Parenting
dimensions
in
mothers
and
fathers
of
children
with
Autism
Spectrum
Disorders
Yagmur
Ozturk
a,*
,
Samantha
Riccadonna
b,
Paola
Venuti
aa
DepartmentofPsychologyandCognitiveScience,UniversityofTrento,Rovereto,Italy
b
DepartmentofComputationalBiology,ResearchandInnovationCentre,FondazioneEdmundMach(FEM),SanMicheleall’Adige,Italy
1. Introduction
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disordercharacterized by difficultiesin social interactionandcommunicationaswellasthepresenceofrestricted,repetitivepatternsofbehavior,interests,oractivities (AmericanPsychiatricAssociation,2013).Thesedifficultiesdonotonlyaffectthediagnosedpeoplethroughouttheirlife,but alsotheirparentswhoplaysalientandinfluentialrolesinchilddevelopment(Karst&VanHecke,2012).Parentinganinfant constitutestheinitialand all-encompassingecologyofinfantdevelopment(Bornstein,2002)and itisaprocesswhich constitutesakeyfoundationalcomponentinthechild’slife.Inaddition,thebirthofanychildwithspecialneedspresents significantdifficultiestotheparents.TakingintoaccountthecharacteristicsofASD,rearingachildwiththosedevelopmental difficultiesisanimportantanduniquechallengeforbothmothersandfathers.
ARTICLE INFO Articlehistory:
Received4October2013
Receivedinrevisedform27June2014 Accepted4July2014
Availableonline26July2014 Keywords:
AutismSpectrumDisorder(ASD) Mothersandfathers
Parentalstress Parentalattitude Parentalmentalhealth
ABSTRACT
RearingachildwithAutism SpectrumDisorder (ASD)is auniquechallengeforboth parents.Previousstudiesaddressedhowmothersareaffectedbythechallengesofraising a child with ASD, mostly in terms of stress pattern. In this study, we focused on comparisonsbetweenmothersandfathersofchildrenwithASDinparentalstress,attitude andmentalhealth.Weexamined99parentsofchildrenwithASDusingtheParenting StressIndex-ShortForm, theParentalStyle Questionnaire,theSelf-Perceptionsofthe ParentalRoleandtheSymptomChecklist-90-Revised.Theresultsrevealedthegender differencesintheparentalattitudeandmentalhealth.Mothersreportedthattheyengaged inmoresocialbehaviorswiththeirchildrenthanfathers.Inadditionmothersreported higherlevelof depressionthanfathers.Nodifferenceamong parentsemerged inthe ParentingStressIndex-ShortForm.Theresultsofamultipleregressionanalysisrevealed thatparentingdistressisassociatedwithdepression,balanceofparents’diverserolesin theirlife anddysfunctional interactionbetweenparentsandchildren. Thesefindings highlightbothsimilaritiesanddifferencesbetweenmothersandfathersofchildrenwith ASDand the existence ofa relationshipbetween parental stress, mental healthand attitude.Resultssuggesttheimportanceofdevelopingspecificinterventionprograms whichincorporatethesefundamentalparentingdomains.
ß2014ElsevierLtd.Allrightsreserved.
* Correspondingauthorat:DepartmentofPsychologyandCognitiveScience,UniversityofTrento,ViaMatteodelBen5B,38086Rovereto,Italy. Tel.:+390464808115.
E-mailaddress:yagmur.ozturk@unitn.it(Y.Ozturk).
ContentslistsavailableatScienceDirect
Research
in
Autism
Spectrum
Disorders
J ou rna l hom e pa ge : h tt p: / / e e s . e l se v i e r . com / R AS D / de f a ul t . a s p
http://dx.doi.org/10.1016/j.rasd.2014.07.001
Inthelastdecademanystudieshavetendedtofocusonhowparentsareaffectedbythechallengesofraisingachildwith ASD, particularly in terms of their stress (Baker-Ericzn, Brookman-Frazee, & Stahmer, 2005; Davis & Carter, 2008; Eisenhower,Baker, &Blacher,2005;Hastings,2003;Hoffman,Sweeney,Hodge,Lopez-Wagner,&Looney,2009; Moes, Koegel,Schreibman,&Loos,1992;Sharpley,Bitsika,&Efremidis,1997;Tehee,Honan,&Hevey,2009).However,fartoolittle attentionhasbeenpaidtootherimportantdomainsofparenting,suchasparentalattitudewhichisthewayparentsbehave, andmentalhealthwhichdescribesalevelofpsychologicalwell-being.Inaddition,thereisalittlediscussionaboutfathersof childrenwithASD,eventhoughfathersareimportantasmothersinchildren’sdevelopment(Parke,2002).Inthepresent study,weaimedtoexaminetheprofilesofbothmothersandfathersofchildrenwithASDaddressingparentingstress, parentalmentalhealth,andparentalattitude.Itiscrucialtotakeparentsintoaccountinordertogainabetteranddeeper understandingoffamilydynamicsofchildrenwithASD,andtodevelopstrategiestosupportsbothparentsandchildren. Oneofmostfrequentlyexaminedaspectsofparentingisstress.Inthepastdecade,anumberofresearchershaveattempted todescribeparentingstress(Crnic&Low,2002;Deater-Deckard,2004),asasetofprocessesthatleadtoaversivepsychological andphysiologicalreactionsarisingfromattemptstoadapttothedemandsanditisoftenexperiencedasnegativefeelings towardandabouttheselfandthechild(Deater-Deckard,2004).Avarietyofinteractingvariablescontributeovertimeto parents’perceptionofstress,suchaspresenceofchallengingsituations(Crnic&Low,2002;Deater-Deckard,2004).Considering thefactthatASDaffectsnotonlytheworldofachild,butalsotheparents’life,thechild’sdisabilitywhichisaconsiderable challengingsituationisafundamentalvariabletotakeintoaccountinthetopicofparentingstress.
Themajorityofstudieshavefocusedonmaternalstress,mostlycomparisonbetweenmotherswhoaredifferentiateddue totheirchildren’sconditions(e.g.,existenceofdisability).Eisenhowerandcolleagues(2005)foundthatmothersofchildren with ASD demonstrated more parenting stress than mothers of children with Down syndrome, undifferentiated developmentaldelays,cerebralpalsyandtypicaldevelopment.SimilarresultswereobtainedbyEstes,Munson,Dawson,and Koehler(2009)intheircomparisonofmothersofchildrenwithASDandchildrenwithdevelopmentaldelaywithoutautism. Hoffmanandcolleagues(2009)reportedthedifferencealsobetweenmothersofchildrenwithASDandmothersoftypically developingchildren.
