Social Functioning and Parental Well-Being in Preschoolers with ASD

Background: Families of children with autism spectrum disorders (ASD) experience greater stress levels than families with other or no disabilities, placing them at risk for poor mental health (Boyd, 2002).  Research suggests parental distress may be related to child functioning areas across several domains, including autism severity and cognitive ability (Lounds et al., 2007).  Similarly, maternal stress has been associated with treatment outcome for children with ASD (Robbins, Dunlap, & Plienis, 1991).  The primary intervention for most children with autism is the education they receive in school.  Given the importance of early school-based interventions for these children (Dawson et al., 2010), and the important role parents play in their child’s response to treatment, it is critical to understand which domains of functioning may significantly impact parental distress and well-being (Taylor & Warren, 2012).

Objectives: To examine the effects of social and autism severity outcomes in preschoolers enrolled in TEACCH, LEAP, and Business as Usual (BAU) classrooms on  parental stress and depression.  We hypothesized that reports of lower social functioning in children would be associated with increased parental stress and depression.  

Methods: Participants included 198 preschoolers with a confirmed ASD diagnosis and their parents. Students were aged 34 to 62 months (M = 47.60, SD = 7.49) and enrolled into high fidelity TEACCH (n = 85), LEAP (n = 54), or BAU (n = 59) classrooms.  Students were administered the Autism Diagnostic Observation Schedule.  Parents completed the Social Communication Questionnaire, the Social Responsiveness Scale, the Beck Depression Inventory-II, and the Parenting Stress Index-SF. 

Results: Controlling for age, symptom severity, and pre-assessment scores, results indicated end of the school year parent reports of their child’s social functioning as they relate to social awareness, R² = .49, F(4, 150) =  11.44, p < .001, β = 0.36, t(150) = 3.65, p < .001, social cognition, R² = 0.49, F(4, 148) =  11.48, p < .001, β = 0.51, t(148) = 4.72, p < .001, social communication, R² = 0.53, F(4, 150) = 14.03, p < .001, β = 0.47, t(150) = 4.69, p < .001, and social motivation, R² = 0.44, F(4, 150) = 8.59, p < .001, β = 0.33, t(150) =  3.07, p < .01 were associated with self-reports of distress.  Additionally, autistic mannerisms was shown to be associated with self-reports of distress, R² = 0.52, F(4, 150) = 13.49, p < .001, β = 0.43, t(150) =  4.47, p < .001, and symptoms of depression, R² = 0.30, F(4, 147) = 3.46, p < .05, β = 0.27, t(147) =  2.51, p < .05.  

Conclusions: Results from the current study suggest a relationship between student improvements and parental distress at the end of the school year.  Parental reports of their child’s level of social functioning at the end of the school year were associated with self-reported stress levels and depressive symptomatology.  Specifically, lower levels of functioning were associated with higher stress as well as some associations with depression.