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Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay
Open accessAbstract
Parents of children with developmental disabilities, particularly autism spectrum disorders (ASDs), are at risk for high levels of distress. The factors contributing to this are unclear. This study investigated how child characteristics influence maternal parenting stress and psychological distress. Participants consisted of mothers and developmental-age matched preschool-aged children with ASD (N = 51) and developmental delay without autism (DD) ( N = 22). Evidence for higher levels of parenting stress and psychological distress was found in mothers in the ASD group compared to the DD group. Children's problem behavior was associated with increased parenting stress and psychological distress in mothers in the ASD and DD groups. This relationship was stronger in the DD group. Daily living skills were not related to parenting stress or psychological distress. Results suggest clinical services aiming to support parents should include a focus on reducing problem behaviors in children with developmental disabilities.
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“It has been widely demonstrated that raising a child with autism involves chronic challenges consistently associated with high levels of psychological distress [3,4,5,6].”
From The effect of acceptance and commitment therapy for improving psychological well‐being in parents of individuals with autism spectrum disorders: A randomized controlled trial (2021) · cites this paper as [4]
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Taylor, J. L., & Warren, Z. E. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1375-x · Cited by 99
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BackgroundResultInfluentialPilot study of a school-based parent training program for preschoolers with ASD
Ingersoll, B. R., & Wainer, A. (2011) · Autism · doi:10.1177/1362361311427155 · Cited by 84
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“Mothers of children with autism have been shown to have a higher degree of stress as compared with mothers of children with other developmental disabilities (Estes et al., 2009).”
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“In another study, the authors examined how child characteristics influence parenting behavior and psychological stress among parents of young children with ASD and other developmental disabilities (Estes et al. 2009).”
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“…of childhood symptoms in general population studies (Ford et al., 2004) and parents of autistic children appear to be at greater risk, probably both for genetic (Bolton et al., 1998; Piven & Palmer, 1999) and likely environmental reasons, manifesting as parental stress (Estes et al., 2009).”
Parenting stress: A novel mechanism of addiction vulnerability
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“Many studies have reported that the behavioral problems of children with ASD were related to anxiety and depression as well as stress in the mothers.([11,22,23]) Children’s behavioral problems were positively correlated with maternal emotional problems and stress regardless of whether the total scores of the behaviora…”
BackgroundFactors associated with depressive symptoms in parents of children with autism spectrum disorders
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“These findings are interesting because higher levels of parental stress have been found in the parents of young children with autism than with other disabilities (Estes et al. 2009).”
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Investigating Parenting Stress across Pediatric Health Conditions - A Systematic Review
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“…compared to other disabilities, ASD is commonly cited as the most stressful disability for parents (Abbeduto et al., 2004; Eisenhower et al., 2005; Estes et al., 2009; Lecavalier et al., 2006), but as measured by the PSI-SF, the parents of children with FASD in our sample reported signifi cantly…”
BackgroundShrestha, A., Anderson, A., & Moore, D. W. (2012) · Journal of Behavioral Education · doi:10.1007/s10864-012-9165-x · Cited by 70
Factors associated with stress in families of children with autism spectrum disorder
Chamberlain, A., Vaz, S. M. A., Cordier, R., Joosten, A. V., Parsons, D. N., Smith, C., & Falkmer, T. (2017) · Developmental Neurorehabilitation · doi:10.1080/17518423.2017.1326185 · Cited by 83
Singh, N. N., Lancioni, G. E., Karazsia, B. T., Myers, R. E., Hwang, Y., & Anālayo, B. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00385 · Cited by 85
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“(Gupta, 2007; Meirsschaut, Roeyers, & Warreyn, 2010), higher than stress levels in parents of children with other disabilities (Estes et al., 2009; Phetrasuwan & Miles, 2009).”
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“…that caregivers of children with autism spectrum disorder (ASD) and other developmental disabilities (DD) experience higher levels of stress than parents of children without disabilities (e.g., Baker, Blacher, Crnic, & Edelbrock, 2002; Dyson, 1997; Estes et al., 2009; Rao & Beidel, 2009).”
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Guler, J., de Vries, P. J., Seris, N., Shabalala, N., & Franz, L. (2017) · Autism · doi:10.1177/1362361317716604 · Cited by 71
“Caregivers of children with ASD report significant economic and emotional impact of care, and higher rates of caregiver stress in comparison to families of children with other developmental disabilities (Abbeduto et al., 2004; Estes et al., 2009).”
