function.

These findings contribute to identifying, understanding the mechanisms of, and developing effective coping strategies for early-stage hypersensitivity.

This study explores the experiences of siblings of autistic adolescents within families. Without the novel insights generated from engaging with siblings of autistic adolescents within a qualitative framework, it can be challenging to develop strategies for practicing effectively with this group or structuring interventions with these families. Using a social constructivist approach and qualitative participatory methodology, the exploratory study was conducted using in-depth interviews with ten non-autistic siblings, analyzed via a thematic analysis method. The results reveal a common feeling of uncertainty and apprehension in the relationships, leading siblings to physical and emotional detachment from their autistic brothers or sisters. The research emphasizes the caregiving roles predominantly taken up by sisters, especially when the autistic sibling is a brother with intellectual disability. These roles exert substantial demands, with unclear boundaries suggesting potential role confusion. The findings have important implications for family practice, necessitating the need to address role conflict and promote role clarity. They also underscore the gendered nature of caregiving, advocating for support to sister-siblings in these roles. This study revealed the complexities of sibling relationships in families with a member who is an autistic adolescent sibling. The study suggests interventions that promote open family dialogues for a balanced approach to family roles, providing valuable guidance to practitioners to enhance siblings and family well-being.

This study aimed to investigate the relationship between the severity of autism, emotional and behavioral problems of autistic children, internalized stigma, depressive symptoms, and primary caregiver parental stress. Specifically, we explored the mediating role of internal stigmatization and total difficulties of individuals with autism on parenting stress and depressive symptoms of the primary caregiver.

Mothers of 93 children with autism were included in the study. The mothers were given the Beck Depression Inventory (BDI), The Internalized Stigma of Mental Illness Scale (ISMI), the Autism Behavior Checklist, the Parenting Stress Index-Short Form, Strength, and Difficulties Questionnaire -Parent Form (SDQ-P).

As a result of our study, the emotional and behavioral problems of the child and the internalized stigmatization felt by the parent played a mediator role in the relationship between the child's autism severity and the parent's stress and depressive symptoms.

Our findings highlight that internalized stigmatization and behavioral characteristics of individuals with autism are among the most critical problems for their primary caregivers. These results have important implications for the development of interventions aimed at reducing the internalized stigma experienced by primary caregivers of individuals with autism and for improving their mental health outcomes.

The current study was a secondary analysis of cross-sectional data collected in New Zealand. Parents (n = 291) of an autistic child completed an online survey that included temporal/demographic questions relating to the parent and child, and parent ratings of the child's core ASD symptoms, their parenting stress, and psychological well-being. Child and parent ages were related to ASD core symptoms, parenting stress, and psychological well-being, the parent-child age gap was not. Diagnostic delay was only positively associated with parent depression and negatively associated with child communication impairment. Findings indicated that temporal variables can be predictive of parent well-being and child autism symptoms. The findings suggest that focusing interventions on communication abilities may have positive impacts parental mental health.

Mothers of children with autism reported higher levels of anxiety than mothers of typical children. This study revealed the relationship between parent-child conflict, children's problem behavior, parenting stress, and maternal anxiety from the perspective of the relationship within the family.

The State-Trait Anxiety Inventory (STAI) and Caregiver Strain Questionnaire (CGSQ) were used to measure maternal anxiety and parenting stress respectively from 102 mothers of children with autism. We also collected information on parent-child relationships and children's problem behaviors by using the Child-Parent Relationship Scale (CPRS) and Conners Parent Symptom Questionnaire (PSQ).

Parent-child conflict positively predicted state and trait anxiety in mothers of children with autism. The severity of children's psychosomatic disorders fully mediated the positive association between parent-child conflict and state-trait anxiety in mothers of children with autism. Parenting stress significantly moderated the impact of parent-child conflict on maternal state anxiety and trait anxiety.

In the case of children with autism spectrum disorders, parent-child conflict can directly affect maternal anxiety levels, especially when mothers have low levels of parenting stress. Parent-child conflict can also affect children's problem behaviors and thus indirectly affect maternal anxiety. Therefore, this study is of great significance for the alleviation of anxiety of mothers of autistic children and the family intervention for the early rehabilitation of autistic children.

Welfare and rehabilitation centers prioritize the welfare of children over the mental and physical well-being of mothers. The present study aimed to determine the impact of resilience training on stress, hope, and psychological toughness of mothers living with mentally and physically disabled children.

