Caractéristiques cliniques et individuelles associées au stress maternel chez les jeunes adolescents avec un diagnostic de "trouble du spectre de l'autisme"

Aperçu: G.M.

Les parents de personnes avec un diagnostic de "trouble du spectre de l'autismeé vivent à la fois des événements stressants négatifs et positifs. Plusieurs caractéristiques cliniques et sociodémographiques des enfants autistes ont été associées au stress parental dans leur famille. Cependant, peu d'études se sont concentrées sur les adolescents et le rôle de la déficience cognitive a rarement été abordé.
L'objectif principal de la présente recherche est d'explorer les associations entre les symptômes de l'autisme, les troubles cognitifs, les problèmes émotionnels et comportementaux, les caractéristiques sociodémographiques et le stress maternel chez un échantillon de jeunes adolescents avec un diagnostic de "trouble du spectre de l'autisme" avec et sans troubles cognitifs.
La déficience cognitive et les problèmes émotionnels et comportementaux sont associés au stress maternel, tandis que les symptômes de l'autisme semblent jouer un rôle mineur.
L'éducation et la profession de la mère ne sont associées au stress maternel que dans le groupe ayant une déficience cognitive, tandis que l'âge maternel est associé au stress dans le groupe d'adolescentes sans déficience cognitive. 

Les implications liées à l'âge pour l'intervention et les orientations futures de la recherche sont discutées.

. 2021 May 20.  doi: 10.1002/aur.2539. 

Clinical and individual features associated with maternal stress in young adolescents with autism spectrum disorder

Francesco Scibelli  ¹ , Elisa Fucà  ¹ , Silvia Guerrera  ¹ , Elisabetta Lupi  ¹ , Paolo Alfieri  ¹ , Giovanni Valeri  ¹ , Stefano Vicari  ^{1   2}

Affiliations

• PMID: 34013607
• DOI: 10.1002/aur.2539

Abstract

Parents of people with autism spectrum disorder experience both negative stressful and positive events. Several clinical and socio-demographic features of children on the autism spectrum have been associated with parenting stress in their families. However, there have been few studies that focus on adolescents and the role of cognitive impairment has rarely been addressed. The main aim of the present research is to explore associations between autism symptoms, cognitive impairment, emotional and behavioral problems, socio-demographic features, and maternal stress in a sample of young adolescents with Autism Spectrum Disorder with and without cognitive impairment. Cognitive impairment and emotional and behavioral problems are associated with maternal stress, while autism symptoms seem to play a minor role. Maternal education and occupation are only associated with maternal stress in the group with cognitive impairment, while maternal age is stress-associated in the group of adolescents without cognitive impairment. Age-related implications for intervention and future research directions are discussed. LAY SUMMARY: Parents of individuals on the autism spectrum are exposed to both negative stressful and enriching experiences during their parenthood. While the influence of several child characteristics and socio-demographic features on parental stress during childhood has been widely explored in past studies, studies on teenagers are limited. The aim of the present research is to explore the influence of several characteristics on maternal stress levels in families with teenagers on the autism spectrum. We found that cognitive impairment and emotional and behavioral problems are associated with maternal stress, while autism symptoms seem to play a minor role. Socio-demographic features are not associated with maternal stress. Broadly speaking, the subjective perception of parental distress in both groups is less related to teenagers' characteristics then the perception of having a difficult interaction with the teenagers. We divided our participants into two groups (one group with cognitive impairment and the other group without). We found that mothers of teenagers with cognitive impairment are generally more stressed compared to the other group. Furthermore, we confirm that emotional and behavioral problems seem to play a major role in maternal stress (especially in the group without cognitive impairment), while autism symptoms seem to play a minor role. Furthermore, we found that maternal education/occupation and maternal age are associated with maternal stress in the group with and the group without cognitive impairment respectively. This research highlights the association between several variables and stress in mothers of adolescents on the spectrum. Results are discussed in the framework of previous findings highlighting the lack of adequate care and support services for families, especially for those of adolescents on the spectrum with cognitive impairment.

Keywords: adolescence; autism symptoms; cognitive; emotional and behavioral problems; maternal stress; parent mediated therapy; socio-demographic features.