However,littleattentionhasbeenspecificallydirectedtowardfathers(Flippin&Crais,2011).In1992,Rodrigue,Morgan, andGeffken(1992) suggestedthatfathersadaptrelativelywelltothedemandsassociatedwithraisinga childwitha developmentaldisability.WithrespecttofathersofchildrenwithASD, fathersaswellasmothers,werefoundtohave elevatedstresscomparedtothoseoftypicallydevelopingchildren(Baker-Ericznetal.,2005;Rao&Beidel,2009),however thereisnogeneralagreementinwhetheroneofparentsofchildrenwithASDexperiencehigherlevelofstressthanother. Somestudiesreportedthatmothersweresignificantlymorestressedandmoreinvolvedthanfathers(Moesetal.,1992; Sharpleyetal.,1997;Teheeetal.,2009),otherstudiesshowedthatmothersandfathershadsimilarstresslevels(Davis& Carter,2008;Hastings,2003).Similardebatestandsintheresearcheswhichfocusedonthecomparisonsbetweenmothers andfathersofchildrenwithotherdisabilitiesorwithoutdisabilities(Baker,1994;Beckman,1991;Deater-Deckard,2004; Perry,Sarlo-McGarvey,&Factor,1992;Theule,Wiener,Tannock,&Jenkins,2010).Itisinterestingtonotethat,althoughthey hadsimilarstresslevels,fathersofchildrenwithASDweremostlydistressedbythechild’sexternalizingproblems,while mothersweremoreaffectedbythechild’sregulatoryproblems(Davis&Carter,2008).
AlthoughmanystudiesofparentingachildwithASDhaveconcentratedinparentingstress,alsomentalhealthand well-beingofparents arean importantdomainof parenting. Mentalhealth hasbeenshown tohaveeffects on parenting; comparedtonon-depressedwoman,depressedmothershavebeenfoundtobemorenegativewiththeirchildrenfrom infancythroughadolescence(Foster,Garber,&Durlak,2008;Jacob&Johnson,1997).Moreover,ithasbeenpointedoutthat paternalandmaternaldepressionweresimilarlyassociatedwithchildadjustmentproblemsandmoreimpairedparent– childcommunication(Gottman&Wilson,2002;Jacob&Johnson,1997).Inaddition,well-beingofadultsandchildrenalikeis linkedtothetypesanddegreesofstressfulcircumstancesthattheyfaceintheirdailylives;thosewhoexperiencemore stressfuleventsaremorelikelytosufferfromdepressionandotherproblemsinmentalandphysicalhealth(see Deater-Deckard,2004).
Intermsofcomparisonbetweenparentswhoaredifferentiatedduetotheirchildren’sconditions,researchersshowed thatparentsofchildrenwithASDdemonstratedhigherlevelsofmentalhealthconcernsthanparentsoftypicallydeveloping childrenaswellaschildrenwithotherimpairmentssuchasintellectualdisability(Gauetal.,2012;Karst&VanHecke,2012; Olsson&Hwang,2001).However,thereisnoagreementintheexistenceofsimilaritiesordifferencesinthelevelofvarious psychopathologiesbetweenmothersandfathersofchildrenwithASD.Somestudiesreportedthatmothershavehigher levelsofdepression(Davis&Carter,2008;Hastingsetal.,2005;Olsson&Hwang,2001)andanxiety(Hastings,2003)than fathers,otherstudiesfoundnodifferencesindepression(Hastings,2003).
Anotherwell-knowndomainofparentingisparentalattitude.Allweknowaboutparentalattitudestowardrearinga childwithASDcomefromstudiesonparentalbeliefsandstyle.Parentalbeliefisaperceptionaboutchildrearingandanidea onwhichcomponentsparentingconsistsof.Specifically,beliefsarekeyaspectsofparentingbecausetheygenerateand organizeparentalbehaviorsandmediatetheeffectivenessofparentingandultimatelyaffectchilddevelopment(Bornstein& Lansford,2010;Bornstein&Venuti,2013;Bornstein,2002;Darling&Steinberg,1993;Senese,Bornstein,Haynes,Rossi,& Venuti,2012).Intermsofthedifferentparents’beliefs,Melson,Ladd,andHsu(1993)foundthatmotherswhoattributed difficultyinhelpingtheirchildrentoattainspecificqualitiesperceivedmoredifficultythandidthosemotherswhomade casualattributionstomaternalcharacteristicsorbehavior.CrnicandLow(2002)suggestedthatthismightbeespecially salientforchildrenwhohavespecialneeds.
Inadditiontoparentalbelief,anumberofstudiesfocusedontheimportanceofparentingstyleonacademicachievement ofchildreninschoolshighlighting(Cohen&Rice,1997;Fan&Chen,2001;McGrath&Repetti,2000).Withrespecttothe genderdifferences,anumberofreviewssuggestthatparentingbehaviorofmothersandfathersdifferinseveralimportant ways, suchasfatherinvolvementin infancyandchildhoodis quantitativelyless thanmotherinvolvement(Barnard& Solchany,2002;Parke,2002).Mothersspendmoretimewiththeirchildren,andtheinteractionsarecharacterizedbythe mother’scaregivingandmanagerialrole,whereasfathersspendmoreoftheirtimewiththeirchildreninplayactivities. Althoughparentingattitudeisimportantforthechilddevelopment,surprisingly,ithasnotbeenexploredfromthepoint ofparentsofchildrenwithASD.Neverthelessitisessentialtounderstandcaregivers’beliefintheirownabilitytoparent theirchildandintheirattitudestowardchildrearing.Therefore,inourstudy,weaimtoconsidertheparentalattitudeasone ofimportantdomainsofparenting.
Insum,todate,thestudieshavenotcoveredparentingachildwithASDinmuchdetail,themajorityofresearchhas beenconductedwithmothersandmostlyintermsofmaternalstresspattern.Inthepresentstudy,weaimedtodrawa comprehensiveprofileofbothmothersandfatherswhohavechildrenwithASDaddressingalltheimportantdomainsof parenting. In particular the goals of this studyare: (1) to determine whether mothers andfathers differin terms of parenting stress, parental attitude and parental health; (2) to examine the relationship between the parents’ attitudetowardchildrearing,thementalhealthofbothparentsandtheirexperienceofstress.Guidedbytheliterature on parenting, highlighting the differences between mothers and fathers in parenting stress and mental health (Davis&Carter,2008;Hastingsetal.,2005;Hastings,2003;Moesetal.,1992;Olsson&Hwang,2001;Rodrigueetal., 1992;Sharpleyetal.,1997;Teheeetal.,2009)wehypothesizedthatmothersandfathersdifferintermsofparenting stress,mentalhealth andattitude.Inaddition,weexpectedanassociation betweenparentingstress,mental health andattitude.