This intervention study was conducted in the Hamadan (Iran) Welfare and Rehabilitation Center in 2023. To this end, 70 parents of children with mental and physical disabilities were randomly selected and then randomly assigned to two control and intervention groups. In the intervention group, 9 resilience training sessions were conducted, each lasting 60 min. These meetings were held weekly at the welfare and rehabilitation center. The resilience training included three components: (1) exploring the concept of resilience within families and the attributes of individuals with high resilience, (2) examining internal and external factors that influence resilience, and (3) studying the strategies for enhancing family resilience. No intervention was performed in the control group. Data collection was done using parental stress, hope, and psychological toughness questionnaire. The mothers of both groups completed the above questionnaires both before and one month after the intervention. Data analysis was performed using chi-square (χ2), Kruskal-Wallis, and t-test with SPSS software (version 23) at a significance level of 0.05.

Before the intervention, there was no statistically significant difference in parental stress between the two groups (p = 0.370). However, after the intervention, the difference between the two groups became statistically significant (p = 0.001). Similarly, there was no significant difference in parents' hope before the intervention (p = 0.452), but a significant difference was observed after the intervention (p = 0.001). Besides, parental psychological toughness was not significant before the intervention (p = 0.179) but became significant after the intervention (p = 0.000).

Based on the results, resilience training reduced parental stress and increased hope and resilience in mothers of the test group. Therefore, resilience training is recommended to lower parental stress and increase the hope and psychological toughness of mothers of mentally and physically disabled children.

The capacity of families with autistic children to demonstrate resilience is a notable strength that has received little attention in the literature. A potential predictor of family resilience in households with autistic youth is neighborhood support. This study examined the relationship between neighborhood support and family resilience in households with autistic youth utilizing data from the National Survey of Children's Health. A structural equation model was constructed as neighborhood support and family resilience were latent variables. Findings demonstrated that neighborhood support significantly predicts family resilience. This study contributes to the literature as the first quantitative investigation of predictors of family resilience with this group. Strengths of autistic youth, their families, and their communities can be and should be leveraged to address challenges.

This study explores the associations between gifted children's stress management and parental stress level. A sample of 78 primary school children and their 76 parents took part in this study. Children were screened for intelligence and emotional quotients, while parents were tested for stress levels. Results show that the more children are aware of their stress-management skills, the less parents are stressed out. Moreover, the intelligence quotient is not significant in mediating this association, supporting the idea that it is not an a priori protective factor from a developmental perspective. The study findings suggest that when a child is equipped with the skills to handle stress by harnessing their emotional intelligence, it can have a beneficial effect on the entire family's well-being. Given that these skills can be developed, and the significant positive influence they have on a child's growth and adaptation, it is essential to offer specialized educational programs to gifted children. These programs should aim to enhance their emotional skills, which, in turn, can indirectly bolster the psychological health of the family unit as a whole.

This study explored the relationship between parenting stress, parenting style, parenting quality, and young children's executive function. In total, 243 firstborns aged 2-9 years old (SD = 3.82) and their parents from two-child families in Beijing participated in the study, which used executive function tasks and parenting questionnaires. The results found that (1) parenting stress negatively predicted parenting quality; (2) parenting style partially mediated the relationship between parenting stress and parenting quality; (3) children's executive function partially mediated the relationship between parenting stress and parenting quality; and (4) the spoiled, democratic, permissive, and authoritarian parenting styles each play a chain mediating role with young children's executive function between parenting stress and parenting quality. Taken together, these findings provide implications for scientific parenting of children with different psychological characteristics (such as executive function) in multiple-child families under Parenting stress.

Existing research has compared Family Quality of Life (FQOL) in autism spectrum disorder (ASD) populations and typically developing populations but has not yet explored differences in FQOL across ASD, attention-deficit/hyperactivity disorder (ADHD), and comorbid ASD and ADHD populations (ASD + ADHD). In the present study, 117 North American mothers of 92 sons and 25 daughters (ages 6-11) with ASD, ADHD, or ASD + ADHD completed an online survey exploring FQOL. An ANOVA failed to show group differences in overall FQOL, however, mothers of children with ASD + ADHD reported significantly lower family Emotional Well-being than mothers of children with ASD only. The results of this study provide insight into FQOL in families of children with ASD and/or ADHD. Greater research is needed in this area to understand how mothers of children with ASD, ADHD, or ASD + ADHD experience FQOL. The COVID-19 pandemic, which ran concurrent with this study, potentially influenced results.

