The Family Adjustment Measure: Identifying Stress in Parents of Youth with Autism

Abstract

Families caring for children and adolescents with autism spectrum disorder (ASD) have a unique parenting experience and often report high stress. Resilience factors such as coping and social support are linked to positive family outcomes and protect against stress. The Family Adjustment Measure (FAM) was developed as a screener for both parental stress and coping, and in the current study, we validated its use for ASD-affected families. With data from parents of children and adolescents with rigorously-confirmed ASD diagnoses (n = 362), we also used receiver-operating characteristics (ROC) analyses to identify cut-off scores, sensitivity, and specificity for the FAM’s four subscales, which differed for parents of children versus parents of adolescents. For parents of children, FAM subscale cut-off scores were: Parental Distress = 16.5 (78% sensitivity, 64% specificity); Social Support = 30.5 (70% sensitivity, 52% specificity); Family-Based Support = 27.5 (73% sensitivity, 57% specificity); and Positive Coping = 24.5 (58% sensitivity, 54% specificity). For parents of adolescents, FAM subscale cut-points were: Parental Distress = 18.5 (83% sensitivity, 82% specificity); Social Support = 30.5 (73% sensitivity, 51% specificity); Family-Based Support = 28.5 (80% sensitivity, 62% specificity); and Positive Coping = 22.5 (70% sensitivity, 50% specificity). Results support the validity of using the FAM subscales to predict clinically-significant stress within families of both children and adolescents with ASD, though the differing cut-off scores underscore the need for age-related considerations when working with ASD-affected families. Findings suggest potential clinical utility of using the FAM to identify unique risk and protective factors of families raising children and adolescents.