2. Method
2.1. Participantsandprocedure
The participantsin thepresent study were99 parents (50 mothers: Mage=40.67years, SD=5.66; 49 fathers: M age=44.1years, SD=5.72)of childrenwithASDand94 ofthemwerepaired(bothmotherand fatherofa childwere enrolled).Thechildren’saverageageatthetimeofthestudywas87.5months(SD=40.9months).Thediagnosisofchildren was confirmedthrough clinicaljudgmentby an independent clinician based on theDSM-IV-TR criteria forPervasive DevelopmentalDisorders(PDD)aswellasthroughtheAutismDiagnosticObservationSchedule-Generic(ADOS-G;Lord, Rutter,DiLavore,&Risi,2003)intheObservation,DiagnosisandEducationLabattheUniversityofTrento,Italy(27%ofthe samplewereautisticchildrenwithhighcognitivefunction,36%ofthesamplewereautisticchildrenwithlowcognitive function,25%werepervasivedevelopmentaldisordernototherwisespecified,and12%wereAspergersyndrome).Oneof threemoduleswasusedforthechildrenpassedthecut-offpointsfortheAutismSpectrumDisorder.Thesocioeconomic status(SES)oftheparentswascalculatedwiththeFour-FactorIndexofSocialStatus(Hollingshead,1975;Rossi,1994)which is todaythemostwidelyadoptedindexofSESinpsychologicalresearch(Bornstein,Haynes,O’Reilly,&Painter,1996; Bornsteinetal.,2003;DeFalco,Esposito,Venuti,&Bornstein,2008;Gottfried,1985;Ribasetal.,2003;Rossi,1994;Venuti& Senese,2007;Venuti,deFalco,Giusti,&Bornstein,2008).Inthepresentstudy,oursamplerepresentedamiddlestatusinthe Italianpopulation(M=36.42,SD=16.5).
Parentsweregivenfourquestionnaires:theParentingStressIndex-ShortForm(PSI/SF;Abidin,1995),theParentalStyle Questionnaire(PSQ;Bornstein,Haynes,etal.,1996;Bornsteinetal.,1996),theSelf-PerceptionsoftheParentalRole(SPPR; MacPhee &Benson, 1986)andtheSymptomChecklist-90-Revised(SCL-90-R;Derogatis&Lazarus, 1994).Bothparents completedthequestionnairesontheirown(takingapproximately45mintodoso)andreturnedthemtotheresearchers. 2.2. Measures
2.2.1. TheParentingStressIndex-ShortForm
(PSI/SF;Abidin,1995)isaself-reportedmeasuredesignedtoevaluateparentingstress.Itconsistsof36itemsthatparents respondtoona5pointLikert-typescaletoindicatethedegreetowhichtheparticipantsagreewitheachstatement,ranging from1(StronglyAgree)to5(StronglyDisagree).ThePSI/SFiscomposedofthreescales:ParentalDistress(PD),DifficultChild Characteristics(DC)andParent–ChildDysfunctionalInteraction(P-CDI).ThePDscaleconsistsofitemsrelatingthedistress parentsexperienceintheirrolesasparentsasafunctionofpersonalfactorsthataredirectlyrelatedtoparenting.Asample itemfromthePDscaleis:‘‘SincehavingachildIfeelthatIamalmostneverabletodothingsIliketodo’’.TheDCscale measuresparents’perceptionrelatedtosomeofthebasicbehavioralcharacteristicsofchildrenthatmakethemeasyor difficulttomanage,forexample,‘‘MychildturnedouttobemoreofaproblemthanIhadexpected’’.TheP-CDIscalefocuses onparents’perceptionsoftheinteractionsystembetweentheparentandchildthroughitemssuchas,‘‘MosttimesIfeelthat mychilddoesnotlikemeanddoesnotwanttobeclosetome’’.ThePSIincludesaDefensiveRespondingscale(DF)that indicatesthedegreetowhichtheparentmightbeattemptingtogiveamorepositiveself-image,denystressorminimize problemsintheirrelationshipwiththeirchild.ThePSIalsoyieldsaTotalStressscore(TS)thatisthesumofPD,P-CDIandDC toprovideanindicationofthetotallevelofparentalstressthatanindividualisexperiencinginhis/herroleasaparent.
Ingeneral,foreachscale,ascorerangingbetweenthe15thand80thpercentileisconsideredtypicalwhileequalor greaterthanthe85thpercentile(theclinicalcut-point)isconsideredashigh.AscoreontheDFscaleequaltoormorethan the10thpercentileindicateshighlevelsofdefensiveresponding.Thethreescalesandthetotalscalehaveshownhigh internalconsistency(Abidin,1995;Guarino,DiBlasio,D’Alessio,Camisasca,&Serantoni,2007).Inthepresentsample,alphas rangedfrom.84to.92formothersacrossthethreescalesandthetotalscale.Forfathers,alphasonthesescalesrangedfrom .81to.91.
2.2.2. TheParentalStyleQuestionnaire
(PSQ;Bornstein,Haynes,etal.,1996;Bornsteinetal.,1996)isaself-reportedmeasureofparentingbehavior.Itconsistsof 16itemsassessingthreeparentingstyle:SocialExchange(sensitivity,expressionsofaffection,andpositiveresponsiveness tothechild),Didactic/Material(providingstimulationandorganizinganenvironmentconducivetoexploration),andLimit Setting(emphasizingrulekeepingandmannerlinessinthechild).Parentswereaskedtoratetheitemsona5-point Likert-typescale(from1hardlyatallto5allthetime)howfrequentlytheyactuallyengageinspecificparentingbehaviors.ThePSQ scaleshavedemonstratedgoodinternalconsistencyandconstructvalidity(Bornstein,Haynes,etal.,1996;Bornsteinetal., 1996;Bornstein,Cote,&Venuti,2001;Venuti&Senese,2007).Forthepresentstudy,internalconsistenciesrangedfrom.71 to.78formothers,and.68to.80forfathers.
2.2.3. TheSelf-PerceptionsoftheParentalRole
(SPPR; MacPhee &Benson, 1986) is a self-reported measure containing22 itemsto assess thefour parental self-perceptions:Competence,Satisfaction,Investment,andRoleBalance.Eachitemhasapairofstatementsthatdescribes contrastingendpointsofthedimensiontominimizesociallydesirableresponses.Theparentswereaskedtochoosethe statementthatdescribestheirbestandthenchecks‘‘sortoftrueforme’’or‘‘reallytrueforme.’’Possiblescoresrangefrom1 (low perceived competence, satisfaction, investment, or role balance) to 5 (high perceived competence, satisfaction, investment,orrolebalance).SPPRscaleshaveshowngoodinternalconsistency,Cronbach’salphasrangedfrom.72to.80 acrossthescales(MacPhee&Benson,1986;Seybold,Fritz,&Macphee,1991).Thegoodinternalconsistencywasconfirmed inthepresentstudywithCronbach’salphasrangedfrom.75to.78formothersand.72to.77forfathers.