Parents of children with autism spectrum disorder (ASD) report experiencing more parenting stress than parents of children with typical development or other developmental disorders. Eighty mothers of preschool children with ASD completed questionnaires with the purpose of exploring the extent and characteristics of parenting stress and the possibility of predicting parenting stress based on the mother's coping strategies, perceived social and professional support, the severity of the child's symptoms, and certain sociodemographic characteristics. The results show that 19% of the mothers had clinically significant parental stress. Most of the mothers experienced increased stress levels related to the following: poor interactions with their children (34%), the child's demandingness (27%), and their personal ability to cope with parental distress (20%). The predictors significantly explained 42.8% of the variance in total parental stress, with support from friends and severity of the child's symptoms being significant unique contributors.

Parenting a child with a chronic illness presents a complex journey marked by various challenges, along with possible personal growth following these challenges. In this systematic review we present three meta-analyses, in order to examine the associations of post-traumatic growth (PTG) among parents of children with diverse chronic illnesses, and psychological distress, social support, and resilience. Analyzing 34 studies encompassing a total of 5328 parents, the results reveal several key findings. First, PTG was found to be prevalent among the parents. Second, there was no significant correlation between PTG and psychological distress, suggesting that these two processes may exist independently. Third, a positive correlation was observed between PTG and both social support and resilience-related factors, underscoring the role of these factors in fostering growth among parents of children with chronic illnesses. Additionally, illness type emerged as a moderator, affecting the strength of the above-mentioned correlations with PTG. Specifically, in the case of psychiatric illnesses, correlations of PTG with social support and resilience were stronger than in the context of other illnesses. Overall, this review emphasizes the significance of recognizing and addressing PTG correlates among parents of children with chronic illnesses, offering insights for clinical practice.

Parents of autistic children often experience high levels of parenting stress, which can have negative mental and physical effects on both the parent and child. This study tested the efficacy of mindfulness-based stress reduction in reducing parenting stress in parents of preschool-aged autistic children compared to a psychoeducation and support intervention. We assessed parenting stress before and after the interventions and at 6- and 12-month follow-up. Both interventions significantly decreased parenting stress, but mindfulness-based stress reduction reduced stress more than did psychoeducation and support, with the strongest effect observed 1 year later. This suggests that the stress-reducing benefits of mindfulness-based stress reduction persist and may increase over time.

Parents of autistic children experience significant parenting stress, which is prospectively associated with increases in child externalizing behaviors. However, family factors that place specific families at risk for experiencing the negative impacts of parenting stress on child externalizing behaviors have not been identified. The present study examined whether parental mental health moderates the association between parenting stress and child externalizing behaviors. Parents of 501 autistic children (Mage=5.16yrs) completed the Parenting Stress Index and Eyberg Child Behavior Inventory. Parents reported whether they had ever been diagnosed with a mental health disorder. Parenting stress, parental internalizing diagnosis, and parental externalizing diagnosis all independently predicted child externalizing behavior. However, parenting stress did not interact with any category of parental mental health diagnoses to predict child externalizing. Results implicate high levels of parenting stress as a risk factor for increased child behavior problems among autistic children across parental mental health statuses. Interventions aimed at reducing parenting stress may improve parent outcomes and prevent the development of child externalizing behaviors among families of autistic children.

Most studies of how parents of children with autism see the parent-child relationship used questionnaires completed by the parents and focused on challenges. This study broadened the lens by interviewing parents using open-ended questions that provide an opportunity to raise challenging but also positive experiences. Seventy-five mother-father dyads were interviewed individually about their own and their spouses' relationships with their preschooler, and we found nine relationship themes. In descending order, the themes mentioned most frequently by mothers were "Security and Closeness," "Love," and "Tenderness and Sensitivity," and by fathers were "Pleasure in Joint Activities," "Security and Closeness," and "Guidance." Positive themes were more common than challenging themes. Finally, more mothers mentioned the themes "Love," "Tenderness and Sensitivity," "High Involvement and Care," and "Difficulties" than did fathers, whereas more fathers mentioned the themes "Guidance" and "Pleasure in Joint Activities" than did mothers. The findings portray a nuanced view of the parenting experience of mothers and fathers of preschoolers with autism.

