Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Mar 27, 2019; 9(2): 30-46
Published online Mar 27, 2019. doi: 10.5498/wjp.v9.i2.30
Parenting preschoolers with autism: Socioeconomic influences on wellbeing and sense of competence
Nisha E Mathew, Karen L O Burton, Anne Schierbeek, Rudi Črnčec, Amelia Walter, Valsamma Eapen
Nisha E Mathew, Karen L O Burton, Rudi Črnčec, Amelia Walter, Valsamma Eapen, School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
Anne Schierbeek, Vrije Universiteit Amsterdam, De Boelelaan, Amsterdam 1081 HV, The Netherlands
Amelia Walter, Valsamma Eapen, Academic Unit of Child Psychiatry South West Sydney and Ingham Institute, South West Sydney Local Health District, Liverpool Hospital, ICAMHS, Mental Health Centre (Level L1), Locked Bag 7103, Liverpool NSW 1871, Australia
Author contributions: Mathew NE, Burton KLO, Schierbeek A, Črnčec R, Walter A, Eapen V contributed to this paper.
Institutional review board statement: The collection of information for this study was approved by the Human Research Ethics Committee at the University of New South Wales, Sydney, Australia.
Informed consent statement: Families provided informed consent for any information collected as part of a broader study of an early intervention program for Autism Spectrum Disorders to be discussed and published provided that all information included in any publication is anonymised such that they cannot be personally identified.
Conflict-of-interest statement: None.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Valsamma Eapen, PhD, Professor, MBBS, FRCPsych, Academic Unit of Child Psychiatry South West Sydney and Ingham Institute, South West Sydney Local Health District, Liverpool Hospital, ICAMHS, Mental Health Centre (Level L1), Locked Bag 7103, Elizabeth Street, Liverpool NSW 2170, Australia. v.eapen@unsw.edu.au
Telephone: +61-2-96164205 Fax: +61-2-96012773
Received: May 29, 2018
Peer-review started: May 29, 2018
First decision: July 9, 2018
Revised: February 5, 2019
Accepted: February 18, 2019
Article in press: February 19, 2019
Published online: March 27, 2019
Processing time: 289 Days and 23.9 Hours
Abstract
BACKGROUND

Previous research suggests that parents raising a child with autism experience higher levels of psychological distress than parents of typically developing children and parents of children with other developmental disorders. Little is known, however, about the intersection between the effects of socioeconomic status (SES) on the wellbeing and sense of parental competency of parents of pre-schoolers with autism and how it relates to child symptom severity.

AIM

To examine the relationship between their child’s symptom severity, SES, as measured by neighbourhood advantage and occupational status, on the psychological wellbeing and perceived parenting competence among parents of preschoolers with autism.

METHODS

Parents of 117 preschool-aged children with a diagnosis of autism spectrum disorder (ASD), 107 mothers and 54 fathers, completed questionnaires about their child’s symptoms of ASD and functioning, their own perceptions of their wellbeing and parental competence on entry to an early intervention program in Sydney, Australia. Parents also provided demographic information pertaining to their occupation, level of education attained and address (postcode). All children were also assessed for their severity of symptoms using the Autism Diagnostic Observation Schedule. The Australian Socioeconomic Index of occupational status as a measure of familial SES and the Index of Relative Socio-economic Advantage and Disadvantage as a measure of neighbourhood advantage were used to examine the impact of SES on parental sense of competence and wellbeing.

RESULTS

Compared to normative populations, both mothers and fathers in our sample reported significantly higher levels of parenting sense of efficacy but lower levels of interest in the parenting role. Mothers also displayed higher levels of satisfaction. Both mothers and fathers displayed higher levels of depression than normative populations with mothers also reporting greater levels of stress and anxiety. Child symptom severity was associated with maternal parenting competency with these relationships amplified among mothers with higher familial SES and who lived in areas of greater neighbourhood advantage. Increased adaptive functioning was associated with better maternal wellbeing, particularly among mothers who lived in areas of greater neighbourhood advantage. Contrastingly, paternal parenting competence was generally not influenced by child adaptive functioning or symptom severity, although for those in higher familial SES brackets, children’s symptom severity and maladaptive symptoms were negatively related to paternal sense of parenting efficacy. There was a trend towards moderate relationships between lower familial SES and greater depression, stress and anxiety among fathers, but no relationship with their child’s ASD symptom severity or functioning.

CONCLUSION

SES differentially impacts wellbeing and sense of parenting competence and its relationship to the impact of child symptoms for mothers and fathers of preschoolers with autism.

Keywords: Wellbeing; Parenting competency; Autism; Autism spectrum disorder; Parent; Mother; Father; Socioeconomic status

Core tip: Previous research suggests that parents raising a child with autism experience comparatively higher levels of psychological distress than other parents. Little is known, however, about how socioeconomic status (SES) affects perceived parenting competence and overall wellbeing and how these factors relate to the nature of children’s autism. In this study, a cross-sectional analysis of parents of preschoolers with autism found that mothers and fathers were differentially affected by SES and their children’s symptom severity. Those working with parents of pre-schoolers with autism need to consider differential effects of factors, such as SES and symptom severity, in contributing to maternal and paternal wellbeing and their experiences of parenting.