2.2.4. TheSymptomChecklist-90-Revised
(SCL-90-R;Derogatis&Lazarus,1994)isaself-reportedquestionnairecontaining90itemstoscreenforabroadrangeof symptoms.Itconsistsof9primarysymptomdimensions:Somatization(SOM),Obsessive–Compulsive(O–C),Interpersonal Sensitivity(I-S),Depression(DEP),Anxiety(ANX),Hostility(HOS),PhobicAnxiety(PHOB),ParanoidIdeation(PAR),and Psychoticism(PSY). Parents wereaskedto answerto on a 5 point Likert-type scale, rangingfrom‘‘not at all’’(0) to ‘‘extremely’’(4).Thescaleshavedemonstratedgoodinternalconsistency(Derogatis&Lazarus,1994;Sarno,Preti,Antonio,& Madeddu,2011).Forthepresentstudy,theinternalconsistencyrangedfrom.63to.91formothers,from.62to.81forfathers acrossthescales.
2.2.5. TheAutismDiagnosticObservationSchedule-Generic
(ADOS-G;Lordetal.,2003)isasemi-structured,standardizedassessmentusedfordiagnosingindividualswithASD.Itis anassessmentofthechild’ssocialinteraction,communication,play,andimaginativeuseofmaterialsthroughaninteraction witha trainedprofessional.WeuseADOS-Gtoclassifythechildrenashavingautismandtoexaminetherelationship betweenparentingmeasuresandthreescoresofADOS-GwhichareCommunicationscore,ReciprocalSocialInteraction score,Totalscore(asumoftheCommunicationandReciprocalSocialInteractionsscores).Goodinternalconsistencyhave beenreportedbyLordandcolleagues(2003).
2.3. Dataanalyses
Firstofall,weremovednineofthe99parents(threemothersandsixfathers)fromtheanalysis,sincetheyhadhighlevel scoresontheDefensiveRespondingscaleofthePSI/SF.Weperformedpreliminaryanalysesontheremaining90parents(47 mothersand43fathers),reportingdescriptivestatisticsofeachparentingmeasuresafterincompletecaseswereremoved. Moreover,wecheckedifthereisacorrelationbetweentheparentingmeasuresandtheADOS-G.
Thenweexaminedallthequestionnairestodetermineifthereareanygenderdifferencesandassociations,usingonly pairedsamples(bothparentsofachild).WeexploredgenderdifferencestestingthePSI/SF,thePSQandtheSPPRscoreswith pairedt-tests,afterhavingcheckednormalitywiththeShapiro–Wilktest.FortheSCL-90-R,WilcoxonSigned-Ranktestwas usedduetosmallsamplesize(20mothersand20fathers).Moreover,correlationanalysiswasperformedtodeterminethe relationshipstrengthbetweenparents’scalescoresofthePSI/SF,thePSQ,theSPPRandtheSCL-90-R,usingPearsonfor normally distributed variables, and Spearman correlation coefficients for the remaining comparisons. We reported correlationcoefficientsfrommoderatetostrong,i.e.,rangingbetween0.50and1.00,orbetween 0.5and 1.00,repeating theanalysisforallparentstogetherandalsoformothersandfathersseparately.
Finally,tofurther exploretherelationshipbetween parentingstressandotherparentingdomains,wecarriedouta multipleregressionanalysisonthe90subjects.First,linearmodelswerebuiltbothusingforwardselectionandbackward eliminationtechniquesusingallparentingdomainmeasuresandchoosingthebestmodelonthebasisofminimumBICscore
(Schwarz,1978).Thebestmodelwasverycomplex(having10explanatoryvariables),thuswerepeatthemodelbuilding proceduretothevariablesmorecorrelatedwithPD.AgainusingtheminimumBICscoreapproach,wechooseamodelwith3 explanatoryvariables.Themodelwasvalidatedusinga10-foldcrossvalidationprocedure.Inwhatfollowswereportand discussonlytheresultsofthemodelwith3explanatoryvariablessincethelossofperformanceofthismodel(adjustedR2
equalto0.56forthe3variablesmodelversus0.76forthe10variablesmodelafterthe10-foldcrossvalidationprocedure)are balancedbybetterinterpretabilityofthe10variablesmodel.
3. Results
Weinvestigatedtheassociationbetweenourmeasureson90parentsandthecorrespondingdemographicvariables:no associationsemergedbetweenparentingmeasuresandchildage,parents’age,orfamilySES.Moreover,wecheckedifthere isacorrelationbetweentheParentingStressIndex-ShortForm(PSI/SF)andtheADOS-G:astatisticallysignificantpositive correlationwasfoundbetweentheTotalStress(TS)scoreofthePSI/SFandCommunicationdomainoftheADOS-G(
r
=.50, p<.001).Formothers,weobservedastatisticallypositivecorrelationbetweenTSandCommunication(r
=.53,p<.001); whereas,forfathers,wedetectedacorrelationbetweentheDifficultChild(DC)scaleofthePSI/SFandCommunication (r
=.50,p<.001).Regardingtotheothermeasures,astatisticallysignificantpositivecorrelationwasemergedforfathers betweentheSomatizationscaleoftheSCL-90-RandCommunicationdomainofADOS-G(r
=.57,p=.003).MeanscoresandpercentagesofsubjectsinclinicallysignificantrangeamongmothersandfathersonthePSI/SFare presentedinTable1.Tables2and3showthemeanscoresforthePSQ,theSPPRandtheSCL-90-R.Thedataintablesare basedondifferentsamplesizesbecauseofincompletedata.
Focusing on genderdifferences, wefounda statistically significantresult inthe Social Exchange scaleof thePSQ, t(31)=3.46,p=.002(seeFig.1):mothersreportedhigherscorethanfathersinthisscaleMoreover,astatisticallysignificant differenceemergedintheDepressionscaleoftheSCL-90-R,T(19)=135,p=.03(seeFig.2):mothersreportedhigherlevelof depressionthanfathers.ItisworthnotingthatnogenderdifferenceswerefoundinthePSI/SFandtheSPPR.
