Mothers Of Autism Spectrum Disorder Children Research Articles

Improving Parental Stress and Child ASD Severity through the Japanese Parent Mentorship Program: A Research Protocol

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental condition which often begins in early childhood and can involve a spectrum of persistent challenges with social communication, restricted interests, and repetitive behaviours. Literature in western and non-western countries has demonstrated that parents of children with ASD experience elevated stress relative to parents of neurotypical children. Despite the health-related burdens presented by raising children with ASD, little clinical and research emphasis is placed on reducing parental stress. Furthermore, much of the limited work on parent-centered interventions been conducted in the U.S., and few similar interventions have been developed for the Japanese population. Methods: The Japanese Parent Mentorship Program (JPM) seeks to modify a pre-existing social support intervention (the Colorado Parent Mentorship Program developed for parents of ASD children in the U.S.) to Japanese parents by incorporating dialogue about the culturally relevant stressors, social acceptability, maternal burden, saving the face, and parent-child attachment. To test the efficacy of the JPM at reducing parental stress, a randomized control trial will be conducted with mothers of ASD children who were born and are living in Japan for a minimum of five years. Results: Enrolment into the JPM will be associated with decreased parental stress post-intervention. The social support provided in the JPM will also be a protective moderator on the relationship between parental stress and ASD severity by weakening the overall association between parental stress and ASD severity. Discussion: The JPM can improve health outcomes for parents and their children with ASD by decreasing parental stress and consequently, ASD severity, leading to numerous indirect and positive implications on their physical, emotional, and social well-being. As prompted by the JPM, cultural competence in ASD management, is associated with positive outcomes such as such as increased likelihood of treatment continuation, increased strength of perceived therapeutic alliance and increased perceived treatment benefit. Conclusion: This research contributes to a major gap in the cross-cultural literature about parental stress and ASD. This work can be used to inform intervention strategies in Japan and researchers can emulate this design towards a global shift of providing culturally competent interventions for all.

Quality of life, stress and burnout of mothers of autistic children – the case of Latvia

Abstract Background Caring for children with autism spectrum disorders (ASD) demands constant parental attention to all life activities. Mothers of children with ASD experience higher stress levels comparing to mothers of developmentally intact children. That can increase parental burnout, and inversely affect their quality of life (QOL). In addition, those living in East Europe suffer from lack of appropriate support. The study aims to investigate the association between stress, burnout and QOL among Latvian mothers of ASD children. Methods Mothers of ASD children (N = 76) were enrolled in the study using Internet platforms. We used Perceived Stress Scale (PSS), Shirom-Melamed Burnout Scale (SMBS), and World Health Organization QOL (WHOQOL) questionnaires, and assessed socio-demographic data. Multiple logistic regression models adjusted for personal covariates were built for the association between PSS, SMBS and WHOQOL. Results Most of respondents were married (56.6%) 30-39 years old (52.6%), having male (84.2%) 6-10 years old (52.6%) children with ASD. Mean PSS and SMBS were 3.31±0.63 and 6.04±1.63, respectively. Strong significant correlation (rs = 0.75, p < 0.01) was found between PSS and SMBS, therefore, only SMBS was included in regression model. In fully adjusted multiple logistic regression model, better QOL was inversely associated with SMBS (odds ratio, OR = 0.35 [95% confidence interval 0.19; 0.62]), single family status (OR = 0.43 [0.20; 0.92]), and unemployed status of mother (OR = 0.12 [0.03; 0.50]), but not with age of mother and of the child. Conclusions Mothers of ASD children in East Europe are in high risk of stress, burnout and bad QOL, as the diagnostics and care for ASD children in these countries is insufficient, and support for their parents is not provided at the state level. Raising awareness of policy makers and public health authorities may help to improve this situation. Key messages Mothers of ASD children in East Europe should be treated at the state level to reduce their burnout and improve QOL. Raising awareness of policy makers and public health authorities may help to improve the situation of mothers of ASD children.