Baylor, C. R., & Darling-White, M. (2020) · American Journal of Speech-Language Pathology · doi:10.1044/2020_ajslp-19-00043 · Cited by 69
“Similar literature is available relevant to families of children with disabilities that are often associated with communication disorders (Abbeduto et al., 2004; Estes et al., 2009; Guillamón et al., 2013; N. Murphy et al., 2011, 2007; Namkung et al., 2018).”
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Schiltz, H. K., McVey, A. J., Magnus, B. E., Dolan, B. K., Willar, K. S., Pleiss, S. S., Karst, J. S., Carson, A. M., Caiozzo, C. N., Vogt, E. M., et al. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3446-0 · Cited by 81
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Personal Growth Experiences of Parents to Children with Autism Spectrum Disorder
Waizbard‐Bartov, E., Yehonatan-Schori, M., & Golan, O. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3784-6 · Cited by 79
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Filicide-Suicide Involving Children With Disabilities
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“Estes et al found mothers of autistic children to have significantly more parenting and psychological stress than mothers of developmentally delayed children without autism.(24) Autism has been linked to increased psychological stress in caretakers compared to nondisabled children and children with Down syndrome,(25)…”
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“The evidence of prevalent stress and depression among parents raising children with autism spectrum disorder (ASD) is vast, and parents of younger children are particularly vulnerable (e.g. see Davis and Carter, 2008; Estes et al., 2009).”
BackgroundDisparity of Care for Children With Parent-Reported Autism Spectrum Disorders
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BackgroundWomen's posttraumatic stress symptoms and autism spectrum disorder in their children
Roberts, A. L., Koenen, K. C., Lyall, K., Ascherio, A., & Weisskopf, M. G. (2014) · Research in Autism · doi:10.1016/j.rasd.2014.02.004 · Cited by 59
“…of children with ASD are at higher risk of stress-related health outcomes, including poorer general mental health (Sawyer, et al., 2010), distress (Estes et al., 2009), depression (Brooke Ingersoll & Hambrick, 2011; B. Ingersoll, Meyer, & Becker, 2011; Sawyer, et al., 2010) and anxiety (Micali,…”
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“…higher rates of parenting stress as compared with families of children with fragile X syndrome, Down syndrome, cerebral palsy, ID, and typically developing children (e.g., Dumas, Wolf, Fisman, & Culligan, 1991; Estes et al., 2009; Griffi th, Hastings, Nash, & Hill, 2010; Hastings & Johnson, 2001).”
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“(It should be noted that while the ABC Total score was used in prior research about relations between problem behavior and stress (Estes et al. 2009), the developers of the ABC (Aman and Singh 1986) caution against its use due to concerns about the construct validity of this overall score.”
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Lambrechts, G., Leeuwen, K. G. V., Boonen, H., Maes, B., & Noens, I. L. J. (2011) · Research in Autism · doi:10.1016/j.rasd.2010.12.011 · Cited by 67
Siu, Q. K. Y., Yi, H., Chan, R. C. H., Chio, F. H. N., Chan, D. F. Y., & Mak, W. W. S. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3791-7 · Cited by 50
Lin, Y.-N., Iao, L.-S., Lee, Y.-H., & Wu, C.-C. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04720-z · Cited by 50
Mello, C., Rivard, M., Morin, D., Patel, S., & Morin, M. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05131-4 · Cited by 49
Early Identification of Autism Spectrum Disorder: Current Challenges and Future Global Directions
Barbaro, J., & Halder, S. (2016) · Current Developmental Disorders Reports · doi:10.1007/s40474-016-0078-6 · Cited by 53
Seymour, M., Giallo, R., & Wood, C. (2017) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2017.07.018 · Cited by 51
An Integrative Review of Parenting Stress in Mothers of Children with Autism in Japan
Porter, N., & Loveland, K. A. (2018) · International Journal of Disability Development and Education · doi:10.1080/1034912x.2018.1439159 · Cited by 59
“…behaviour problems, low level of social communication, ASD symptoms, adaptive functioning and regulatory patterns (e.g. sleeping, emotional regulation) (Bromley, Hare, Davison, & Emerson, 2004; Davis & Carter, 2008; Estes et al., 2009; Hayes & Watson, 2013; Seymour, Wood, Giallo, & Jellett, 2013).”
