Cited by 865Family and Disability Support ResearchAutism Spectrum Disorder ResearchChild Nutrition and Feeding Issues

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Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay

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Estes, Annette, Munson, Jeffrey, Dawson, Geraldine, Koehler, Elizabeth, Zhou, Xiao-Hua, Abbott, Robert·2009·Autism

DOI 10.1177/1362361309105658PMC PMC2965631

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Abstract

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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BackgroundInfluential
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Background
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Sesso, G., Bonaventura, E., Buchignani, B., Vecchia, S. D., Fedi, C., Gazzillo, M., Micomonaco, J., Salvati, A., Conti, E., Cioni, G., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18157902 · Cited by 8
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Trends in Autism Spectrum-Related Motherhood Research: A Bibliometric Study
González, O. H., Fernández, D. G., Spencer, R., Mínguez, R. T., & Ponce-Carrasco, V. (2023) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe13020036 · Cited by 9
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“…and other low-incidence disabilities experience stressors that have negative consequences for the family system (Dabrowska & Pisula, 2010; Davis & Carter, 2008; Estes et al., 2009; Hayes & Watson, 2013; Pastor-Cerezuela et al., 2015; Phetrasuwan & Shandor Miles, 2009; Shawler & Sullivan, 2017).”
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Depression, anxiety, and mental health service experiences of women with a twin-twin transfusion syndrome pregnancy
Falletta, L. M., Fischbein, R. L., Bhamidipalli, S. S., & Nicholas, L. (2017) · Archives of Women s Mental Health · doi:10.1007/s00737-017-0758-1 · Cited by 8
“2004); anticipating, and caring for, a child with disabilities (Estes et al. 2009; Singer 2006); and fetal/newborn loss (MunkOlsen et al.”
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Autism Spectrum Disorder symptomatology in children with Mucopolysaccharide Disease Type III
Wolfenden, C., Wittkowski, A., Jones, S. A., Rust, S., & Hare, D. J. (2018) · British Journal of Learning Disabilities · doi:10.1111/bld.12248 · Cited by 8
Stress in mothers of children with neurodevelopmental disorders
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Trastornos leves del espectro autista en educación infantil: Prevalencia, sintomatología co-ocurrente y desarrollo psicosocial [Mild autism spectrum disorders in preschool children: Prevalence, co-occurrent symptoms and psychosocial development]
Morales, P., Llaberia, E. D., Ballabriga, M. C. J., & Canals, J. (2014) · Revista de Psicopatología y Psicología Clínica · doi:10.5944/rppc.vol.18.num.3.2013.12922 · Cited by 10
The contribution of psychological capital and parental age to job satisfaction: a comparison of parents of children with autism spectrum disorder and parents of typically developing children
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“…functioning, and a greater presence of psychological distress, compared to parents of children without this diagnosis (Khanna et al., 2011; Seguí et al., 2008) or even parents of children with other developmental conditions, intellectual disabilities, or physical disabilities (Estes et al., 2009).”
Maternal Psychological Distress Before and After Childbirth and Neurodevelopmental Delay in Toddlers
Matsumura, K., Tanaka, T., Kuroda, M., Tsuchida, A., Hatakeyama, T., Kasamatsu, H., Inadera, H., Japan Environment and Children’s Study Group, Kamijima, M., Yamazaki, S., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.40907 · Cited by 7
Examining factors associated with sleep quality in parents of children 4–10 years with autism spectrum disorder
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Cazzorla, C., Gragnaniello, V., Gaiga, G., Gueraldi, D., Puma, A., Loro, C., Benetti, G., Schiavo, R., Porcù, E., Burlina, A. P., et al. (2025) · International Journal of Neonatal Screening · doi:10.3390/ijns11010014 · Cited by 7
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Effectiveness of Acceptance and Commitment Therapy on Psychological Flexibility and Health Promotion Among Mothers with Autistic Children
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Validity and Reliability of Parenting Stress Construct among Mothers of Children with Autistic Spectrum Disorder
Daulay, N., Ramdhani, N., & Hadjam, N. R. (2020) · Jurnal Psikologi · doi:10.22146/jpsi.43744 · Cited by 19
An Effectiveness Trial of PCIT for Children with and without Autism Spectrum Disorder in a Private Practice Setting
Han, R. C., Naguib, S., Owen, C. K., Druskin, L. R., Keen, K. R., Piper, R., Holbert, S. N., Shank, S. D., Victory, E. J., & McNeil, C. B. (2021) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2021.1993109 · Cited by 7
“This has important clinical implications for caregivers of young children with ASD, whose parenting stress levels are often higher than those of children with other disabilities (Estes et al., 2009).”
A cross-cultural comparison of a measure of parent perceptions among families of children with autism in Vietnam
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“Consistently, parents of autistic children report higher stress than parents caring for children with other diagnosable conditions, and higher than parents whose children have no diagnoses (Estes et al., 2009; Karst & Van Hecke, 2012; Kissel & Nelson, 2016).”
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Association Between Neighborhood Support and Family Resilience in Households with Autistic Children