Comparison of depressive disorders between the mothers of children with and without autism spectrum disorder

Autism spectrum disorder (ASD) is a neuro-developmental disorder and a lifelong condition which has considerable impact on parents. Various psychiatric conditions are common in mothers of ASD children including depression, anxiety, low self-esteem, feeling of social isolation and high social anxiety. The objective of the study was to evaluate the presence of depression in mothers of ASD children in comparison with mothers of normally developing children. This was a cross-sectional, comparative and analytical study carried out in the outpatient department of Psychiatry in collaboration with the Shishu Bikash Kendro of Sylhet MAG Osmani Medical College Hospital Sylhet, Bangladesh during the period from 1st January 2015 to 31st December 2015. A total of 75 mothers of ASD children were selected by convenient sampling technique and grouped as group A. Another 75 age matched mothers of normally developing children were recruited and grouped as group B. Depression was assessed primarily by using the Beck Depression Inventory (BDI). Those who scored 10 or above points, were evaluated further by mental state examination and DSM 5 criteria. The results showed that, depressive disorder was present in 31 (41.3%) mothers of ASD children and 12 (16.0%) mothers of normally developing children. Significantly higher rate of depressive disorder was present in mothers of ASD children than that of mothers of normally developing children (p=0.001). These findings concluded that the proportion of depressive disorders was higher and statistically significant.
 Bang J Psychiatry December 2017; 31(2): 32-37

Child-directed communication behaviours during mother-child interaction in children with autism spectrum disorder and typically developing children in south India

Child-directed verbal and non-verbal behaviours play a crucial role in the development of communication skills in young children. This study compared child-directed utterances and pragmatic acts used by mothers of 2-4 year old children with autism spectrum disorder (ASD) (n =50) with that of two groups of typically developing (TD) children: one matched for chronological age (TD-CA; n = 50) and other for language level (TD-LL; n=50). Forty minutes mother-child interaction during free play at home was analysed. Results indicated that the the number of utterances used by mothers in the three groups were similar. However, the type of sentences used by each group varied distinctly. Mothers in the ASD (49.1%) and TD-LL group (35.47%) predominanlty used imperatives, while mothers in TD-CA group used more of interrogatives (50.12 %). Among the three groups, declarative and exclamatory sentences were more in TD-LL group; and negative sentences were more in mothers of ASD children. Analysis of pragmatic acts indicated that mothers in ASD group initiated more and took a dominant role during the interaction, while mothers of TD children were engaged predominantly in responding to their children. The study concluded that, in addition to children's language profiling, a comprehensive assessment of child-directed speech would provide directions for child-oriented assessment and management. Considering the era of globalisation and migration, this language and culture specific findings may be of interest to several practitioners catering to Tamil population.

Early processing (N170) of infant faces in mothers of children with autism spectrum disorder and its association with maternal sensitivity.

Individuals with autism spectrum disorder (ASD) exhibit impaired adult facial processing, as shown by the N170 event-related potential. However, few studies explore such processing in mothers of children with ASD, and none has assessed the early processing of infant faces in these women. Moreover, whether processing of infant facial expressions in mothers of children with ASD is related to their response to their child's needs (maternal sensitivity [MS]) remains unknown. This study explored the N170 related to infant faces in a group of mothers of children with ASD (MA) and a reference group of mothers of children without ASD. For both emotional (crying, smiling) and neutral expressions, the MA group exhibited larger amplitudes of N170 in the right hemisphere, while the reference group showed similar interhemispheric amplitudes. This lateralization effect within the MA group was not present for nonfaces and was stronger in the mothers with higher MS. We propose that mothers of ASD children use specialized perceptual resources to process infant faces, and this specialization is mediated by MS. Our findings suggest that having an ASD child modulates mothers' early neurophysiological responsiveness to infant cues. Whether this modulation represents a biological marker or a response given by experience remains to be explored. Autism Research 2019, 12: 744-758. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: When mothers of children with autism spectrum disorder (ASD) see baby faces expressing emotions, they show a right-sided electrical response in the brain. This lateralization was stronger in mothers who were more sensitive to their children's needs. We conclude that having a child with ASD and being more attuned to their behavior generates a specialized pattern of brain activity when processing infant faces. Whether this pattern is biological or given by experience remains to be explored.

