Toddler Social-Communication and Parenting Stress Are Mediating Factors in the Psychosocial Well-Being of Parents with ASD-Related Concerns

Background:

The parents of toddlers with ASD-related concerns encounter significant delays to accessing diagnostic and intervention services for their child. While parents have reported feeling stressed, isolated, and fatigued during this time period, the psychosocial well-being of parents with ASD-related concerns about their toddlers has not been well-characterized empirically. The current study examined psychosocial well-being, as well as potential contributing factors that may affect parents’ interactions with their toddlers (i.e., toddler social-communicative functioning and parenting stress), in 3 parent groups: those with ASD-related concerns, developmental delay (DD) concerns, and no developmental concerns.

Objectives:

To examine the extent to which the effect of parent group on psychosocial well-being is mediated sequentially by toddler social-communication and parenting stress.

Methods:

Parents completed surveys on the outcomes of interest at Time 1 as part of a longitudinal community-based research study; data collection is ongoing. The ASD-related concerns group (n= 22,males=16,M_age= 26.41 mos) comprised toddlers whose parents indicated that they and/or a healthcare provider had concerns about ASD and/or social interactions. The DD concerns group (n= 15,males=6,M_age= 20.47 mos) comprised toddlers whose parents indicated that they and/or a healthcare provider had concerns about language and/or motor development. The no concerns group (n= 56,males=21,M_age= 19.95 mos) comprised toddlers whose parents indicated that they had no concerns about development.

Toddlers’ social-communication was assessed as a mean score of the four domains on the Parent Interview for Autism-Clinical Version: Social Relating, Imitation, Nonverbal Communication, and Language Understanding. Parenting stress was assessed as a total score of the three subscales from the Parenting Stress Index: Difficult Child, Parental Distress, and Parent-Child Dysfunction. Parent psychosocial well-being was assessed as a mean score of the Psychological and Social Relationship scales on the WHO Quality of Life Survey.

Results:

A three-path, serial mediation analysis was conducted using PROCESS Model 6 (Hayes, 2013;see Figure 1). Parent group was analyzed as two dummy vectors and child age, sex, and parental education were included as covariates.

Parent group had a significant total effect on psychosocial well-being (path c); the ASD-related concerns group had lower levels than the other two groups. Parent group also had a significant effect on each of the two proposed mediators (path a₁ and a₂); the ASD-related concerns group had lower levels of toddler social-communication and higher levels of parenting stress than the other two groups. While the direct effect was not significant (path c’), indirect effect #3 was significant, indicating that the effect of parent group on psychosocial well-being is mediated sequentially by toddler social-communication and parenting stress.

Conclusions:

Toddler social-communication and parenting stress represent mechanisms that help explain why parents of toddlers with ASD-related concerns exhibit lower levels of psychosocial well-being than other parent groups. Lower levels of toddler social-communication and higher levels of parenting stress functioned sequentially to predict lower levels of psychosocial well-being. These findings suggest that providing the parents of toddlers with ASD-related concerns with strategies for improving their toddlers’ social communication and their parent-child relationship may also have a positive and protective impact on their own well-being.