The Double ABCX Model of Family Adaptation in Families of Children with ASD Attending Early Intervention

Background:  Families of children with ASD experience greater levels of individual distress and reduced family functioning relative to families of children who are typically developing (e.g., Lee, 2009), have another disability (e.g., Eisenhower, Baker, & Blacher, 2005), or who have a child with a chronic illness (e.g., Bouma & Schweitzer, 1990). The Double ABCX model of Family Adaptation (McCubbin & Patterson, 1983) has been used to conceptualize and organize the factors which may underlie such outcomes following diagnosis (Stuart & McGrew, 2009), at school age (Manning, Wainwright, & Bennett, 2010), and across a childhood sample (Bristol, 1987). These studies suggest a significant proportion of the variance in outcomes for the family system is explained by components of this model. To date however, no research has investigated this model’s applicability to a key period, while the child with ASD is attending early intervention. Such research has important theoretical and practical implications in better conceptualizing both the modifiable and fixed factors which affect family outcomes during their child’s early intervention. 

Objectives:  The current study sought to investigate the applicability of the Double ABCX Model of Family Adaptation to families of children with ASD attending early intervention through investigating the links between model components and family outcomes. The outcomes investigated included individual impact (mood symptoms and parenting stress), relationship quality, and impact on family. It was predicted based on the model, that family systems outcomes would be linked to child symptoms (ASD symptoms and challenging behavior), pile-up of demands, internal resources (self-esteem), external resources (social support), appraisals, and coping strategies.

Methods:  Participants included 43 parents (18 males, 25 females) of children aged 2½ to 6 years (M = 49.35, SD = 9.21 months; 8 female, 35 male) with an ASD who were attending an early intervention service. Participants completed questionnaire packets of standardized measures assessing constructs of the Double ABCX Model. 

Results:  As predicted by this model, family systems outcomes (individual, relationship and family) were linked to pile-up of demands, self-esteem, social support, appraisals, and coping strategies. Children’s reported level of challenging behavior was also linked with individual outcomes (both mood symptoms and parenting stress) and negative impact on families, although it was not significantly linked to relationship burden. Level of ASD symptoms was linked only to parenting stress and negative impact on families, but not to mood symptoms or relationship burden. 

Conclusions:  This study provides preliminary support for the applicability of the ABCX model to families with children attending early intervention with the majority of hypothesized links between predictors and outcomes supported. Further research with larger samples is needed to investigate the relative contribution and relationships between predictor variables, as well as longitudinal or intervention studies to test the direction of effects. Such research has important practical implications for identifying fixed (e.g., gender) and modifiable (e.g., coping strategies) factors which may be indicators of needs, or targets for interventions and services to better support families of children with ASD during their child’s early intervention.