© 2021 International Society for Autism Research and Wiley Periodicals LLC.

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Trouble du sommeil familial et "trouble du spectre de l'autisme": une étude d'actigraphie pilote sur la qualité du sommeil, la qualité de vie et la détresse psychologique

Aperçu: G.M.

Objectifs:
Les problèmes de sommeil sont courants chez les enfants avec un diagnostic de "trouble du spectre de l'autisme (dTSA) et peuvent avoir un impact négatif sur le comportement et le fonctionnement de l'enfant pendant la journée. L'étude pilote actuelle a examiné des mesures objectives du sommeil des enfants et des parents en tant que facteurs associés au stress, à l'anxiété, aux symptômes dépressifs, au soutien social et à la qualité de vie des parents d'enfants avec un dTSA. 

Méthodes:
Les participants étaient neuf enfants avec un dTSA et leurs parents (neuf mères et trois pères). Les participants ont porté un actigraphe pendant 7 jours et nuits consécutifs. Des mesures des habitudes et de la qualité du sommeil ont été utilisées pour vérifier le sommeil des enfants et des parents. Des mesures du stress parental, de l'anxiété, des symptômes dépressifs, de la qualité de vie et du soutien social ont été rassemblées. 

Résultats:
Les résultats ont indiqué l'émergence d'un stress parental élevé, d'anxiété et de symptômes dépressifs. Des corrélations significatives ont été observées entre les symptômes dépressifs des parents et la qualité subjective du sommeil et les perturbations du sommeil des enfants. 

Conclusions:
La présente étude a révélé que le bien-être des parents est affecté par les problèmes de sommeil des enfants.

• 2021 May 11;1-11.  doi: 10.1017/ipm.2021.24. 

Familial sleep and autism spectrum disorder: a pilot actigraphy study of sleep quality, quality of life and psychological distress

Geraldine Leader  ¹ , Carmel Glynn  ¹ , Bernadette Kirkpatrick  ² , June L Chen  ³ , Páraic S O'Súilleabháin  ^{4   5} , Arlene Mannion  ¹

Affiliations

• PMID: 33973508
• DOI: 10.1017/ipm.2021.24

Abstract

Objectives: Sleep problems are common among children with autism spectrum disorder (ASD) and can have a negative impact on the child's behaviour and daytime functioning. The current pilot study examined objective measurements of child and parent sleep as factors associated with the stress, anxiety, depressive symptoms, social support and quality of life of parents of children with ASD.

Methods: Participants were nine children with ASD and their parents (nine mothers and three fathers). Participants wore an actigraph for 7 consecutive days and nights. Measures of sleep habits and quality were used to ascertain child and parent sleep. Measures of parenting stress, anxiety, depressive symptoms, quality of life and social support were collated.

Results: Results indicated the emergence of high parental stress, anxiety and depressive symptoms. Significant correlations were observed between parent depressive symptoms, and both subjective sleep quality and child sleep disruptions.

Conclusions: The present study found that parental well-being is affected by child sleep problems.

Keywords: Autism spectrum disorder; actigraphy; parents; quality of life; sleep problems.

Examiner les relations entre le stress parental, le soutien familial et la qualité de vie de la famille: une approche de modélisation par équation structurelle

Aperçu: G.M.

CONTEXTE:
Des recherches ont montré que le soutien apporté aux familles ayant des enfants avec un diagnostic de "trouble du spectre de l'autisme (dTSA) aux États-Unis avait permis de réduire le stress parental. Pour mieux comprendre la situation en Chine, il est essentiel d'évaluer l'état actuel du soutien familial et de fournir des preuves claires de l'impact du soutien familial sur les résultats positifs pour la famille.
OBJECTIFS:
Cette étude a pour objectif de fournir des preuves initiales pour examiner ces relations entre le soutien familial, le stress parental et la qualité de vie de la famille en Chine continentale.
MÉTHODE:
Au total, 226 parents d'enfants avec un dTSA ont rempli deux questionnaires (FQOL échelle de qualité de vie de la famille du Centre Beach et échelle de soutien familial pour les enfants chinois avec un dTSA) et un formulaire d'informations démographiques sur la famille. La modélisation par équation structurelle a été utilisée pour examiner l'interrelation entre le stress parental, le soutien familial et la FQOL.
RÉSULTATS:
Les parents ont perçu un niveau de soutien familial modéré à faible et de FQOL ainsi qu'un niveau élevé de stress parental. Le soutien familial a eu un effet positif direct sur la FQOL (β = 0,54) et un effet indirect sur la FQOL par le stress parental (β = 0,06).
CONCLUSION:
Des ressources devraient être consacrées à la mise en place d'un système de soutien familial qui favorise la FQOL et atténue le stress parental chez les familles d'enfants avec un dTSA.