BackgroundResultInfluentialAlon, R. (2019) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2019.04.010 · Cited by 57
Rizk, S., Pizur‐Barnekow, K., & Darragh, A. R. (2011) · OTJR Occupational Therapy Journal of Research · doi:10.3928/15394492-20110415-01 · Cited by 49
“Maternal depressive symptoms and stress are associated with the child’s symptoms, particularly behavioral symptoms (Abbeduto et al., 2004; Barker et al., 2011; Ekas & Whitman, 2010; Estes et al, 2009; Meltzer, 2011).”
BackgroundHou, Y., Stewart, L., Iao, L., & Wu, C. (2018) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.12471 · Cited by 56
“Similar findings were also found in preschoolers with ASD aged 5 years (Weitlauf, Vehorn, Taylor, & Warren, 2014) and even before age 4 (Carter, Martínez- Pedraza, & Gray, 2009; Davis & Carter, 2008; Estes et al., 2009, 2013; Zaidman- Zait et al., 2017).”
BackgroundResultInfluentialParents on the autism continuum: Links with parenting efficacy
Lau, W. Y. P., Peterson, C. C., Attwood, T., Garnett, M. S., & Kelly, A. B. (2016) · Research in Autism · doi:10.1016/j.rasd.2016.02.007 · Cited by 47
Informal Support, Health, and Burden Among Parents of Adult Children With Autism
Marsack‐Topolewski, C. N., & Hopp, F. P. (2018) · The Gerontologist · doi:10.1093/geront/gny082 · Cited by 47
Ludlow, A. K., Brown, R., & Schulz, J. (2018) · Journal of Health Psychology · doi:10.1177/1359105316669878 · Cited by 46
“This may be important to address in the future as mothers of children with developmental disabilities have been identified as being at particular risk from physical and emotional strain (Estes et al., 2009).”
BackgroundJohnson, N. L., Lashley, J., Stonek, A. V., & Bonjour, A. (2012) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2012.02.009 · Cited by 46
Freuler, A., Baranek, G. T., Tashjian, C. A., Watson, L. R., Crais, E. R., & Turner‐Brown, L. (2013) · Autism · doi:10.1177/1362361313483928 · Cited by 46
“Caregivers of children with ASD report higher rates of stress as compared to those with other developmental disabilities (DDs) and those of children of typically developing peers (Baker-Ericzen et al., 2005; Estes et al., 2009).”
BackgroundLangley, E., Totsika, V., & Hastings, R. P. (2017) · Autism Research · doi:10.1002/aur.1773 · Cited by 46
“…levels of parental psychological distress [Bromley, Hare, Davison, & 1260 Langley et al./Parental relationship satisfaction INSAR Emerson, 2004; Estes et al., 2009; Jones et al., 2013]; parenting stress [Lecavalier, 2006]; and depression [Abbeduto et al., 2004; Benson & Kersh, 2011; Orsmond,…”
Derguy, C., Roux, S., Portex, M., & M’Baïlara, K. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.07.006 · Cited by 46
Autismo e mães com e sem estresse: análise da sobrecarga materna e do suporte familiar
Faro, K. C. A., Santos, R. B., Bosa, C. A., Wagner, A., & Silva, S. S. D. C. (2019) · Psico · doi:10.15448/1980-8623.2019.2.30080 · Cited by 46
Bennett, T. A., Boyle, M., Georgiades, K., Georgiades, S., Thompson, A., Duku, E., Bryson, S. E., Fombonne, E. J., Vaillancourt, T., Zwaigenbaum, L., et al. (2011) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2011.02451.x · Cited by 49
“…and mental health problems (Daniels et al., 2008; Estes et al., 2009; Micali, Chakrabarti, & Fombonne, 2004; Wolf, Noh, Fisman, & Speechley, 1989), which may affect their report on the child (Abbeduto et al., 2004; Bromley, Dougal, Davison, & Emerson, 2004; Estes et al., 2009; Wolf et al., 1989).”
