Associations between Stress and Resourcefulness Among Parents of Children Exhibiting Risk for Autism Spectrum Disorder

Background: Parents who are rearing children with a developmental disability have higher stress than parents raising typically developing children. Protective factors, such as optimism and social support, are associated with psychological well-being among parents of children with and without disabilities. However, little is known about when elevated stress among parents with developmental disabilities emerges; associations between parents’ level of stress and resilience prior to their child’s initial diagnostic evaluation has not been thoroughly researched. Resourcefulness refers both to internal processes to handle stress and external help-seeking behaviors that contribute to resilience. It is related to psychological adjustment in adults, but it has yet to be examined among parents whose children demonstrate risk for developmental disability.

Objectives: This study utilizes a strengths-based approach to investigate associations between child functioning, parents’ stress, and parents’ resourcefulness just prior to an evaluation. In particular, this study sought to understand whether resourcefulness plays a buffering role against stress for parents.

Methods: The sample consisted of 119 parents of toddlers (mean age=21.0 months; SD=4.0) who demonstrated risk on an autism-specific screening questionnaire and had no prior DSM-5 diagnoses. Prior to the child’s diagnostic evaluation, parents completed the Perceived Stress Scale and Resourcefulness Scale. During the evaluation, the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) was completed. Diagnostic outcomes included autism spectrum disorder (ASD; n=37), language disorder and other developmental disorder (DD; n=55), and no diagnosis (n=27). A moderation analysis was conducted to examine whether resourcefulness moderates the relation between child symptom severity (i.e., ADOS-2 comparison score) and parents’ stress.

Results: Parent perceived stress levels measured before their child’s evaluation were not significantly elevated (M=15.9, SD=7.5). Parent stress was significantly correlated with parent resourcefulness (r=-.267, p<.01). Moderation results indicated a significant moderating effect of resourcefulness on the relation between children’s autism symptom severity and parents’ stress, b=-.034, SE=.013, β=-.241, p=.009. Among parents with low levels of resourcefulness, high severity of autism symptoms was associated with high stress. Exploratory analyses examining ADOS-2 Social Affect subscale as the predictor also yielded significant moderation with significant simple slopes at both low (b=.977, p=.009) and high (b=-.839, p=.049) levels of resourcefulness. This demonstrates a buffering effect against stress associated with greater impairments in child social communication skills (i.e., having high resourcefulness may be a protective buffer). With ADOS-2 Restricted and Repetitive Behaviors score as the predictor in this model, the moderation was significant; however simple slopes were only significant at low levels of resourcefulness.

Conclusions: Although parent perceived stress levels were within normal limits, parents with low levels of resourcefulness may be vulnerable to stress related to severity of child’s very early symptom presentation. However, greater resourcefulness may be a protective factor against parent stressors associated with their child’s impairments in reciprocal social interaction and communication skills in particular. In the future, screening parents at risk for elevated stress and poor mental health functioning during the diagnostic evaluation of their child’s developmental disability may be helpful to promote positive well-being in parents after diagnosis of their toddler.