Res Dev Disabil. 2019 Nov 27;96:103523. doi: 10.1016/j.ridd.2019.103523.

Examining the relationships of parental stress, family support and family quality of life: A structural equation modeling approach

Zeng S¹, Hu X², Zhao H³, Stone-MacDonald AK⁴.

Author information

1

University of Massachusetts Boston, United States. Electronic address: songtian.zeng@umb.edu.

2

Beijing Normal University, China. Electronic address: huxiaoyi@bnu.edu.cn.

3

New Mexico State University, Carlsbad, United States. Electronic address: hzhao@nmsu.edu.

4

University of Massachusetts Boston, United States. Electronic address: angela.stone@umb.edu.

Abstract

BACKGROUND:

Research has shown that support for families with children with autism spectrum disorder (ASD) in the United States has led to reduce parental stress. To better understand the situation in China, it is crucial to evaluate the current status of family support and provide clear evidence of the impact of family support on positive family outcomes.

AIMS:

This study aims to provide initial evidence to examine these interrelations among family support, parental stress, and family quality of life in mainland China.

METHOD:

A total of 226 parents of children with ASD completed two questionnaires (Beach Center Family Quality of Life (FQOL) Scale and the Family Support Scale for Chinese Children with ASD) and a demographic family information form. Structural equation modeling was used to examine the interrelation among parental stress, family support, and FQOL.

RESULTS:

Parents perceived a moderate to low level of family support and FQOL and high level of parental stress. Family support had a direct positive effect on FQOL (β = .54) and an indirect effect on FQOL through parental stress (β = .06).

CONCLUSION:

Resources should be devoted to establishing a family support system that promotes FQOL and buffers parental stress for families of children with ASD.

Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.

PMID:31785472

DOI:10.1016/j.ridd.2019.103523

Facteurs familiaux et aptitudes à la communication chez les enfants autistes sans déficience intellectuelle

Aperçu: G.M.

L’objectif principal de cette étude était d’identifier les profils des familles d’enfants avec un diagnostic de "trouble du spectre de l'autisme" (TSA) sans déficience intellectuelle (DI) en fonction de plusieurs indicateurs de risque: indicateurs sociodémographiques et émotionnels, stress parental, soutien social confidentiel et stratégies d’adaptation. 

Un deuxième objectif était de déterminer les différences de compétences en communication entre les enfants de sous-types familiaux établis de manière empirique en fonction des facteurs de risque susmentionnés. 

Les participants étaient 52 mères espagnoles et leurs enfants avec un diagnostic de TSA. L'analyse par grappes a permis d'identifier trois sous-types de familles, en les classant comme "à haut risque, à risque modéré et à faible risque". Le profil "peu risqué" montrait beaucoup moins de stress et une plus grande utilisation de stratégies d'adaptation et de soutien social confidentiel. En outre, la communication des enfants présentait un meilleur développement par rapport aux enfants des autres environnements familiaux.

J Autism Dev Disord. 2019 Sep 6. doi: 10.1007/s10803-019-04216-5

Family Factors and Communicative Skills in Children with Autism Without Intellectual Disability

Baixauli I¹, Mira A², Berenguer C³, Roselló B², Miranda A².

Author information

1

Facultad de Psicología, Universidad Católica de Valencia San Vicente Mártir-Campus Capacitas, C/Guillem de Castro, 175, 46008, Valencia, Spain. inmaculada.baixauli@ucv.es.

2

Facultad de Psicología, Universidad de Valencia, Av. de Blasco Ibáñez, 13, 46010, Valencia, Spain.

