Examining the Relationship Between ASD Symptom Severity, Family Management Ability, and Parental Stress

Background and Purpose: The epidemic of autism spectrum disorders (ASD) has been characterized as "an urgent public health concern," which has significant implications for the family and larger culture. Indeed, the entrance of a child with an ASD into the family poses unique stressors and demands. Prior research has documented higher levels of depression, anxiety, embarrassment, and lower relationship satisfaction for parents of children with ASD when compared to parents of children with Down syndrome or no disability. In contrast, other studies have identified families who are thriving and attributing family benefits to their child with ASD. A small body of research suggests that the severity of the child’s symptoms is predictive of parental adjustment. Another possible reason for these variable parent outcomes is the family’s approach to managing their child’s condition. Little is known about the relationship between the way families respond to ASD and parent functioning. In the current study, we hypothesize that 1) ASD symptom severity will significantly predict parental stress; and 2) Family Management Ability (FMA) will moderate the relationship between ASD symptom severity and parental stress.

Methods: This study reports the findings of a cross-sectional survey of parents of children with ASD in a southeastern state. Participants included 102 parents whose children were living in the home. Participants were recruited via local service providers, ASD-specific list serves, and through letters sent through SC’s Department of Disabilities and Special Needs (DDSN). ASD symptom severity was assessed using nine likert-type items created for this study. FMA was measured with the Family Management Measure (FAMM), which includes 5 subscales. The Parental Stress Scale (PSS) was used to measure parental stress. Hierarchical multiple regression was employed to assess 1) the contribution of ASD severity to parental stress; and 2) the degree to which FMA moderated the relationship between ASD severity and parental stress.

Results: As hypothesized, ASD severity significantly predicted parental stress (R=.346^a; R²=.120; Adj-R²=.108) in the first step of the regression model. Consistent with the second hypothesis, when the FAMM scale scores were added to the model, the contribution of ASD severity to parental stress was no longer significant. The final model predicted 64.8% of the variance in parental stress (R=.822^b, R²=.675, Adj-R²=.648). Further examination of the FAMM subscales revealed that Family Life Difficulty (Beta=.778, P=.000) and Condition Management Ability (Beta=-.294, P=.004) made significant contributions to parental stress, while Condition Management Effort and Child’s Daily Life did not.

Conclusions and Implications: Results support the hypotheses that family management ability moderates the relationship between child symptom severity and parent’s experience of stress. In particular, we found that the degree to which parents perceive life to be more difficult when having a child with ASD, and parents’ perception of competence in managing the child’s condition contributed to their parental stress.  Findings suggest that FMA may be a modifiable protective factor against parent stress. Future research may be compelled to move beyond group-level comparisons to examine the family-level mechanisms through which ASD impacts parent adjustment.