Therelationships amongparentingmeasures, i.e.,betweenthescalesaredisplayedinFig.3.Wefoundstatistically significantpositivecorrelationsbothwithinthePSI/SFandwithintheSPPR.Inparticular,forthePSI/SF,wehighlightthe correlationbetweenPDandP-CDI(
r
=.53,p<.001),betweenPDandDC(r
=.55,p<.001),andbetweenP-CDIandDC (r
=.58,p<.001),whilewithintheSPPR,betweenRoleBalanceandSatisfaction(r
=.56,p<.001).Moreover,weobserved statisticallysignificantpositivecorrelationsbetweenthePSI/SFandtheSCL-90-R:PDandDepression(r
=.56,p<.001),PD andHostility(r
=.55,p<.001).Furthermore,statisticallysignificantnegativecorrelationsbetweenthePSI/SFandtheSPPR emerged:PDandRoleBalance(r
= .60,p<.001),TSandRoleBalance(r
= .56,p<.001).Focusing separately on mothers or fathers some differences emerged. In particular, for mothers, two over three correlationswereconfirmedwithinthePSI/SF:PDandP-CDI(
r
=.51,p<.001),andPDandDC(r
=.56,p<.001),aswellas withinthe SPPR:Satisfaction and RoleBalance (r
=.53, p<.001).Moreover, wefoundstatisticallysignificantpositive correlationswithinthePSQ:SocialExchangeandDidactic(r
=.54,p<.001).ThecorrelationbetweenthePSI/SFandthe SCL-90-Rarepartiallyconfirmed:PDandDepression(r
=.66,p<.001),andpositivecorrelationwasfoundbetweenPDand Anxiety(r
=.55,p<.01).AlsothenegativecorrelationsbetweenthePSI/SFandtheSPPRwereconfirmedinthematernal data:PDandRoleBalance(r
= .64,p<.001),TSandRoleBalance(r
= .58,p<.001).Interestingstatisticallysignificant negativecorrelationswerealsofoundbetweentheSPPRandtheSCL-90-R:RoleBalanceandAnxiety(r
= .52,p=.008), Satisfaction and Hostility (r
= .55, p=.004), Satisfaction and Phobic Anxiety (r
= .55, p=.005), Satisfaction and Psychoticism(r
= .54,p=.005).Paternal datawereinterestingaswell, wherethepositive correlationsfoundon thewhole datasetwereconfirmed withinthePSI/SF:PDandP-CDI(
r
=.54,p<.001),PDandDC(r
=.53,p<.001),P-CDIandDC(r
=.74,p<.001)andwithin theSPPR:RoleBalanceandSatisfaction(r
=.55,p<.001).Theresultsareconfirmedalsoforthecorrelationsbetweenthe PSI/SFandtheSCL-90-R:PDandDepression(r
=.58,p=.003),and PDandHostility(r
=.64,p<.001),andadditionally TSandDepression(r
=.55,p=.005),TS andHostility(r
=.54,p=.006).Furthermore,negativecorrelationsbetweenthe PSI/SF and the SPPR emerged as well: not only PD and Role Balance (r
= .52, p=.001), and TS and Role Balance (r
= .53,p<.001),butalsoP-CDIandSatisfaction(r
= .53,p<.001),DCandSatisfaction(r
= .52,p=.001),andTSandTable1
Meanscores(withStandardDeviation)andpercentagesofsubjectsinclinicalrangeontheParentingStressIndex-ShortForm(PSI/SF)on90samples(47 mothersand43fathers).PercentagesofsubjectsintheclinicalrangeforeachscaleofPSI/SFweredeterminedusingnormativeguidelinesprovidedinthe PSI/SFManual.
Mean(SD) %Clinicalrange
Mothers Fathers Total Mothers Fathers Total PD 55.0(27.3) 54.2(26.6) 54.6(26.8) 26 23 24 DC 81.6(20.7) 79.5(23.6) 80.6(22.0) 72 63 68 P-CDI 75.9(20.6) 77.7(21.3) 76.7(20.8) 47 53 50 TS 74.9(21.8) 74.2(24.2) 74.6(22.8) 49 51 50 Notes:PD:ParentalDistress,DC:DifficultChildCharacteristics,P-CDI:Parent–ChildDysfunctionalInteraction,TS:TotalStress.
Table2
Meanscores(withStandardDeviation)ontheParentalStyleQuestionnaireandtheSelf-PerceptionoftheParentalRoleon75 samples(39mothersand36fathers).
Mean(SD)
Mother Father Total
SocialExchange 4.11(0.44) 3.76(0.44) 3.94(0.47) Didactic/Material 3.48(0.54) 3.29(0.36) 3.39(0.47) LimitSetting 4.20(0.59) 4.00(0.64) 4.10(0.62) Competence 2.64(0.50) 2.52(0.41) 2.58(0.46) Satisfaction 3.37(0.48) 3.16(0.64) 3.27(0.57) Investment 2.44(0.34) 2.37(0.32) 2.41(0.33) RoleBalance 2.82(0.55) 2.76(0.51) 2.79(0.53) Notes:SocialExchange,Didactic/MaterialandLimitSettingarethescalesoftheParentalStyleQuestionnaire.Competence, Satisfaction,InvestmentandRoleBalancearethescalesoftheSelf-PerceptionoftheParentalRole.
Table3
Meanscores(withStandardDeviation)ontheSymptomChecklist-90-Revisedon52samples(28mothersand24fathers). Mean(SD)
Mother Father Total
SOM 0.58(0.47) 0.32(0.23) 0.46(0.40) O-C 1.51(1.86) 1.75(3.79) 1.62(2.89) I-S 0.68(0.75) 0.43(0.46) 0.56(0.64) DEP 0.69(0.60) 0.52(0.42) 0.61(0.53) ANX 0.55(0.51) 0.45(0.44) 0.50(0.48) HOS 0.56(0.68) 0.49(0.43) 0.53(0.57) PHOB 0.13(0.34) 0.11(0.21) 0.12(0.28) PAR 0.70(0.69) 0.47(0.50) 0.59(0.61) PSY 0.30(0.49) 0.21(0.25) 0.26(0.40) Notes:SOM:Somatization,O–C:Obsessive–Compulsive,I-S:InterpersonalSensitivity,DEP:Depression,ANX:Anxiety,HOS: Hostility,PHOB:PhobicAnxiety,PAR:ParanoidIdeation,PSY:Psychoticism.
Fig.1.BoxplotsoftheParentingStyleQuestionnairescoresgroupedbymothers(white)andfathers(gray).Anasteriskhighlightsthescalehaving statisticallysignificantdifferencebygender.