3

Facultad de Psicología, Universidad Católica de Valencia San Vicente Mártir-Campus Capacitas, C/Guillem de Castro, 175, 46008, Valencia, Spain.

Abstract

The primary objective of this study was to identify the profiles of families of children with autism spectrum disorder (ASD) without intellectual disability (ID) based on several risk indicators: sociodemographic and emotional indicators, parental stress, confidant social support, and coping strategies. A second aim was to determine the differences in communicative skills between children of family subtypes empirically established according to the aforementioned risk factors. Participants were 52 Spanish mothers and their children with ASD. Through cluster analysis, three subtypes of families were identified, classifying them as "high risk, moderate risk, and little risk". The "little risk" profile showed significantly less stress and greater use of coping strategies and confidant social support. Furthermore, the children's communication exhibited better development, compared to children from the other family environments.

PMID:31493155

DOI:10.1007/s10803-019-04216-5

Associations entre le stress parental, la santé mentale des parents et les problèmes de sommeil chez les enfants avec un TDAH et un TSA: examen systématique

Aperçu: G.M.

CONTEXTE:
Les enfants avec un trouble déficitaire de l'attention / hyperactivité (TDAH) et un diagnostic de "trouble du spectre de l'autisme" (dTSA) présentent des taux élevés de problèmes de sommeil. Leurs parents souffrent davantage de stress parental et de problèmes de santé mentale que les parents d’enfants au  développement typique.
OBJECTIF:
Examiner le lien entre les problèmes de sommeil, le stress parental et la santé mentale des enfants avec un TDAH ou ub dTSA.
METHODES:
Les bases de données MEDLINE Complete, EMBASE, PsycINFO et CINAHL Complete ont été explorées. Les études devaient inclure: les enfants de 5 à 18 ans avec un TDAH ou un dTSA, une mesure du sommeil de l'enfant et une mesure de stress parental ou de santé mentale de l'adulte.
RÉSULTATS:
Onze études ont été identifiées (quatre TDAH, sept TSA). Six études ont porté sur le stress parental (cinq transversales, une longitudinale) et cinq ont mis en évidence des associations, de forces variables, avec des problèmes de sommeil. Six études ont examiné la santé mentale des parents (quatre transversales, deux longitudinales) et cinq ont révélé des associations d'ampleur différente avec les problèmes de sommeil des enfants.
CONCLUSIONS:
Ces études démontrent que les problèmes de sommeil chez les enfants sont associés à une moins bonne santé mentale des parents et à un stress parental accru.
IMPLICATIONS:
De futures recherches longitudinales comprenant plusieurs mesures des problèmes de sommeil des enfants et du fonctionnement de la famille sont nécessaires pour clarifier la directionnalité des associations. 

Ces connaissances sont essentielles pour adapter les interventions en matière de sommeil afin de mieux répondre aux besoins des enfants atteints de TDAH ou de TSA et de leurs familles.

Res Dev Disabil. 2019 Aug 22;93:103463. doi: 10.1016/j.ridd.2019.103463.

Associations between parenting stress, parent mental health and child sleep problems for children with ADHD and ASD: Systematic review

Martin CA¹, Papadopoulos N², Chellew T², Rinehart NJ², Sciberras E³.

Author information

1

Deakin University, 1 Gheringhap Street, Geelong, Victoria, Australia 3220. Electronic address: machri@deakin.edu.au.

2

Deakin University, 1 Gheringhap Street, Geelong, Victoria, Australia 3220.

3

Deakin University, 1 Gheringhap Street, Geelong, Victoria, Australia 3220; Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, Victoria, Australia 3052; The University of Melbourne, Grattan St, Parkville, Victoria, Australia 301.

Abstract

BACKGROUND:

Children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) experience high rates of sleep problems. Their parents experience higher parenting stress and more mental health difficulties than parents of typically developing children.

AIM:

To examine the association between child sleep problems, parenting stress and parent mental health for children with ADHD or ASD.

METHODS:

MEDLINE Complete, EMBASE, PsycINFO and CINAHL Complete databases were searched. Studies needed to include: children aged 5-18 with ADHD or ASD, a child sleep measure, and a parenting stress or adult mental health measure.

