Perceptions of the Parenting Experience Among Caregivers of Toddlers: Comparison of ASD Risk and Non-Risk Groups

Background: Parenting a child with autism spectrum disorder (ASD) may be especially challenging due to symptoms of ASD and the associated problems (e.g., regulation during daily living tasks; externalizing behaviors; Davis & Carter, 2008; Ming et al., 2008). Whereas much research on children with ASD assesses deficits, relatively fewer studies have examined strengths. Nevertheless, including an assessment of strengths is important, as they may protect against parental stress (Carter et al., 2003) and can provide a broader picture for intervention planning (Oswald et al., 2001).

Objectives: The present study compares perceptions of parenting among caregivers of two groups of children—those above and those below the cut-score consistent with an ASD diagnosis on the Modified Checklist for Autism in Toddlers (M-CHAT). Understanding more about parents’ perceptions of both difficulties and strengths can inform interventions to ameliorate difficulties and build upon strengths with a goal of reducing parenting stress.

Methods: Data were drawn from a national primary care sample who completed online questionnaires prior to children’s health supervision visits. Caregivers of 5,690 children, aged 16-30 months (M = 1.30 years; SD = 1.85; 67.8% European-American, 30.2% African-American) completed the M-CHAT (Robins, Fein, Barton, Green, 2001), a validated parent-report for screening toddlers for ASD. These caregivers were also asked to choose one or two items from 22 choices representing the best parts of parenting and one or two items from 23 choices representing the hardest parts of parenting. Best and hardest choices were theoretically and clinically derived.

Results: Consistent with the general population base rate (APA, 2013), 1.14% (n = 65) scored 7 or higher on the M-CHAT (indicating a possible diagnosis of ASD). Group comparisons (M-CHAT <7 and >7) for items most frequently endorsed as the best parts of parenting and the hardest parts of parenting are presented in Figures 1 and 2, respectively. Overall, caregivers most frequently endorsed playing with him/her, the way he/she smiles, and watching him/her with siblings among the best parts of parenting. Caregivers most frequently endorsed crying/fussing/tantrums and managing other stress among the hardest parts of parenting. Chi-square analyses indicated the same pattern regardless of M-CHAT scores for most choices. However, there were statistically significant differences for wondering if I am a good enough parent (p = .04; endorsed more in the M-CHAT <7 group) and too much/not enough help/advice (p = .03; endorsed more in the M-CHAT >7 group).

Conclusions: Even among caregivers of children with a significant M-CHAT score, the parts of parenting identified as best included social (i.e., interactions with family) and early communicative (i.e., smiling) behaviors. Likewise, these caregivers endorsed struggling with the same child behavior problems and other stress as other caregivers, with a few significant differences. These results underscore the commonalities in the experience of caregivers of toddlers, regardless of level of child ASD symptoms. These findings highlight the importance of targeting social skills and communication in early interventions with at-risk children as well as assisting caregivers to build skills to address behavior problems and reduce stress.