Satisfaction(
r
= .58,p<.001).Interestingly,LimitSettingscaleofthePSQwascorrelatedwithseveralscalesofthe SCL-90-R:LimitSettingandInterpersonalSensitivity(r
= .65,p=.001),LimitSettingandAnxiety(r
= .57,p=.005),LimitSetting and Hostility(r
= .52,p=.01),LimitSettingandParanoidIdeation(r
= .64, p=.001),LimitSettingand Psychoticism (r
= .66,p<.001).MultipleregressionanalysiswasusedtotestifthePDscorewassignificantlypredictedbyotherparentingdomain measures.Theresultsindicatedaregressionmodelwiththreepredictorsexplained64%ofthevariance(adjustedR2=.64,
F(3,43)=28.52,p<.001;seeTable4)ofthedatasetonwhichitwasbuiltandpredictsthePDscoreonthe10-fold cross-validationtestsetswithagoodaccuracy(adjustedR2=.56,ascomputedbytheDAAGRpackage).Thesethreepredictorsare
theRoleBalance,theDepressionandtheP-CDIscores.Fig.4showsthecomparisonbetweenthepredictedvaluesofPD versustherealvalue.
4. Discussion
ThepurposeofthisstudywastoexaminetheprofilesofbothparentsofchildrenwithASDaddressingthreeimportant domainsofparenting.Specifically,weaimedtodeterminewhethermothersandfathersdifferintermsofparentingstress, parentalattitudeandmentalhealth.Thesecondaimofthisworkwastoexaminetherelationshipbetweentheparental attitudestowardchildrearing,thementalhealthconditionsofbothparentsandtheirexperiencesofstress.Tothebestofour knowledge,this is thefirstattempttocover parentinga child withASDin muchdetail. Ourresultshighlightedboth similaritiesanddifferencesbetweenmothersandfathersofchildrenwithASDandtheexistenceofalinkbetweenparenting distressandotherparentingdomains. Below,wediscusstheresultswithrespecttoeach parentingdomain,providing possibleinterpretations.
Wefounddifferencesamongparentsintermsoftheirscoresonmeasuresofattitudeandmentalhealth.Theseresultsare partiallyconsistentwithourhypothesis.Consideringtheparentalattitude,wefoundthatmothersreportedhigherscoreon theSocialExchangescale oftheParentalStyle Questionnairethanfathers.Socialexchangesareaffectiveinterpersonal dyadicinterchanges(Barnard&Solchany,2002;Kaye,1982)thatincluderocking,kissing,comforting,smiling,andplayful face-to-facecontact(Bornstein&Cote,2004).Apossibleexplanationofthisfindingliesindegreetowhichparentsengage withtheirchildren.OurdatasuggestthatmothersofchildrenwithASDactuallyengageinmoresocialbehaviorwiththeir childrenthanfathers.Thisresultmaybeinterpretedinlightoftheliteratureonthemother–childinteractionintypical development.Inapreviousstudy,indeed,Italianmothersreportedthattheyinteractedwiththeiryoungchildreninsocialas wellasdidacticways(Seneseetal.,2012).Ourfindingsexpandthisresult,byextendingtomothersofchildrenwithASDand introducingacomparisonwithfathers.Theseresultsfurthersupporttheideathatmothersandfathersinteractwithandcare forchildren indifferentandoftentimescomplementaryways(Barnard &Solchany, 2002;Parke,2002). Alsoparenting responsibilities,likesocialexchange,usuallyfalltomother(Bornstein&Sawyer,2008).Consideringthatsocialinteractions
Fig.2.BoxplotsoftheSymptomChecklist-90-Revisedscoresgroupedbymothers(white)andfathers(gray).Anasteriskhighlightsthescalehaving statisticallysignificantdifferencebygender.SOM:Somatization,O–C:Obsessive–Compulsive,I-S:InterpersonalSensitivity,DEP:Depression,ANX: Anxiety,HOS:Hostility,PHOB:PhobicAnxiety,PAR:ParanoidIdeation,PSY:Psychoticism.
includedifferentbehaviorswhichparentsusetoengagechildreninvisual,verbal,affectiveandphysicalinterpersonal exchanges(Bornstein,2002;Seneseetal.,2012)andmotherstendtotakeonmoreparentingresponsibilities(Bornstein& Sawyer,2008),itcouldbethat,comparedtofathers,mothersinoursamplemaytakeonmoreresponsibilityforthesocial interactionthanfathers.Inotherwords,parentingattitudeofmothersandfathersdifferinsocialbehaviorstotheirchildren.
Table4
PredictorsoftheParentalDistress(PD). Model Estimate StdE (Intercept) 59.3776* 19.3255 Rolebalance 18.9628** 5.0236 P-CDI 0.4385** 0.1126 Depression 21.8309*** 4.7527 (Adjusted)R2 0.6422 F 28.52 BIC 411 CV(Adjusted)R2 0.5509
Note:N=47(removed43sampleswithincompleteinformation).StdE=standarderror, BIC=BayesInformationCriterion,CV=cross-validation,P-CDI:Parent–Child Dysfunc-tionalInteraction.
* p<0.01. ** p<0.001. *** p<0.0001.
Fig.3.Correlationplotonallparents’data.Forimprovingreadability,thecorrelationcoefficientsaremultipliedby100.Comparisonsarecolorcoded accordingtotheassociationstrength:blueindicatingastrongpositivecorrelationandredindicatingastrongnegativecorrelation.PD(ParentingDistress), P–CDI(Parent–ChildDysfunctionalInteraction),DC(DifficultChild),andTS(TotalStress)arefromtheParentingStressIndex-ShortForm(PSI/SF). Investment,Competence,RoleBalance,andSatisfactionarethescalesoftheSelf-PerceptionsoftheParentalRole(SPPR).SocialExchange,Didactic,and LimitSettingarefromtheParentalStyleQuestionnaire(PSQ).SOM(Somatization),O–C(Obsessive–Compulsive),I-S(InterpersonalSensitivity),DEP (Depression),ANX(Anxiety),HOS(Hostility),PHOB(PhobicAnxiety),PAR(ParanoidIdeation),andPSY(Psychoticism)aretheSymptom Checklist-90-Revised(SCL-90-R).(Forinterpretationofthereferencestocolorinthistext,thereaderisreferredtothewebversionofthearticle.)