There is limited recent research on the association between parenting practices and externalizing behaviors in autistic children. To address this gap, the current systematic review examined the associations between parenting practices and externalizing behaviors in autistic children, along with the mediating and moderating effects of parent and child variables (PROSPERO registration number CRD42022268667). Study inclusion criteria were (1) Peer-reviewed journals, (2) Participants included parents of autistic children and their children, (3) Quantitative measures of both parenting practices or behaviors/style and child externalizing behaviors, (4) Cross-sectional or longitudinal studies only, and (5) Studies published in English. Study exclusion criteria were: (1) Qualitative studies, (2) Published in a language other than English, (3) Participants included non-human participants, (4) Participants that did not include parents and their autistic children as participants or did not report this group separately, (5) Systematic review and meta-analyses, and (6) No quantitative measures of parenting practices and/or child externalizing behaviors. Quality appraisal and risk of bias were conducted using the McMaster Tool and results were synthesized in Covidence and Excel. Thirty studies were included in the review. Results demonstrated that mindful parenting was associated with fewer or lower levels of externalizing behaviors; positive parenting practices had non-significant associations with externalizing behaviors; specific parenting practices had differing associations with externalizing behaviors; and negative parenting practices were associated with higher levels of externalizing behaviors. We are unable to draw causal relationships due to focus on cross-sectional and longitudinal articles only. The potential for future research to target specific parent practices to support children's externalizing behaviors is discussed.

Parents of autistic children may be especially vulnerable to the negative effects of COVID-19. The current study examined changes in mental health and marital functioning of mothers and fathers of autistic children across three time points between April and October 2020. The study also explored whether pre-COVID factors could predict outcomes during the pandemic. Participants were 94 mothers and 58 fathers of autistic children drawn from a larger study about family relationships and autistic children's mental health that began prior to the pandemic. Results indicated that mothers reported higher levels of mental health problems compared to fathers in July and October 2020. Levels of mental health and marital functioning did not change between April and October 2020. Pre-pandemic child functioning and marital satisfaction predicted changes in mother's ratings of marital satisfaction. The findings have implications for ways to best support families during challenging periods.

Mothers of children with Autism Spectrum Disorder (ASD) often experience chronic stress and are at risk for adverse health. However, little is known about fathers, especially when their child is in early childhood. Parenting stress, eating behavior and physical health was evaluated in mothers (n = 48) and fathers (n = 43) of young children (3-7 years) with ASD by questionnaires and physical measurements. Mother's prevalence rates of obesity (39.1%), abdominal obesity (59.6%) and metabolic syndrome (21.6%) were higher than the norm. In fathers, the prevalence rate of clinical parenting stress (33%) was higher than the norm. Parenting stress was positively related to disinhibited eating in mothers, not in fathers. It is crucial to monitor stress and health of parents of children with ASD.

Autism spectrum disorder (ASD) is a neurobehavioral condition marked by social interaction challenges, communication deficits, and repetitive behaviors, with studies in Saudi Arabia showing varying prevalence rates in different regions. This study aimed to evaluate the social context of autistic children and the quality of life (QOL) for families of children with autism utilizing the Beach Center Family Quality of Life Scale (BCFQOL).

This cross-sectional study, conducted at King Abdulaziz Medical City in Saudi Arabia over a six-month period, included ASD children aged 1-14 years. The QOL was measured using the BCFQOL scale for families. Data were analyzed using the Jamovi software (Windows version 2.4.1, the Jamovi Project, retrieved from https://www.jamovi.org).

A total of 102 responses were collected in the study. The overall satisfaction score was 93.6±16.6 out of 125, with 85.3% of participants expressing satisfaction. Domains explored included family interaction (23.8±5.29 out of 30), parenting practices (23.9±3.83 out of 30), emotional well-being (13.1±4.16 out of 20), physical and material well-being (18.7±4.24 out of 25), and disability-related support (14.2±4.0 out of 20). In terms of specific sociodemographic factors, no statistically significant differences in satisfaction were observed across various categories.

Families of children with ASD in Saudi Arabia generally report high levels of satisfaction, as assessed by the BCFQOL. The study covered various domains, including family interaction, parenting practices, emotional well-being, physical well-being, and disability-related support, with most respondents expressing satisfaction in these areas. Notably, sociodemographic factors did not significantly influence satisfaction levels, underscoring the pervasive nature of the findings across different demographic groups. Further studies with a larger sample size and a longer follow-up period are required to validate these findings.

