Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Mar 27, 2019; 9(2): 30-46
Published online Mar 27, 2019. doi: 10.5498/wjp.v9.i2.30
Parenting preschoolers with autism: Socioeconomic influences on wellbeing and sense of competence
Nisha E Mathew, Karen L O Burton, Anne Schierbeek, Rudi Črnčec, Amelia Walter, Valsamma Eapen
Nisha E Mathew, Karen L O Burton, Rudi Črnčec, Amelia Walter, Valsamma Eapen, School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
Anne Schierbeek, Vrije Universiteit Amsterdam, De Boelelaan, Amsterdam 1081 HV, The Netherlands
Amelia Walter, Valsamma Eapen, Academic Unit of Child Psychiatry South West Sydney and Ingham Institute, South West Sydney Local Health District, Liverpool Hospital, ICAMHS, Mental Health Centre (Level L1), Locked Bag 7103, Liverpool NSW 1871, Australia
Author contributions: Mathew NE, Burton KLO, Schierbeek A, Črnčec R, Walter A, Eapen V contributed to this paper.
Institutional review board statement: The collection of information for this study was approved by the Human Research Ethics Committee at the University of New South Wales, Sydney, Australia.
Informed consent statement: Families provided informed consent for any information collected as part of a broader study of an early intervention program for Autism Spectrum Disorders to be discussed and published provided that all information included in any publication is anonymised such that they cannot be personally identified.
Conflict-of-interest statement: None.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Valsamma Eapen, PhD, Professor, MBBS, FRCPsych, Academic Unit of Child Psychiatry South West Sydney and Ingham Institute, South West Sydney Local Health District, Liverpool Hospital, ICAMHS, Mental Health Centre (Level L1), Locked Bag 7103, Elizabeth Street, Liverpool NSW 2170, Australia. v.eapen@unsw.edu.au
Telephone: +61-2-96164205 Fax: +61-2-96012773
Received: May 29, 2018
Peer-review started: May 29, 2018
First decision: July 9, 2018
Revised: February 5, 2019
Accepted: February 18, 2019
Article in press: February 19, 2019
Published online: March 27, 2019
Research background

There is converging evidence that higher levels of stress and psychological distress is experienced by parents of children with autism compared to typically developing children.

Research motivation

There is limited research on the role of socioeconomic status (SES) on the wellbeing of parents of preschool children with autism and its impact if any on parental competency and children's autism symptom severity

Research objectives

The primary objective of this study was to examine the relationship between symptom severity, SES and psychological wellbeing among parents of preschoolers with autism. The findings will have implications for future planning of services to support the parents and also for future research on family and psychosocial predictors of treatment response.

Research methods

The study assessed parents (mothers and fathers) of preschool-aged children with autism on their own perceptions of parental competence and wellbeing using questionnaires and children were assessed using objective standardised measures of autism severity, cognitive level and parent reports of adaptive functioning.

Research results

A differential impact was observed for mothers and fathers as to the impact of SES and their child’s symptom severity on their parenting competence and sense of wellbeing.

Research conclusions

The findings from this study suggest that SES differentially impacts the wellbeing and sense of parenting competence in fathers and mothers of preschool children with autism. While both mothers and fathers displayed higher levels of depression than normative populations, mothers also reported greater levels of stress and anxiety. Child symptom severity was associated with maternal parenting competency, and this was exaggerated among mothers with higher familial SES and who lived in areas of greater neighbourhood advantage. However, paternal parenting competence was generally not influenced by child adaptive functioning or symptom severity, albeit for those from higher familial SES background, there was an inverse relationship between children’s symptom severity and maladaptive symptoms and paternal sense of parenting efficacy. This has implications for service provision as it highlights the need for comprehensive assessment of the support needs for both fathers and mothers independently.

Research perspectives

Since this study was done in a specialised early intervention centre, the findings may have been influenced by sampling bias in terms of access to such services. In this regard, families in the lowest SES category were underrepresented and this was particularly the case for father participation in this research project. It is possible that lower SES families may not have had the benefit of early identification and enrolment to early intervention centres such as the one where this project was undertaken. This may have been compounded by the fact that fathers from lower SES background may have less time availability and capacity to participate in research. Future studies would benefit from targeted recruitment of those sections of the autism community who are currently not engaging with routine health services and are also underrepresented in research.