Parents of children with autism often report elevated levels of depression and parenting-related stress relative to parents of children with typical development or those with other developmental disorders (Carter et al., 2009; Davis & Carter, 2008; Estes et al., 2009). Additionally, higher levels of depression have been shown to be related to lower perceived parenting efficacy (Kuhn & Carter, 2006).
This study examines the relation of parental well-being (i.e., stress, depression, and perceived parenting efficacy) and child behaviors within parent-child dyads involving young children exhibiting early symptoms of autism.
Parental well-being and child characteristics were assessed in families of 55 toddlers (mean CA = 21.2 mo., range = 15.5 – 25.0 mo.) as part of the initial assessment of a multi-site clinical randomized trial of the Hanen More than Words intervention. Children had met a predetermined cutoff on the Screening Tool for Autism in Two-Year-Olds (STAT) and had a clinical presentation consistent with an ASD. Parental well-being was evaluated using the Center for Epidemiologic Studies Depression Inventory (CES-D), Parenting Stress Index-Short Form (PSI), and Maternal Efficacy Scale (MES). Child behaviors were measured using the Parent Interview for Autism-Clinical Version (PIA-CV), Brief Infant-Toddler Social and Emotional Assessment (BITSEA), Infant-Toddler Social and Emotional Assessment (ITSEA) and Vineland Adaptive Behavior Scales- Second Edition (VABS II).
A multi-step process was used to select predictors for the exploratory multiple regression model that: (a) created same-construct groupings of bivariate correlates with parental well-being and (b) selected the child characteristic most strongly related to parental well-being.
High levels of depression and parenting stress were reported, with 25.5% of parents obtaining clinically elevated CES-D scores and 30.9% exceeding the clinical cutoff for PSI Total Stress. Significant associations between all three measures of parental well-being were found, with correlations ranging from |.34| to |.56| (ps < .05). Parent-reported measures of child characteristics and measures of parental well-being were also significantly correlated (r values ranged from |.32| to |.71|, ps < .05). Regression analyses revealed two unique predictors for each parental measure of well-being. For the CES-D, 20.9% of the variance was accounted for by the ITSEA Maladaptive and PIA-CV Language Understanding subscales, with each subscale uniquely accounting for about 7% of the variance. For the PSI, 49.7% of the variance was accounted for by the BITSEA Problem and PIA-CV Language Understanding subscales, with BITSEA Problem and PIA-CV Language Understanding subscales uniquely accounting for 21.5% and 7.3% of the variance, respectively. For the MES, 60% of the variance was accounted for by the BITSEA Competence and BITSEA Problem subscales, with each subscale uniquely accounting for about 18% of the variance.
Parents of young children with early autism symptoms demonstrated elevated levels of depression and parenting stress. Both child competence and problem behaviors contributed to the variance in parental stress, depression, and efficacy, with particularly strong predictions found for parental efficacy. The emergence of language understanding as a significant predictor of parental well-being highlights the importance of helping parents learn strategies for communicating effectively with their children.