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“social communication and restricted/repetitive behaviors in autistic children and adolescents are associated with poorer caregiver mental health and sibling adjustment (Benson & Karlof, 2008; Davis & Carter, 2008; Estes et al., 2009; Pilowsky et al., 2004).”
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“One such factor is behaviour problems, as these have long been associated with heightened maternal stress, anxiety and depression in families of children with ID (Hastings 2002; Hodapp et al. 2003; Johnston et al. 2003; Ricci and Hodapp 2003; Tomanik et al. 2004; Estes et al. 2009).”
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The Impact of COVID-19 on Parents of Children with Special Needs
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“…higher levels of stress and adjustment difficulties in comparison with parents of neurotypical children (Hayes & Watson, 2013; Ni’matuzahroh et al., 2022; Pastor-Cerezuela et al., 2021) or children with other disorders (Estes et al., 2009; Hayes & Watson, 2013; Pastor-Cerezuela et al., 2021).”
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Maternal Psychological Resources in Parenting Children with Autism Spectrum Disorders
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Assessing Caregiver Stress and Coping at Time of Autism Spectrum Disorder Diagnosis
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The effects of a web-based 24-hour movement behavior lifestyle education program on mental health and psychological well-being in parents of children with autism spectrum disorder: A randomized controlled trial
Zhao, M., You, Y., Gao, X., Li, L., Li, J., & Cao, M. (2024) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2024.101865 · Cited by 6
Reducing Depressive Symptoms Among Latina Mothers of Autistic Children: A Randomized Controlled Trial
Yu, A. P., Zeng, W., Lopez, K., & Magaña, S. (2024) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-129.4.294 · Cited by 6
OTİZMLİ ÇOCUĞA SAHİP EBEVEYN PERSPEKTİFİ İLE SERBEST ZAMAN VE FİZİKSEL AKTİVİTE
Sarol, H., AYDIN, İ., GÜMÜŞBOĞA, İ., Güngörmüş, H. A., & ALICI, Y. (2020) · Ankara Üniversitesi Beden Eğitimi ve Spor Yüksekokulu SPORMETRE Beden Eğitimi ve Spor Bilimleri Dergisi · doi:10.33689/spormetre.589006 · Cited by 6
Mental health strategies to support families of children with autism: Lessons learned from a psychologist and parent for non-mental health professionals
Bram, L. H. (2020) · Journal of Interprofessional Education & Practice · doi:10.1016/j.xjep.2020.100405 · Cited by 6
Resourcefulness revisited: Further psychometric evaluation of resourcefulness scale
Rossetti, K. G., & Zlomke, K. R. (2021) · Stress and Health · doi:10.1002/smi.3024 · Cited by 6
Dyadic Effect of Coping on the Perceived Impact of ASD of Children on Parental Quality of Life: Report from the ELENA Cohort
Brillet, L., Périés, M., Vernhet, C., Rattaz, C., Michelon, C., Baghdadli, A., for the ELENA study group, Baghdadli, A., Chabaux, C., Chatel, C., et al. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05414-w · Cited by 6
“Studies have shown that parents of children with ASD express more psychological distress (Estes et al., 2009; Pisula, 2007) and perceive a greater negative impact on their QoL than those of children with other disabilities or chronic diseases (Bourke-Taylor et al.”
Background
Parental Stress and Bringing up a Child with Cerebral Palsy: A Foreign Studies Review
Kim, K.-M., & Kadyrov, R. V. (2022) · Clinical Psychology and Special Education · doi:10.17759/cpse.2022110401 · Cited by 6
The trauma of parting: Endings of music therapy with children with autism spectrum disorders
Kim, J. (2013) · Nordic Journal of Music Therapy · doi:10.1080/08098131.2013.854269 · Cited by 6
“It would become even worse if mothers of these children felt rebuffed, therefore, discouraged in their attempt to engage their child in a dyadic interaction with them (Estes et al., 2009; Rutgers et al., 2007).”
Background
Finding Common Ground: Exploring Undergraduate Student Volunteering as a Support for Parents of Children With Autism
Breithaupt, A. G., Thomas, K. C., Wong, C. S., Mesibov, G. B., & MORRISSEY, J. P. (2015) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/1088357615610112 · Cited by 6
“…mothers of children with autism report higher levels of stress and psychological distress than mothers of children with developmental delays (Estes et al., 2009), and among families with adolescents and young adults with autism, unmet need for services is associated with caregiving burden…”
Background
The effect of the psychoeducational group family education program for families of children with ASD on parents: A pilot study.
Ardıç, A., & Cavkaytar, A. (2019) · International Journal of Early Childhood Special Education · doi:10.20489/intjecse.581495 · Cited by 6
Satisfaction with the support received by parents of children with disabilities and the diversity of parental behaviour towards the child
Kuracki, K. (2019) · Interdyscyplinarne Konteksty Pedagogiki Specjalnej · doi:10.14746/ikps.2019.26.09 · Cited by 7

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
ORCID: Estes, Annette
Munson, Jeffrey
Zhou, Xiao-Hua
Venue: Autism
Publisher: SAGE Publications
Published: 2009-06-17
Volume: 13
Issue: 4
Pages: 375-387
ISSN: 1362-3613 (ISSN-L)
1461-7005
DOI: 10.1177/1362361309105658
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
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
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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Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay

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