Adaptive Social Communication in Children with ASD As a Predictor of Parent Stress

Background: Research examining stress in parents of children with autism spectrum disorder (ASD) indicates that these parents report higher levels of stress in comparison to parents of typically developing children (Dawson et al., 2004) and children with other developmental disabilities (Estes, Munson et al. 2009). Deficits in adaptive behaviors may place increased burden on parents because their child requires more assistance to perform everyday activities. Although there is a body of research examining the correlation of maladaptive behaviors with parent stress (e.g. Hall & Graff, 2011), there is a paucity of research examining the linkages between deficits in adaptive behavior within specific skill domains and parent stress. Identifying the key variables contributing to parent stress is critical to develop targeted interventions that support the whole family (Hayes & Watson, 2013).

Objectives: The purpose of the present study was to explore the specific nature of adaptive social communication skills on parent stress. We were interested in examining if adaptive social communication skills explain a unique amount of variance in parent stress after controlling for age and IQ. We hypothesized that some of the variance in reported parent stress on the Parenting Stress Index-Short Form(Abidin, 1990) would be explained by adaptive social communication skills. Further, we hypothesized that adaptive social and communication abilities would account for the most variance in the Parent-Child Dysfunctional Interaction subscale of the PSI because this subscale seemed most likely to be impacted by a child’s deficits in social- communication abilities.

Methods: Data for 667 children with ASD between 3 and 14 years were drawn cross-sectionally from an extant longitudinal survey conducted with a national sample. Parent stress was measured using the Parenting Stress Index-Short Form (PSI). Measures of adaptive social communication skills included: the Communication Domain Standard Score and the Socialization Domain Standard Score from the Vineland Adaptive Behavior Scales-Second Edition(VABS-2; Sparrow et al., 2005) and a parent report of their child’s verbal expressive language level. The child’s IQ as reported by parents, and the child’s chronological age in months were control variables in the model. A multiple regression analysis was conducted to predict PSI Total Score from VABS Socialization Standard Score, VABS Communication Standard Score, and Parent Expressive Language Estimate after controlling for age and IQ.

Results: After controlling for the variance accounted for by chronological age and IQ (1.584%), the adaptive social and communication variables accounted for 7.76% of the variance in parent stress on the PSI Total Score (p<.001). Linear regression models were run for each PSI subscale, which confirmed our hypothesis that deficits in social and communication abilities accounted for more variance in the Parent-Child Dysfunction (R² = .070) subscale than the Difficult Child Subscale (R² = .054) or the Parent Distress Subscale (R² = .036) after controlling for age and IQ. 

Conclusions: Our findings indicate that adaptive social communication skills in children with ASD are contributing to parent stress. Clinical implications of these findings include further consideration of the needs of the entire family when developing treatment goals for children with ASD.