Association of Child Autistic Characteristics with Parenting Stress in Mothers of Children with Autism Spectrum Disorder: A Comparison between the United States and Japan

Background:

Research in various industrialized countries indicates mothers of children with Autism Spectrum Disorder (ASD) experience severe stress. Factors influencing stress in mothers of children with ASD are complex and reflect the sociocultural contexts of parenting. Child ASD characteristics may be strongly related to parenting stress in collectivistic cultures such as Japan. The atypicality of the child may be perceived more negatively compared to individualistic cultures such as the U.S. There is a need to understand how parenting stress is related to child ASD characteristics across cultures.

Objectives:

To investigate potential interactions between child ASD characteristics and the country of residence (US vs. Japan) in relation to parental stress in mothers.

Methods:

We used data from our ongoing cross-cultural research on mothers of children with ASD that included 52 mothers from the US and 51 Japanese mothers of children ages 2-12 years old with confirmed diagnosis of ASD. Each mother completed three questionnaires to measure characteristics of mothers (Parenting Stress Index (PSI)) and children (Social Communication Questionnaire (SCQ), Social Responsiveness Scale (SRS-2)), and one background questionnaire. The Japanese versions of the PSI, SCQ, SRS-2, and the background questionnaire were used for the Japanese participants. We used logistic regression to compare the association of child ASD characteristics with parental stress between the US and Japan.

Results:

Mean age of children from the US and Japan were 7.0 and 7.4 years respectively; 78.9 % and 76.5% of the children from the US and Japan were male, respectively. About 63% of the US mothers and 70% of the Japanese mothers showed clinically significant levels of parenting stress. There were no cross-cultural differences (p = .257) on the level of parenting stress measured by the PSI after controlling the child age and the parent’s socioeconomic status (SES) score. Comparison of child ASD characteristics measured by the SCQ and SRS scores indicated that Japanese children had significantly lower scores than those of the US (p = .004 and <.001, respectively). SCQ scores were associated (p = .047) with maternal stress related to child characteristics (Child Domain). However, there were no significant interactions between the SCQ and country in relation to maternal stress. For both countries the SRS score had a statistically significant association with maternal stress (US p = .004, Japan p = .034). After adjusting for children’s age and SES, one unit increase in SRS score was expected to increase the odds of clinically significant maternal stress by 6 % and 3 % in the US and Japan, respectively. However, the country difference was not statistically significant.

Conclusions:

This is the first study to examine cultural differences in the association of child ASD characteristics in maternal parenting stress. There were not differences by country in the level of parenting stress influenced by the level of child ASD characteristics (SCQ and SRS). Nevertheless, our study revealed that child ASD characteristics are associated with the level of parenting stress across the nationalities.