Correlation of Gut Microbiome Between ASD Children and Mothers and Potential Biomarkers for Risk Assessment

Variation of maternal gut microbiota may increase the risk of autism spectrum disorders (ASDs) in offspring. Animal studies have indicated that maternal gut microbiota is related to neurodevelopmental abnormalities in mouse offspring, while it is unclear whether there is a correlation between gut microbiota of ASD children and their mothers. We examined the relationships between gut microbiome profiles of ASD children and those of their mothers, and evaluated the clinical discriminatory power of discovered bacterial biomarkers. Gut microbiome was profiled and evaluated by 16S ribosomal RNA gene sequencing in stool samples of 59 mother–child pairs of ASD children and 30 matched mother–child pairs of healthy children. Significant differences were observed in the gut microbiome composition between ASD and healthy children in our Chinese cohort. Several unique bacterial biomarkers, such as Alcaligenaceae and Acinetobacter, were identified. Mothers of ASD children had more Proteobacteria, Alphaproteobacteria, Moraxellaceae, and Acinetobacter than mothers of healthy children. There was a clear correlation between gut microbiome profiles of children and their mothers; however, children with ASD still had unique bacterial biomarkers, such as Alcaligenaceae, Enterobacteriaceae, and Clostridium. Candidate biomarkers discovered in this study had remarkable discriminatory power. The identified patterns of mother–child gut microbiome profiles may be important for assessing risks during the early stage and planning of personalized treatment and prevention of ASD via microbiota modulation.

Health-related quality of life in children and adolescent with ASD: the role of mothers' emotional symptoms

Objective: Health-related quality of life (HRQOL) in children with autism spectrum disorder (ASD) has been the subjects of many studies. However, there is limited literature about the effects of parental mental health problems on the HRQOL of children with ASD. This study aims to compare HRQOL of ASD children and their mothers’ emoti-onal problems with healthy controls and to investigate the associations between ASD children’s HRQOL and mater-nal psychiatric symptoms. Methods: The sample consisted of 81 ASD patients and 79 healthy controls, with an age range of 2-18 years, and an equal number of mothers. Childhood Autism Rating Scale was used to check severity of autistic symptoms, Kinder Lebensqualitatsfragebogen: Children’s Quality of Life Questionnaire-revised (KINDL-R) was used to examine child HRQOL, Beck Depression Inventory (BDI) was used to evaluate maternal depressive symptoms, and State-Trait Anxiety Inventory (S-STAI, T-STAI) was used to assess maternal anxiety symptoms. Results: BDI and T-STAI total scores were significantly higher, KINDL-R total score, physical well-being, family, social, and school subscores were significantly lower in children with ASD than the control group. BDI total score was significantly higher, self-esteem and social subscores of KINDL-R were significantly lower in the severe ASD group. Self-esteem and school subscores of KINDL-R were significantly lower in ASD children with clinically anxious mothers. Among ASD children, family and school subscores of KINDL-R were negatively corre-lated with BDI total score. Conclusions: ASD patients have lower HRQOL than typically developing peers. Mothers of ASD children experience greater anxiety and depressive symptoms. Self-esteem and school performance in ASD children appear to be linked with maternal anxiety symptoms. Family and school problems in ASD children may be associated with maternal depressive symptoms.

Effectiveness of parent training in improving stress-coping capability, anxiety, and depression in mothers raising children with autism spectrum disorder.

