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Service Delivery Processes and Parenting Stress Among Families of School-Aged Children with ASD
Autism Spectrum Disorder (ASD) presents a wide range of challenges for which families seek professional support across the lifespan. Parents also experience high levels of stress that is chronic and persistent over time (Zaidman-Zait et al., 2013). Thus, treatments and supports for families of children with ASD should address the needs of the entire family. The provision of family-centered services (FCS) has been shown to be associated with higher levels of parental satisfaction and better parental and child psychosocial well-being in non-ASD populations (King et al., 2004; Rosenbaum et al., 1998).
Objectives:
This study sought to examine (1) parents’ perceptions of the extent to which the after-school treatment services their children with ASD received were family-centered, over a 12-month period; and (2) the relationship between parents’ perceptions, child service utilization, and parenting stress over a 12-month period, after controlling for child behavior problems.
Methods:
Data were drawn from the Canadian Pathways in ASD study and included 124 parents and their children with ASD, who were 7-8 years old at T1 (mean age = 7.75 years). Data were available 12 months later (T2) for 82 of these families, when the children were aged 8.7 years, on average. At both time points, parents completed a family demographic survey; the Measure of Processes of Care (MPOC-20; King et al., 2004); and the Community Program Services and Activities questionnaire (Brayson et al., 2009). At T2, parents completed the Parenting Stress Index-Short Form (PSI-SF) and the Child Behavior Checklist 1.5-5 (CBCL). Teachers also completed the CBCL at T2.
Results:
Profile analysis results indicated that, at T1, mean scores on the MPOC subscales related to providing general information (M = 4.18) and enabling partnerships with families (M = 4.83) were lower than scores on the other three subscales (i.e., providing specific information about the child, providing coordinated and comprehensive care for the child and family, and providing respectful and supportive care). Paired t-tests indicated that, over a 12-month period, there was a significant increase in scores on the enabling partnerships subscale (t = -2.28, p = 0.02). In the regression analysis, parent and teacher child behavior problem scores on the CBCL at T2 were entered in the first block, and accounted for 23% of the variance in parenting distress (F=17.85, p<.001). The average number of after-school treatment hours at T1 and scores on the two MPOC information-providing subscales were entered in the next two steps, with no significant effects. Scores on the three MPOC subscales addressing supportive care and parent–professional relationships were entered in a final step, and accounted for an additional 14% of the variance in parenting stress at T2. The overall model explained 38% of the variance in parental distress on the PSI-SF at T2 (F = 4.72, p<.001).
Conclusions:
Service delivery processes make an important contribution to parents’ experiences of stress. Professionals providing interventions to school-age children with ASD should endeavor to build supportive and collaborative relationships with families. Such relationships may help to ameliorate parenting stress over time.