RESULTS:

Eleven studies were identified (four ADHD, seven ASD). Six studies examined parenting stress (five cross-sectional, one longitudinal) and five found associations, of varying strengths, with child sleep problems. Six studies examined parent mental health (four cross-sectional, two longitudinal) and five found associations, of differing magnitudes, with child sleep problems.

CONCLUSIONS:

These studies demonstrate child sleep problems are associated with poorer parent mental health and higher parenting stress.

IMPLICATIONS:

Future longitudinal research including multiple measurements of child sleep problems and family functioning is required to clarify the directionality of associations. Such knowledge is key in adapting sleep interventions to better meet the needs of children with ADHD or ASD and their families.

Copyright © 2019 Elsevier Ltd. All rights reserved.

PMID:31446370

DOI:10.1016/j.ridd.2019.103463

Impact du comportement perturbateur dans les difficultés d’alimentation des enfants

Aperçu: G.M.

Des problèmes d'alimentation pédiatrique se produisent chez 25 à 40% de tous les enfants et touchent de manière disproportionnée les enfants ayant des problèmes de santé et / ou de développement. Les enfants avec un diagnostic de "troubles du spectre de l'autisme" (dTSA) courent un risque particulièrement élevé de problèmes d'alimentation, bien que le lien entre TSA et problèmes d'alimentation ne soit pas bien compris. Comme les problèmes liés aux comportements alimentaires problématiques sont fréquents dans les cliniques pédiatriques ambulatoires, il est nécessaire de comprendre les facteurs communs qui contribuent au développement de comportements alimentaires adaptatifs et inadaptés. 

La présente étude a examiné les facteurs prédictifs du comportement alimentaire problématique chez les enfants avec ou sans dTSA. 

Les parents d’enfants avec un dTSA ont signalé un comportement perturbateur, un stress parental, des difficultés d’alimentation, et des sentiments et des stratégies problématiques des parents concernant l’alimentation. 

Le comportement perturbateur des enfants et le stress parental ont le plus varié dans la prédiction des difficultés d’alimentation des enfants et la relation entre les comportements perturbateurs des enfants et les difficultés alimentaires a été partiellement arbitré par les stratégies et les ressentis des parents.

J Clin Psychol Med Settings. 2019 Aug 1. doi: 10.1007/s10880-019-09646-y.

Impact of Disruptive Behavior in Childhood Feeding Difficulties

Murphy J¹, Zlomke K², VanOrmer J¹, Swingle H³.

Author information

1

Department of Psychology, University of South Alabama, 75 S University Blvd, UCOM 1000, Mobile, AL, 36688, USA.

2

Department of Psychology, University of South Alabama, 75 S University Blvd, UCOM 1000, Mobile, AL, 36688, USA. zlomke@southalabama.edu.

3

Department of Pediatrics, University of South Alabama, Mobile, USA.

Abstract

Pediatric feeding problems occur in 25-40% of all children and disproportionately affect children with health and/or developmental concerns. Children with autism spectrum disorder (ASD) are at particularly high risk for feeding difficulties, though the connection between ASD and feeding problems is not well understood. As issues related to problematic feeding behavior frequently present to outpatient pediatric clinics, there is a need to understand the common factors that contribute to the development of both adaptive and maladaptive feeding behaviors. The current study examined predictors of problematic feeding behavior in children with and without ASD. Parents of children with ASD reported significantly greater child disruptive behavior, parenting stress, child feeding difficulties, and problematic parental feelings and strategies regarding feeding. Child disruptive behavior and parenting stress contributed the most variance in the prediction of child feeding difficulties and the relation between child disruptive behavior and feeding difficulties was partially mediated by parental strategies and feelings.

PMID:31372779

DOI:10.1007/s10880-019-09646-y

L’interaction des compétences en communication, des problèmes émotionnels et comportementaux et de la détresse psychologique parentale

Aperçu: G.M.

Nous avons étudié le mécanisme d’impact des faibles compétences en communication et des problèmes émotionnels et comportementaux chez les enfants avec un diagnostic de TSA (22 à 61 mois) sur la détresse psychologique des parents. Les participants étaient des dyades inscrites à deux études d’intervention pilotes; l'ensemble de données comprend des données transversales à la base (N = 82). 