PurposeRaising a child with autism spectrum disorder (ASD) can be a stressor, and mothers of ASD children often present with high levels of stress and depression. Interventional steps to enhance parental coping skills and resiliency are more important for parental mental health and the family-centered care of children with ASD than merely reducing parental stress. Although the importance of stress-coping skills is well established, only a few studies have investigated interventional steps to improve parental coping or resiliency. Parent training (PT) is known to improve a mother’s mental health. Here, we aimed to assess the effectiveness of PT in improving the stress-coping style of mothers raising children with ASD.Patients and methodsThirty mothers of children with ASD aged 4–11 years participated in this study. The mothers underwent PT based on the Hizen Parenting Skills Training in Japan, which comprised seven sessions. Each session included education on behavior therapy, individual consultation, and workshops in small groups. Sixteen mothers completed psychological assessment, including the Stress Coping Inventory, the Beck Depression Inventory Second Edition, the State–Trait Anxiety Inventory, and the Child Behavior Checklist conducted before and after 2 months of PT.ResultsThe outcomes before and after the PT program were compared using the paired t-test and Pearson’s correlation. After the PT program, the mothers’ stress-coping strategy “positive appraisal” significantly increased (P<0.01) and “escape/avoidance” significantly decreased (P<0.01). The Beck Depression Inventory Second Edition (P<0.05) and the trait anxiety scores (P<0.01) also significantly decreased. The change in the stress-coping strategy “distancing” had a significantly negative correlation with the change in the externalizing Child Behavior Checklist T-scores of children with ASD (Pearson r=−0.518, P<0.05).ConclusionPT may be effective for mothers of children with ASD to improve their stress-coping style and to decrease their depression and trait anxiety.

Broader autism phenotype in mothers predicts social responsiveness in young children with autism spectrum disorders.

The aim of this study was to identify phenotypes in mothers and fathers that are specifically associated with disturbances in reciprocal social interactions and communication in their young children with autism spectrum disorder (ASD) in a Japanese sample. Autistic traits in parents were evaluated using the Autism-spectrum Quotient (AQ), the Empathy Quotient (EQ) and the Systemizing Quotient (SQ) in 88 parents (44 mothers and corresponding fathers) of children with ASD and in 60 parents (30 mothers and corresponding fathers) of typically developing (TD) children. For the measurement of autistic traits in children, we employed the Social Responsiveness Scale (SRS). In two of the five AQ subscales (social skills and communication), the parents of ASD children scored significantly higher than did the parents of TD children, regardless of whether the parent was a mother or a father. In addition, in mothers of ASD children, there were significant positive correlations between two of the five AQ subscales (attention-switching and communication) and the SRS T-score in their children. This is the first study to demonstrate that the social skills and communication subscales in the AQ are more sensitive as autism traits in a Japanese sample and to demonstrate that some autistic traits in mothers are specifically associated with disturbances in the social ability of their young children with ASD, as measured by the SRS score. Further study is necessary to determine whether these results were caused by genetic or environmental factors.

Adjustment Problems among Mothers of Children with and without Autism Spectrum Disorder

The present study compared adjustment problems in mothers of children with Autism Spectrum Disorder (ASD) with mothers having normal children. 132 mothers (122 mother from main study and 10 mothers from pilot study) of children with ASD (Clinical group, n=66) and mothers with normal children (Normal group, n= 66) were included in study. Mothers of ASD children were recruited from six different institutions for mentally challenged children. Mothers of normal children were taken from six mainstream schools. Data was collected by administering a Demographic Questionnaire, Bell's Adjustment Inventory and Self Report Questionnaires. ACross Sectional Research Design was used. Descriptive statistics, Independent sample t–test was used to analyze the data. Results showed that mothers of children with ASD reported greater Emotional Adjustment Problems, Health Adjustment Problems, and Social Adjustment Problems as compared to normal group. Conversely, there was no difference in mothers on Home Adjustment. These findings have implications for intervention with mothers of children with ASD. Future studies need to focus on maternal counseling that would help in decreasing their adjustment difficulties.