Parenting Stress in Families with Concerns about ASD in Toddlers Prior to a Diagnosis

Background: Parenting stress, a specific kind of stress that arises from attempts to adapt to the demands of parenthood, is associated with many domains of parent well-being (Deater-Deckard, 2004). Parents of children diagnosed with autism spectrum disorder (ASD) experience higher levels of parenting stress compared to parents of children with developmental delays and typical development (Hayes & Watson, 2013). However, parents often have concerns about ASD long before receiving a diagnostic evaluation and face many challenges associated with caring for their child in the time between initial concern and diagnosis (Zuckerman et al., 2015). Although initial reports suggest that ASD-concerned parents may experience greater parenting stress prior to diagnosis compared to parents without ASD concerns (Mulligan et al., 2012; Ibanez et al., in prep), parenting stress has not been investigated longitudinally. To better characterize the challenging experiences faced by ASD-concerned parents, work is needed to explore patterns of parentings stress across a uniquely tumultuous time in their child’s early development.

Objectives: To assess longitudinal level and change in parenting stress among parents with explicit concerns about ASD during their child’s early development.

Methods: Preliminary analyses were conducted on data collected from 282 parents expressing different kinds of concern about their young child’s development (ASD concerns, n = 50; other types of developmental concerns [e.g., motor delay], n = 57; no concerns, n = 175). Parents were recruited through their child’s health care provider as part of a larger study (data collection on-going). Self-reported parenting stress (Parenting stress Index-Short Form; Abidin, 1995) was collected 3 times at 3-month intervals from parents of children who were 16 to 36 months old. Time 1 measures of parenting efficacy (Maternal Efficacy Scale; Teti & Galfand, 1991), parent psychological and social well-being (WHO Quality of Life, 1997), and child social behavior (Parent Interview for Autism-Clinical Version; Stone, 2003) were tested as additional predictors of parenting stress. Preliminary analyses using Hierarchical Linear Models (HLM; Raudenbush & Bryk, 2002) examined between- and within-person variation in parenting stress over time.

Results: Preliminary results revealed that parenting stress remained stable across early development. However, parents concerned about ASD had significantly greater parenting stress compared to parents with non-ASD developmental concerns, b = 28.34, SE = 4.12, p = .000, and parents with no concerns, b = 31.96, SE = 3.50, p = .000. Additionally, higher levels of Time 1 parenting efficacy, psychological and social well-being, and child social behavior predicted lower levels of parenting stress, ps < .01. Finally, psychological well-being mitigated parenting stress more strongly among ASD-concerned parents compared to parents with no concerns, b = -6.50, SE = 3.04, p =.03.

Conclusions: Parents who are specifically concerned about ASD during their child’s early development experience levels of parenting stress that are consistently higher than parents with either non-ASD developmental concerns or no developmental concerns. However, greater psychological well-being may mitigate parenting stress among ASD-concerned parents, suggesting that parent-focused interventions to improve psychological health may benefit parents who are navigating unique challenges prior to an ASD diagnostic evaluation.