Family Empowerment and Caregiver Strain Among Ethnically Diverse Caregivers of Children with ASD or ADHD

Background:

Caregivers of children with developmental disabilities experience significantly greater stress than parents of typically developing children (Baker et al., 2003). These challenges have been thought to be even greater for ethnic minority parents who face additional difficulties related to socioeconomic status, access to health care and information, and language barriers. However, in previous studies Latino parents have self-reported less family burden than Black and non-Latino White parents (Biel et al., 2015).

Objectives:

This study seeks to compare the extent to which diverse caregivers of children with ASD or ADHD feel strained by their children’s difficulties, feel confident in their abilities as caregivers, and feel confident in their ability to use the mental health systems that impact their child.

Methods:  

Participants in the current study were 103 parents of children diagnosed with ASD (n=33) or ADHD (n=70) who were participating in a larger study comparing two interventions for executive dysfunction. Participants were drawn from Title I eligible schools in the Washington, D.C. area, which resulted in an ethnically and socioeconomically diverse sample (Table 1). White caregivers reported significantly higher levels of income and education than Black and Latino caregivers.

Caregivers completed three self-report measures: the Caregiver Strain Questionnaire-Short Form 7 (CSQ-7) (Brannan et al., 2012), and the Competence and Self-Efficacy subscales of the Family Empowerment Scale (FES) (Singh et al., 1995). Each measure consisted of 5-point Likert scale items. Measures were offered in English and Spanish and presented in paper form or orally by study staff, depending on caregiver preference.

Results:

Overall, the FES Competence total score had a significant negative correlation with CSQ-7 total score, indicating that increased strain was associated with decreased perception of parenting competence (r=-.334, p<.01). FES Competence total score had a significant positive correlation with FES Self-Efficacy total score, (r=.470, p<.01). There was no relationship between FES Self-Efficacy and CSQ-7.

Latino caregivers total scores were higher than White or Black caregivers on both the FES Competence and Self-Efficacy subscales; however, one-way ANOVAs revealed that these differences were only significant for the Competence scale, (F(2,83) = 7.92, p<.001). Post hoc analyses indicated that mean scores were significantly higher for Latino caregivers than White caregivers for 6 of 8 individual items on the Competence scale (Table 2).

No significant differences by race/ethnicity were found for the CSQ-7.

Conclusions:  

Studies have shown that although Latino parents report high levels of problem behaviors in their children, they perceive less impact of these problems on family burden. Consistent with these findings, Latino parents of children in this study did not report greater caregiver strain than parents of other racial/ethnic backgrounds. Moreover, Latino caregivers of children rated themselves higher on measures of parenting competence. Of note, many Latino parents chose to complete the measures verbally. Thus, their higher ratings of parenting competence may reflect pressure to provide socially-desirable responses. Future studies need to clarify this increased confidence in parenting abilities among Latinos and how it relates to seeking and accepting services.