Nous avons postulé un effet indirect de la communication expressive et réceptive de l'enfant sur la détresse psychologique des parents, par le biais de problèmes affectifs et comportementaux. 

L’effet des compétences réceptives sur la détresse psychologique des parents était totalement lié aux problèmes émotionnels de l’enfant:  

des compétences réceptives plus faibles étaient associées à des niveaux plus élevés de symptômes émotionnels, ce qui prédit à son tour une plus grande détresse psychologique des parents. 

Les compétences expressives n'ont pas montré d'effets directs ou indirects.

Les résultats sont discutés à la lumière du profil de communication clairement défini du «désavantage réceptif» des enfants.
Conclusion
Nous avons constaté que l’association des communications réceptives (RC) à la détresse psychologique des parents n’était plus présente après avoir pris en compte les problèmes émotionnels des enfants: des difficultés plus importantes en RC étaient associées à des niveaux plus élevés de symptômes émotionnels, qui étaient à leur tour associés à des niveaux plus élevés de détresse psychologique des parents. La communication expressive (EC) n'était associée ni directement ni indirectement à la détresse psychologique des parents. 

Ces résultats vont dans le sens de la notion générale selon laquelle les compétences réceptives peuvent jouer un rôle important dans la détermination des résultats comportementaux et fonctionnels chez les enfants avec un dTSA (Tager-Flusberg et al. 2005) et justifient des recherches plus approfondies sur la relation entre EC et RC en ce qui concerne la détresse parentale, dans cette tranche d'âge. 

Les aidants rapportent que les résultats cliniques souhaitables pour leurs enfants, futurs adultes, concernent l'amélioration du fonctionnement quotidien et la réduction du stress (McConachie et al. 2018). 

Comme il a été démontré que les parents peuvent effectivement acquérir les compétences nécessaires pour améliorer les capacités de leurs enfants (Oono et al. 2013), de futures recherches sur les interventions devraient examiner si les améliorations dans la communication avec les enfants contribuent à réduire le niveau de difficultés émotionnelles des enfants et, partant, la détresse psychologique des parents. 

Une meilleure compréhension de ces facteurs serait utile pour faire avancer la discussion concernant l’intervention précoce des enfants avec un dTSA et de leurs parents en ce qui concerne la conception de stratégies d’intervention (Lord et al. 2018) et la détermination de résultats cliniques significatifs (Wainer et al. 2017).

J Autism Dev Disord. 2019 Jul 31. doi: 10.1007/s10803-019-04142-6. 

The Interplay of Communication Skills, Emotional and Behavioural Problems and Parental Psychological Distress

Salomone E¹, Settanni M², Ferrara F², Salandin A²; CST Italy Team.

Collaborators (22)

Arduino GM, Baiona M, Borsetti L, Bortolussi N, Cambiano M, Cassardo L, Cocco C, Cometto M, Contardi E, Cordella E, Elia D, Fioretto F, Ghersi S, Gonella E, Mazzotta L, Pirro O, Schiappa L, Serra F, Turco N, Verlato L, Viberti B, Zucca F.

Author information

1

Department of Psychology, University of Milan-Bicocca, Milan, Italy. erica.salomone@unimib.it.

2

Department of Psychology, University of Turin, Turin, Italy.

Abstract

We investigated the mechanism of impact of poor communication skills and emotional and behavioural problems in children with ASD (22-61 months) on parental psychological distress. Participants were dyads enrolled in two pilot intervention studies; the dataset includes cross-sectional data at baseline (N = 82). We postulated an indirect effect of child expressive and receptive communication on parent psychological distress, through child emotional and behavioural problems. The effect of receptive skills on parent psychological distress was fully mediated by child emotional problems: lower receptive skills were associated with higher levels of emotional symptoms, which in turn predicted higher parent psychological distress. Expressive skills did not show either direct or indirect effects. Findings are discussed in light of children's marked 'receptive disadvantage' communication profile.

PMID:31368058

DOI:10.1007/s10803-019-04142-6