Withrespecttotheparentalmentalhealthandwell-being,inlinewithourhypotheses,adifferenceemergedfromthe DepressionscaleoftheSymptomChecklist-90-Revised.Thisscalesummarizesawiderangeofaccompanyingsymptomsofa depressivesyndrome(i.e.,withdrawal,lossofmotivation,suicidalthinking,lossofvitalenergy;seeDerogatis&Lazarus, 1994).Inourstudy,specifically,mothersofchildrenwithASDreportedhigherlevelofdepressionthanfathersofchildren withASD.Inthelightofthepresentstudyandfromtheresultsofpreviousresearch,itappearsasthedifferenceamong parents emerged in psychopathologicalproblems,reflecting characteristics of thedepressivesyndrome. This resultis consistentwiththoseofHastingsandhiscolleagues(2005)whofoundgenderdifferencesinmentalhealthwithmothersof childrenwithASDreportingmoreproblemsthanfathers,intermsofdepression.Moreover,similarresultshavebeenfound amongparentsofyoungnewlydiagnosedchildren(Davis&Carter,2008).
WhydidmothersofchildrenwithASDshowhigherlevelofdepressionthanfathers?Apossibleexplanationmayconcern thedifferencesinresponsibilityassignedtoparentingfromeachparent.Asamatteroffact,historically,mothersremainthe primarycaregiversoftheirchildreninthevastmajorityofculturesaroundtheworld(Barnard&Solchany,2002),andthey morelikelyassumethemanagerialrolethanfathersfromtheirchildren’sinfancythroughmiddlechildhood(Parke,2002; Russell&Russell,1987).Also,Winnicott(1965)describedmotheringasa‘‘holdingenvironment’’forthechild,andproviding a holdingenvironmentrequiresthatmothershavethephysicaland psychologicalresourcestobeonalert tothechild (Barnard&Solchany,2002).Thus,parentingisoftenequatedwithmothering(Bornstein&Sawyer,2008).Inlinewiththese ideas,OlssonandHwang(2001)suggestedthatmotherstakeonalargerpartofextracareandpracticalworkthatthechild withdisabilities requires. In oursample,it couldbethat, mothersof children withASDexperience more depression symptomscomparedtofathersofchildrenwithASD,duetothefactthattheyaremoreinvolvedincaregivingactivities,they takemoremanagerialresponsibilitiesandthereforetheyaremoreexposedtothedifficultiesinrearingachildwithspecial needs(Barnard&Solchany,2002;Crnic&Low,2002;Parke,2002).Howeverfurtherstudiesareneededtoconfirmthis hypothesis.
Besidesthosedifferences,wefoundalsosomesimilaritiesbetween mothersand fathersintermsoftheir scoreson measuresofparentingstress.Theresultsshowthattherewerenosignificantdifferencesbetweenmothers’andfathers’ meanscoresinallaspectsofparentingstress(inallscalesandtotalscoreoftheParentingStressIndex-ShortForm).Although theseresultsdifferfromsomepublishedstudies(Moesetal.,1992;Sharpleyetal.,1997;Teheeetal.,2009),theyare consistentwiththoseofotherstudiessuggestingthatmothersandfathershavesimilarparentingstresslevels(Davis& Carter,2008;Hastings,2003).Moreover,itisimportanttonotethatconsiderablepercentagesofmothersandfathershave scoresabovetheclinicalcut-points,showingthattheyexperienceclinicallysignificantlevelsofparentingstress.Taken together, these resultspoint outthat both mothers and fathersof children withASDhave elevated parentingstress, consistentwiththepreviousstudyofDavisandCarter(2008)whichreportedthatmanymothersandfathersofrecently diagnosedtoddlerssharehighlevelsofstress.TheexperienceofraisingachildwithASDcanbestressfulonindividual parents,asbothmothersandfathersofchildrenwithASDhavebeenshowntoexperiencesignificantstress.Ourresults
Fig.4.Regressionplot.The(observed)valuesoftheParentalDistress(PD),onthexaxis,arecomparedwiththevaluespredictedbythethreevariables regressionmodel,ontheyaxis,whichmeansbytheRoleBalance,theDepressionandtheP-CDIscores.
showedthatthelevelsofparentingstressdidnotreallydifferbetweenmothersandfathersofchildrenwithASD,inlinewith othersstudiesonmothersandfathersoftypicallydevelopingchildren(Baker-Ericznetal.,2005;Rao&Beidel,2009).Given theuniqueandimportantchallengesinraisingachildwithASD,theseresultshighlighttheneedtoconsiderpaternalstress inadditiontomaternalstressinthefurtherresearchandalsoinfamilyinterventions.
OtherimportantfindingsfromourstudyarethepositivecorrelationsfoundbetweentheParentingDistressandthe Depression,theParentingDistressandtheParent–ChildDysfunctionalInteraction,andthenegativecorrelationbetweenthe ParentingDistressandtheRoleBalanceinallsubjects.Itisworthnotingthat,thesearealsothemostconsistentpredictorsof theParentingDistresswithrespecttotheresultsofourmultipleregressionanalysis.Thissuggeststhatthoseparentswho havehighlevelsofdepressionsymptoms,highlevelsofstressrelatedtotheinteractionwiththeirchildrenwithASD,andless balanceofthediverserolesintheirlife,aremorelikelytoexperiencehighstressintheirroleasaparentandpersonalfactors thataredirectlyrelatedtoparenting.Inotherwords,thelevelofdepressivesymptom,theinteractionsystembetweenthem andtheirchild,andthewayinwhichparentsbalancetheirroleslinktothedegreeofstressrelatedparentalfunctioning. ThesefindingsareconsistentwiththoseofPhetrasuwanandShandorMiles(2009)thatshowedtherelationshipbetween highstressandmoredepressionsymptoms.Ourresultsindicatethatthepsychologicalsituationsofparents,inparticular depressivesymptoms includesfeeling hopelessness, lack of motivation, loss of vital energy is one of the sources of experiencingparentingdistress.Thisfindinghighlights theimportanceofparents’ownsenseofwell-being.Moreover, ineffectivenessintheintegrationofparents’diverserolesislinkedtotheparentingdistress.Arecentreviewstudyreports theimpactofhavingachildwithASDextendsbeyondcaregiverstotheentirefamily(Karst&VanHecke,2012).Itislikely thatparentsareexperiencingseveralchallengesinbalancingtheirroleofemployee,parent,spouse,caregiver,andthis situationisanothersourceoftheparentingdistress.Inaddition,stressasafunctionofdysfunctionalinteractionsbetween parentsandtheirchildisrelatedwiththeparentingdistress.Webelievethatthesethreekeyaspectsofparenting,namely parentalattitude,parentalmentalhealthandstressrelatedtothedifficultiesinparent–childinteraction,areimportantto defineandunderstandparentingstressinordertogainadeeperunderstandingofparentingachildwithASD.
