Maternal Cortisol Regulation Patterns, Perceived Parental Stress and Attachment Representations: Impact of a Service Dog's Presence in Families of Children with ASD

Background: Many parents of children with ASD express significantly elevated levels of stress (Baker-Ericzén et al., 2005). Interventions offered in childhood have positive effects on parental stress related to characteristics of the child (Keen et al., 2010). Based on previous studies, it is expected that the use of an assistance dog by the parent as a management strategy for overcoming situations of disability experienced by the child and the family can stimulate social interaction in children with ASD (Burrows et al., 2008) and help regulate the child’s physiological stress (Viau et al., 2010). The conceptual model preferred in this study refers to the inter-influence between parenting stress and diurnal cortisol regulation.   

Objectives: The study of biological markers in addition to parental stress offers a holistic approach to the regulation of stress by these parents. The current study seeks to better understand the adaptation of mothers according to their hormonal regulation, perceived parental stress and the contribution of their attachment style. Considering the additional obligations engendered by the presence of a dog in the family, we also consider the possible impact of managing a service dog on both psychological and physiological parental stress.

Methods: The use of a homogeneous group of service dogs offers a comparable response to each child and their families in addition to further identify their effects on parental stress. 85 mothers of children diagnosed with ASD (17 girls; ages 5-10 years-old) took part in this study and were distributed in two groups (43 families from a waiting list format to serve as a control group). After a three-week baseline period, a service dog was introduced in the 42 families from the experimental group. Salivary cortisol was collected in both groups at home one day per week (awakening, 30 minutes later and bedtime) for 15 weeks. Parental stress (Parental Stress Index short form; Abidin, 1995), severity of behaviours related to autism (Childhood Autism Rating Scale; Schopler et al., 1988), and parental attachment representations (Narrative-Based Attachment Script Assessment; Waters & Rodrigue-Doolabh, 2004) were evaluated.  

Results: Cluster analysis revealed two groups of patterns based on maternal cortisol regulations prior to the dog’s arrival characterized by the AUCg (area under the curve with respect to ground). No differences according to child's age, gender nor diagnostic, maternal age and group membership were observed between clusters. Once the clusters were divided in accordance to intervention protocol, higher AUCg at baseline described mothers from the control group. No associations were found between severity of behavioral characteristics related to autism, attachment representations and cortisol patterns. However, higher perceived parental stress was associated with a flatter diurnal rhythm of cortisol.

Conclusions: The findings suggest that the presence of a service dog in the family did not disrupt diurnal cortisol profiles. In consideration of previous research showing a variety of cortisol patterns, the current findings illustrate significant between-subject differences in profiles associated with high-perceived parental stress. Further analysis might allow us to better understand the bidirectional influences between these concepts specific to a family environment .