Wednesday, April 6, 2016

Autism: Parent Acceptance and Empowerment

Parents are often overwhelmed by the challenges presented by a child with an autism spectrum disorder (ASD).  Research has shown that parents of children on the spectrum exhibit a characteristic stress profile which includes anxiety related to the child's uneven intellectual profiles, deficits in social relatedness, disruptive and maladaptive behaviors (internalizing and externalizing problems) and long-term care concerns. Among these stressors, the child’s maladaptive behavior profile is most reliably linked to parent stress. 

Studies also indicate that raising children with ASD is associated with higher levels of parenting stress and psychological distress than parenting typi­cally developing children, children with a physical disability, or children with developmental delays without ASD. Mothers, in particular, appear to face unique challenges related to the characteristics of ASD. Because autism impairs social relatedness and adaptive functioning, parent stress can decrease helpful psychological processes and directly influence the parent or caregiver’s ability to support the child with disabilities.
Increased attention is now being given to the psychological well-being of parents of individuals with ASD. A number of studies have exam­ined the factors that can influence the impact of children’s problem behavior on parent mental health. A study in the Journal Autism examined the relationships between child problem behavior, parent mental health problems, psychological acceptance (e.g., accepting and not being adversely influenced by negative emotions and thoughts that a parent may have about their child), and parent empowerment (e.g., actively attempting to change or eliminate potentially stressful events through the application of knowledge and skills).
The researchers found that the more positive parents’ psy­chological acceptance and empowerment, the less they reported severe mental health problems. Although greater parent empowerment was associated with fewer parent mental health problems, psychological acceptance had the greatest impact on parent mental health problems, after controlling for ASD symptomatology, negative life events, parent and child gender, and child age. As child problem behavior increased, parent psychological acceptance decreased, resulting in an increase in parent mental health problems. These results suggest that problems that are persistent, stressful and not easily managed via an active problem solving approach may negatively impact the individual’s process of psy­chological acceptance, which in turn can lead to reduced adjustment.
This study has several important implications. The relatively chronic nature of behavior problems in children with ASD may explain why acceptance is a more significant psychological construct for explaining parent mental health than is empowerment. If difficulties are man­ageable and support readily available, then an active, problem-focused coping style would be related to improved parent adjustment. However, for children with ASD who exhibit more persistent behavior problems, or for highly stressed and frustrated parents, a problem-focused process may not be enough to ensure positive parent adjustment. If problems are less controllable and/or support less accessible, it may be impossible for parents to focus exclusively on trying to change or avoid their current experience. The authors comment, “In these situations, parents need a different coping strategy, one that allows them to acknowledge their current experience without trying to change it or avoid it.”  Therefore, it may be critically important to understand and evaluate the situation of the family, and offer parents both types of coping skills (acceptance and empowerment) for use across different situations.
Importantly, this study supports the exploration of accept­ance and mindfulness-based interventions as effective approaches for parents of children with ASD and underscores the importance of considering the parent psychological experience when developing treatments for child problem behavior. The authors conclude, “Child-focused therapy should not focus exclu­sively on the child. At the same time that we provide parents with skills and supports to improve their children’s experience, we must also invest in helping parents to deal with their own emotions and coping strategies. Further research is needed to investigate the effectiveness of such interventions, and other parent-focused therapies, with con­trolled designs and large, diverse samples of parents.
Weiss, J. A., Cappadocia, M. C., MacMullin, J. A., Viecili, M., & Lunsky, Y. (2012). The impact of child problem behaviors of children with ASD on parent mental health: The mediating role of acceptance and empowerment. Autism, 16, 261-274. DOI: 10.1177/1362361311422708
Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. He provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorders. Dr. Wilkinson is author of the award-winning books,  A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBTHe is also editor of a best-selling text in the APA School Psychology Book Series,  Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).

Monday, April 4, 2016

Autism Awareness Month - Continuing Education

More children and youth are being diagnosed with autism spectrum disorder (ASD) than ever before. Epidemiological research indicates a progressively rising prevalence trend for ASD over the past decade. Autism is much more prevalent than previously thought, especially when viewed as a spectrum condition with varying levels of symptom severity. Surveys focusing on this broader definition of autism indicate that ASD is one of the fastest growing disability categories in the world. Recent findings of the Centers for Disease Control and Prevention (CDC) Autism and Developmental Disabilities Monitoring Network ADDM (2012) indicate that 1 in every 68 school-age children has an autism spectrum disorder (ASD). The following CE courses focus on autism with the goal of contributing to autism awareness and knowledge among professionals.  
Autism Spectrum Disorder: Evidence-Based Screening and Assessment is a 3-hour online CE course that identifies DSM-5 diagnostic changes in the ASD diagnostic criteria, summarizes the empirically-based screening and assessment methodology in ASD and describes a comprehensive developmental approach for assessing children, adolescents, and young adults with ASD. Risk factors and/or early warning signs of ASD are described. Course #30-69 | 2014 | 44 pages | 40 posttest questions | 
Autism & Asperger Syndrome in Schools is a 9-hour test only CE course (book available on Amazon) that provides step-by-step guidance for screening, assessing, and educating children with ASD. Grounded in the latest research, special features include illustrative case examples, FAQs, quick reference boxes, glossary, and an index to 50 evidence-based best practice recommendations. Highly readable and comprehensive, this text is for those who want to further their understanding of the identification and treatment of school-age children with ASD. Course #101966 | 2010 | 40 posttest questions | 
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers. He is also editor of a recent volume in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools and author of the new book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT.

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