Caregivers of children with developmental disabilities (DDs) in Ethiopia experience stigma and exclusion. Due to limited existing services and substantial barriers to accessing care, they often lack support. Caregiver empowerment could help address injustices that hinder their capacity to support their child as they would like. The aim of this study was to explore the meaning and potential role of empowerment for caregivers raising a child with a DD and how empowerment was situated in relation to other priorities in service development.

This was a qualitative phenomenological study. Semi-structured interviews were conducted in Amharic and English with caregivers of children with a DD (n = 15), clinicians (n = 11), community-based health extension workers (n = 5), representatives of non-governmental organisations working with families with DDs (n = 17), and representatives of local authorities in health, education, and social care (n = 15). Data were analysed thematically.

Three main themes were developed: "Barriers to exercising caregivers' agency"; "Whose decision is it to initiate empowerment?"; and "Supporting caregivers through support groups". Caregiver capacity to do what they thought was best for their child was undermined by poverty, a sense of hopelessness, experience of domestic abuse and multiple burdens experienced by those who were single mothers. Caregivers were nonetheless active in seeking to bring about change for their children. Caregivers and professionals considered support groups to be instrumental in facilitating empowerment. Participants reflected that caregiver-focused interventions could contribute to increasing caregivers' capacity to exercise their agency. A tension existed between a focus on individualistic notions of empowerment from some professionals compared to a focus on recognising expertise by experience identified as vital by caregivers. Power dynamics in the context of external funding of empowerment programmes could paradoxically disempower.

Caregivers of children with DDs in Ethiopia are disempowered through poverty, stigma, and poor access to information and resources. Shifting power to caregivers and increasing their access to opportunities should be done on their own terms and in response to their prioritised needs.

Aggressive behavior is a prevalent and challenging issue in individuals with autism.

To investigate whether changes in peripheral physiology recorded by a wearable biosensor and machine learning can be used to predict imminent aggressive behavior before it occurs in inpatient youths with autism.

This noninterventional prognostic study used data collected from March 2019 to March 2020 from 4 primary care psychiatric inpatient hospitals. Enrolled participants were 86 psychiatric inpatients with confirmed diagnoses of autism exhibiting operationally defined self-injurious behavior, emotion dysregulation, or aggression toward others; 16 individuals were not included (18.6%) because they would not wear the biosensor (8 individuals) or were discharged before an observation could be made (8 individuals). Data were analyzed from March 2020 through October 2023.

Research staff performed live behavioral coding of aggressive behavior while inpatient study participants wore a commercially available biosensor that recorded peripheral physiological signals (cardiovascular activity, electrodermal activity, and motion). Logistic regression, support vector machines, neural networks, and domain adaptation were used to analyze time-series features extracted from biosensor data. Area under the receiver operating characteristic curve (AUROC) values were used to evaluate the performance of population- and person-dependent models.

There were 70 study participants (mean [range; SD] age, 11.9 [5-19; 3.5] years; 62 males [88.6%]; 1 Asian [1.4%], 5 Black [7.1%], 1 Native Hawaiian or Other Pacific Islander [1.4%], and 63 White [90.0%]; 5 Hispanic [7.5%] and 62 non-Hispanic [92.5%] among 67 individuals with ethnicity data). Nearly half of the population (32 individuals [45.7%]) was minimally verbal, and 30 individuals (42.8%) had an intellectual disability. Participant length of inpatient hospital stay ranged from 8 to 201 days, and the mean (SD) length was 37.28 (33.95) days. A total of 429 naturalistic observational coding sessions were recorded, totaling 497 hours, wherein 6665 aggressive behaviors were documented, including self-injury (3983 behaviors [59.8%]), emotion dysregulation (2063 behaviors [31.0%]), and aggression toward others (619 behaviors [9.3%]). Logistic regression was the best-performing overall classifier across all experiments; for example, it predicted aggressive behavior 3 minutes before onset with a mean AUROC of 0.80 (95% CI, 0.79-0.81).

This study replicated and extended previous findings suggesting that machine learning analyses of preceding changes in peripheral physiology may be used to predict imminent aggressive behaviors before they occur in inpatient youths with autism. Further research will explore clinical implications and the potential for personalized interventions.