Moreover,itisnoteworthythattwoscalesoftheParentingStressIndexarecorrelatedwithaspecificaspectoftheAutism DiagnosticObservationSchedule-Generic(ADOS-G).TheCommunicationscaleoftheADOS-Gispositivelycorrelatedwith theDifficultChildscoreoffathersandwiththeTotalStressscoreofmothers.Inotherwords,thewayinwhichchildrenuseto communicate with others is associated with child related stress of fathers; whereas this children’s communication functioningisrelatedwithtotalstressofmothers.Ourresultsarepartiallyinlinewiththepreviousstudywhichshowedthe correlationbetween child behavior problems and mothers’ stress(Hastings, 2003). Interestingly, in our sample, this associationisemergedwithinfathersonlyfromstressrelatedtothecharacteristicsofchildrenthatmakethemdifficultto manage.Ontheotherhand,withinmothers,itisrelatedwithallaspectsofstress(parentingdistress,stressrelatedtothe interactionwiththeirchildren,andchild-relatedstress).Consideringthatmotherstakemoremanagerialresponsibilities thanfathersincaregivingactivities(Parke,2002;Russell&Russell,1987),itislikelythat mothersandfathersmaybe affecteddifferentlybychildren’scommunicationproblems.
AfurtherinterestingresultemergingfromouranalysesisthenegativecorrelationsforfathersbetweentheLimitSetting scaleoftheParentingStyleQuestionnaireandseveralscalesoftheSymptomChecklist-90-Revised(InterpersonalSensitivity, Anxiety,Hostility,ParanoidIdeationandPsychoticism).LimitSettingisascaleinwhichparentsreportedthemselveshow frequentlytheyactuallyengageinthisspecificparentingbehavior,inthiscaseitrepresentsemphasizingrulekeeping, firmnessindiscipliningandmannerlinessinthechild.Thisparentingstyleincludesmanywaysinwhichparentsguide children’sbehavior(Bornstein&Cote,2004).Inoursample,theresultshowedthattheLimitSettingisassociatedwiththe levelofabroadrangeofsymptomsforfathers.Formothers,instead,theSatisfactiondimensionoftheSelf-Perceptionsofthe ParentalRoleisnegativelycorrelatedwithasetofscalesoftheSymptomChecklist-90-Revised(Hostility,PhobicAnxietyand Psychoticism).A previous study of Furey and Forehand (1984) showedthe relationship between maternal parenting satisfactionanddepression,whereas,inoursample,theself-perceptionofparentingsatisfactionisassociatedwiththelevel ofHostility,PhobicAnxiety,Psychoticismsymptoms.Takentogether,mothers’andfathers’mentalhealthconditionsare associatedwithbeingsatisfiedandbehavingsuchalimitsetting.Itindicatesthatthemoremothersfeelsatisfiedintheir caregivingrelationships,thelesslevelofseveralpsychologicalsymptomsarereportedandthemorefathersthinkthatthey interactwiththeirchildreninalimit-settingway,thelesslevelofseveralpsychologicalsymptomsareexpressed.These cognitionsreflectimportantaspectsabouttheexperienceofparentingandplayaroleinchilddevelopment(Bornsteinetal., 2003). The findings of thecurrent study enhance ourunderstanding of maternal and paternal attitude, showingthe associationswithdiversepsychologicalconditionsofmothersandfatherswhohaveachildwithASD.
Finally,anumberofimportantlimitationsneedtobeconsideredinthepresentwork.Firstofall,althoughthesamplesize wasenoughtoperformthecorrelationsanalysisforeachgender,themultipleregressionanalysescouldbedoneonlywithin allsubjects,notspecificallywithinmothersorfathers;duetothesmallervalidationdatasetwithineachgendertobuildthe bestlinearmodel.Withalargersamplesizesforbothgenders,itwouldbepossibletoexaminethepredictorsofparenting stressformothersandfathersseparately.Therefore,furtherresearchisneededtoconcentrateontheinvestigationofthe predictorsofmothersandfathers.Moreover,althoughthemeasuresappliedinthisworkarewidelyused,theybringanissue inthattheresultsemergefromself-reporteddata.Morebroadly,researchisalsoneededtodetermineparentingdomains usingdifferentmethodologicalapproachesinadditiontotheparents’self-reports.
In conclusion,thecurrent studyon families of children withASDprovidesinsights that willhelp researchersand clinicians tobetter understand the complexity of the treatment of children with ASD.Specifically, theresults make
noteworthycontributionstothecurrentliterature.Firstofall,weincludedfatherswhoaretypicallylessconsideredinthe literature,eventhoughfathersareimportantasmothersinchildren’sdevelopment(Parke,2002).Second,wetookinto considerationseveralimportantdomainsofparenting:stress,attitudeandmentalhealth;whereasmoststudieshaveonly beencarriedoutwithasmallnumberofparentingdomains(e.g.,stress).Takentogether,thecurrentfindingsaddtoa growingbodyofliteratureonparentingandautism.
Inaddition,thisstudyhasclinicalimplicationsandparentalpracticalimportance.Animplicationofthesefindingsisthat bothmothersandfathersshouldbetakenintoaccountbutconsideringthedifferencesandsimilaritiesbetweentheminthe parentingdimensionssincethesedimensionsaffectchilddevelopmentandhaveeffectsonparenting(Bornstein&Lansford, 2010;Bornstein,2002;Darling&Steinberg,1993;Fosteretal.,2008;Jacob&Johnson,1997;Seneseetal.,2012).Different parentalstyleandwell-beingbetweenmothersandfathers,whichwefoundinthepresentstudy,bringdiverseparental experience,andeventuallypracticaleffectsonparent–childrelation.Moreover,havinghigherlevelofstressinbothparents is worth to consider in the clinical implications and parental practice. Therefore, in line with our findings, specific interventionprogramsareneededforbothparentsaimedtoareductionintheirstresslevelswithtakingintoaccountthe differentparentalstyleandwell-beingbetweenmothersandfathers.Thoseinterventionsmightbenefitfromagreater understandingoftherelationshipbetweenstressandotherparentingdomains.Moreover,professionalsmighttakeinto accountamoreeffectivefatherinvolvementinthechildren’slifetomakefatherstoassisttheirchildrenandalsomothers.It mayhelptosharetheresponsibilitiesinthelifeoftheirchildren,anddecreasetheexperienceofstressanddepression.Inthis wayprofessionalswouldbeabletoassistbothparentscomprehensivelyinbecomingawareofimportantfactorstofocusand helpthemtocopeefficientlywithstressusingsuitablestrategies.
Acknowledgements
Wesincerelythankthefamiliesfortheirtimeandparticipation.TheprojectwassupportedbytheObservation,Diagnosis andEducationLabattheUniversityofTrento,Italy.
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