Raising a Child with Autism: A Developmental Perspective on Parental Adaptation

Background:   While raising a child with an Autism Spectrum Disorder (ASD) is known to produce chronic stress and strain on families, positive family outcomes are also evident. Past research has supported the utility of the Double ABCX model of family adaptation in understanding the experience of parents raising a child with ASD. To date, this model has supported the unique prediction of child related stressors and specific coping strategies on mainly negative maternal outcomes. While the experience of fathers has recently been considered, what remains unclear is the impact of family-related variables on positive as well as negative outcomes in both mothers and fathers within the same family.

Objectives:   We sought to provide a coherent understanding of the role of child age and parental gender on family outcomes by charting the trajectory of family stress and coping associated with raising a child with autism. Our objective was to investigate the potential predictors of both maternal and paternal stress and family quality of life in an Australian sample of parents of children with ASD.

Methods:   Participants were 196 parents of children aged 3 to 16 years. Using a cross-sectional design, these 98 parental dyads (mother-father matched pairs) of children across four key stages of childhood (preschool, early school years, middle school, early high school) completed questionnaires assessing factors within the Double ABCX model attributed to family adaptation. The questionnaires assessed child behaviour, family functioning, social support, family appraisal and coping strategies including the outcome variables of family quality of life and parental and life stress.

Results:   The results revealed that mothers were more stressed than fathers and also reported poorer family quality of life. While parents of older children reported significantly less support from professionals than parents of younger children, no differences were found between parental reports on measures of family outcomes across the four child age cohorts. This was despite a significant increase in child internalizing behaviour between early and middle school years.

Conclusions:   The findings support previous research suggesting that time spent caring for a child with ASD has a strong predictive impact on parental stress and coping. They also confirm the negative impact of child externalising behaviours on parent perceptions of FQoL. Importantly, the findings highlight the importance of family sense of coherence on positive parental outcomes. Parents appear to demonstrate stable levels of coping and stress despite fluctuations in child behaviour, indicating that factors other than support and family functioning investigated in the current study (i.e., locus of control) may play an important role in family adaptation. Study implications for future research, including the identification of protective and risk factors for family adaptation, are discussed.