Caregiver Strain Varies By Sensory Subtypes of Children with Autism

Background: Caregivers of children with autism spectrum disorder (ASD) have higher levels of strain than caregivers of children with attention-deficit/hyperactivity disorder, developmental disabilities, or other healthcare needs (Cadman et al., 2012; Dabrowska & Pisula, 2010; Estes et al., 2009). High caregiver strain has been associated with poorer quality of life of the caregiver and negative health behaviors including: decreased physical activity; poor sleep patterns; difficulties with weight maintenance; smoking; and alcohol consumption (Rizk, Pizur-Barnekow, & Darragh, 2014; Gallant & Connell, 1998). Level of strain experienced by caregivers of children with ASD has been shown to be a function of many parent and child characteristics, including the child’s difficulty with reacting to everyday environmental sensory stimuli (Kirby, White, & Baranek, 2015; Schaaf, Toth-Cohen, Johnson, Outten, & Benevides, 2011). Recently, researchers have proposed a classification schema for children with ASD based on shared patterns of sensory difficulties that groups children into one of four sensory subtypes using parent responses to the Short Sensory Profile: Sensory Adaptive; Taste/Smell Sensitive; Postural Inattentive; and Generalized Sensory Difference (Lane et al., 2014). As these subtypes have been documented to differ on many behavioral characteristics, it is reasonable to hypothesize that caregivers of children in different subtypes may differ in level of perceived strain (Lane et al., 2010, 2011, 2014). Therefore, sensory subtyping may be a useful mechanism for determining which caregivers of children with ASD may be at risk for the highest levels of strain.

Objectives: We sought to examine the relationship between child sensory subtype and the level of strain reported by the caregiver.

Methods: This study used a non-experimental, cross-sectional design to conduct an online survey of caregivers of children with ASD (n=367). The primary variables of interest were child sensory subtype, as measured by the Short Sensory Profile (McIntosh et al., 1999), and caregiver strain, as measured by the Caregiver Strain Questionnaire (Brannan et al., 1997). Caregiver age, child age, household income, and number of children in the home were included as covariates. A canonical correlation analysis was conducted to examine the relationship between child sensory subtype and caregiver strain.

Results: Caregiver strain was significantly associated with the child’s sensory subtype membership, while controlling for demographic variables. Caregivers of children in the Sensory Adaptive subtype reported the lowest levels of caregiver strain, followed by caregivers of children in the Taste/Smell Sensitive subtype. Caregivers of children in the Postural Inattentive and Generalized Sensory Difference subtypes reported the highest levels of strain.

Conclusions: This study demonstrates that strain of caregivers of children with ASD is associated with the child’s sensory subtype. Findings from studies using qualitative methods suggest possible mechanisms by which caregiver strain is related to child sensory subtype membership; behaviors consistent with those observed in children in the Postural Inattentive and Generalized Sensory Difference subtypes, for example, were reported to result in disruption of family routines and social activities (Schaaf et al., 2011), which may explain why caregivers of children in these subtypes report the highest levels of strain.