BackgroundMarino, F., Failla, C., Chilà, P., Minutoli, R., Puglisi, A., Arnao, A. A., Pignolo, L., Presti, G., Pergolizzi, F., Moderato, P., et al. (2021) · Brain Sciences · doi:10.3390/brainsci11070880 · Cited by 45
Parenting stress and affective symptoms in parents of autistic children
Gong, Y., Du, Y., Li, H., Zhang, X., An, Y., & Wu, B.-L. (2015) · Science China Life Sciences · doi:10.1007/s11427-012-4293-z · Cited by 61
Minichil, W., Getinet, W., Derajew, H., & Seid, S. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2228-y · Cited by 45
Meirsschaut, M., Warreyn, P., & Roeyers, H. (2011) · Autism Research · doi:10.1002/aur.217 · Cited by 53
An Exploratory Review of the Associations between Adverse Experiences and Autism
Dodds, R. L. (2020) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2020.1783736 · Cited by 44
“Mental health challenges such as elevated levels of stress and depressive symptoms are more prevalent in parents of children with ASD than in other categories of disability (Estes et al., 2009).”
BackgroundStrunk, J. A., Pickler, R., McCain, N. L., Ameringer, S., & Myers, B. J. (2014) · Families, Systems, & Health · doi:10.1037/a0037180 · Cited by 43
“…ranking lowest in impact (3) Child syndrome group had a negative impact above and beyond the contributions of behavior problems and cognitive level Estes et al (2009), Autism United States Level of Evidence: IV Emerging Theme: Stress N=74 mothers and their children (those with ASD and those who…”
BackgroundDaily Couple Experiences and Parent Affect in Families of Children with Versus Without Autism
Hartley, S. L., DaWalt, L. S., & Schultz, H. M. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3088-2 · Cited by 43
A Model of Family and Child Functioning in Siblings of Youth with Autism Spectrum Disorder
Tudor, M. E., Rankin, J., & Lerner, M. D. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3352-5 · Cited by 50
Pathways in ASD Study Team, Rezze, B. D., Duku, E., Szatmári, P., Volden, J., Georgiades, S., Zwaigenbaum, L., Smith, I. M., Vaillancourt, T., Bennett, T. A., et al. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04150-6 · Cited by 53
Chao, K., Chang, H., Chin, W., Li, H., & Chen, S. (2017) · Autism · doi:10.1177/1362361316680915 · Cited by 42
“Email: auaug0327@cgmh.org.tw United Kingdom (Crane et al., 2016), the United States (Estes et al., 2009), Hong Kong (Ho et al., 2014), as well as in Taiwan (Lin et al., 2008).”
BackgroundShivers, C. M., McGregor, C. M., & Hough, A. (2017) · Autism · doi:10.1177/1362361317722432 · Cited by 42
“Among parents of children with IDD, behavior problems are highly correlated with parenting stress (e.g. Estes et al., 2009; Lovell and Wetherell, 2015; Robinson and Neece, 2015).”
Background
Metadata
- Authors
- Estes, A., Munson, J., Dawson, G., Koehler, E., Zhou, X.-H., & Abbott, R.
- Affiliations
- University of Washington (US)
- University of Washington, USA
- Corresponding author
- Estes, Annette
- Venue
- Autism
- Publisher
- SAGE Publications
- Published
- 2009-06-17
- Volume
- 13
- Issue
- 4
- Pages
- 375-387
- ISSN
- 1362-3613 (ISSN-L)
- 1461-7005
- PMC
- PMC2965631
- OpenAlex
- W2165770244
- Cited by
- 865
- References
- 28
- Citations by year
- 2026: 40 · 2025: 43 · 2024: 61 · 2023: 57 · 2022: 48 · 2021: 70 · 2020: 62 · 2019: 70 · 2018: 59 · 2017: 63 · 2016: 57 · 2015: 62 · 2014: 50 · 2013: 54 · 2012: 27
- FWCI
- 24.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Autism (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P50HD055782, U19HD035482, U19HD34565, U19HD035468, U19HD035465)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- parental stress, maternal distress, autism spectrum disorder, developmental delay, preschool children, child behavior problems, daily living skills, mothers of children with developmental disabilities, parenting support
- MeSH terms
- Activities of Daily Living, Adaptation, Psychological, Adult, Autistic Disorder, Child Behavior Disorders, Developmental Disabilities, Child, Preschool, Female, Humans, Male, Mothers, Parent-Child Relations, Personality Inventory, Surveys and Questionnaires, Stress, Psychological, Comorbidity, Parenting
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