Parental Stress in Families of Children with Autism and Other Developmental Disabilities: Associations with Ethnic Groups and Child-Comorbid Symptoms

Background:  Families of children with developmental disorders frequently report higher levels of stress compared to children with typical development. These differences maybe accentuated in an inner city, ethnically diverse population and associated with specific child co-morbid symptoms.

Objectives:  To examine level of parental stress in families of children with autism spectrum disorder (ASD), compared to families of children with other developmental disabilities (DD) and to assess the relationship of stress with feeding, gastrointestinal (GI), sleeping and behavioral problems.

Methods:  Cross sectional study with structured interview in 50 children with ASD and 50 children with other DD, matched by age/gender. Interview included: Parenting Stress Index, GI Questionnaire, Child's Sleep Habits Questionnaire and Aberrant Behavior Checklist. Statistical analysis included chi-square, t test, correlations and regression.

Results:  Mean age8 +/- 3 yr, 15% White, 44% Hispanic and 24% AfricanAmerican. Parental stress was reported in 51% of the ASD group and 30% of the DD (p=0.04). Children with ASD presented more co-morbid symptoms: GI (66% vs 40%p=0.04), sleeping (78% vs 33%p<0.001) and behavioral problems (78% vs 33%p<0.001). Non Hispanic (52% vs 29%p=0.003) and US-born mothers (51% vs 30%p=0.04) reported more stress. In ASD group stress was related to child's irritability(r=.5 p<0.001), hyperactivity (r=.4p=0.002), lethargy(r=.5 p<0.001), food selectivity (78% vs 35% p=0.007) and GI symptoms (61% vs 25% p=0.04); no association with sleeping problems. In DD group stress was also associated with child's behavioral problems: irritability(r=.5p<0.001), hyperactivity (r=.4p=0.002) and sleep problems (59% vs 15%p=0.003); no association to feeding/GI symptoms. The association between parental stress and irritability persisted after adjusting for child developmental diagnosis, demographics and maternal education (OR1.1 95%CI 1.04-1.2).

Conclusions:  Parents of children with ASD reported more stress than parents of children with other DD. In both groups parental stress was related to child's behavioral problems, but in the ASD group it was also related to GI/feeding symptoms and in the DD group to sleeping difficulties. Non Hispanics and US-born mothers reported more stress. Providing more support to parents on behavioral issues may address parental stress in ASD and DD.