Fortschr Neurol Psychiatr 2023; 91(01/02): 10-18
DOI: 10.1055/a-1743-2770
Originalarbeit

Parental Stress of Children with Autism Spectrum Disorder During the Coronavirus Pandemic (COVID-19): Experience from Serbia

Elterlicher Stress bei Kindern mit Autismus-Spektrum-Störung während der Corona-Pandemie (COVID-19): Erfahrungen aus Serbien
Aleksandra Djuric-Zdravkovic
1   University of Belgrade Faculty for Special Education and Rehabilitation, Beograd, Serbia
,
Mirjana Japundza-Milisavljevic
1   University of Belgrade Faculty for Special Education and Rehabilitation, Beograd, Serbia
,
Dijana Perovic
2   Institute of Human Genetics, University of Belgrade Faculty of Medicine, Beograd, Serbia
› Author Affiliations

Abstract

Objective Taking care of children with autism spectrum disorder (ASD), as of children with other developmental disorders, is associated with greater parental stress. The aim of this study was to determine the prevalence and impact of integrative and co-morbid ASD-related symptoms on parental stress levels during the COVID-19 pandemic at four time points. Testing was performed during significant changes related to the state of the COVID-19 pandemic in Serbia.

Methods The research sample included 67 parents of children with ASD 4 to 7 years and 6 months of age. The Autism Parenting Stress Index, Gilliam Autism Rating Scale - Third Edition, diagnostic criteria for ASD from DSM-5 and Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition were used to assess the tested abilities.

Results Core behavior (problems of social development and communication skills) as well as co-morbid behaviors related to ASD (tantrums, aggressive behavior, self-injurious behavior and difficulties with transitions) caused the highest degree of parental stress. Post hoc tests that used Bonferroni correction found that parental stress caused by basic and co-morbid behaviors gradually decreased from first to fourth measurement, respectively. Sleep and toilet training problems, as well as co-morbid physical problems, caused the greatest degree of parental stress during the first measurement. Measuring total parental stress caused by integrative and co-morbid symptoms related to ASD showed that it was at the highest level during the first measurement, decreased during the second measurement and remained unchanged during the third and fourth measurements.

Conclusion Time, as a repeating factor, during the COVID-19 pandemic has an effect on lowering the levels of parental stress caused by all examined ASD-related domains. These results may be useful in creating individual programs to support parents of children with ASD during the COVID-19 pandemic.



Publication History

Received: 21 March 2021

Accepted: 11 January 2022

Article published online:
06 April 2022

© 2022. Thieme. All rights reserved.

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  • References

  • 1 American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Arlington, VA: American Psychiatric Association; 2013
  • 2 World Health Organization. International classification of diseases for mortality and morbidity statistics. 11th rev 2018 https://icd.who.int/(l.v. 9/9/2020)
  • 3 Wiggins LD, Rice CE, Barger B. et al. DSM-5 criteria for autism spectrum disorder maximizes diagnostic sensitivity and specificity in preschool children. Soc Psychiatry Psychiatr Epidemiol 2019; 54: 693-701
  • 4 Bougeard C, Picarel-Blanchot F, Schmid R. et al. Prevalence of autism spectrum disorder and co-morbidities in children and adolescents: A systematic literature review. Front Psychiatry 2021; 12: 744709
  • 5 Baxter AJ, Brugha TS, Erskine HE. et al. The epidemiology and global burden of autism spectrum disorders. Psychol Med 2015; 45: 601-613
  • 6 Baio J, Wiggins L, Christensen DL. et al. Prevalence of autism spectrum disorder among children aged 8 years – autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR CDC Surveill Summ 2018; 67: 1-23
  • 7 Maenner MJ, Shaw KA, Baio J. Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 sites, United States, 2016. MMWR CDC Surveill Summ 2020; 69: 1-12
  • 8 Djuric-Zdravkovic A. Pedagogija osoba s poremećajem intelektualnog razvoja. [Pedagogy of persons with intellectual developmental disorder] Beograd: Univerzitet u Beogradu – Fakultet za specijalnu edukaciju i rehabilitaciju [Belgrade: University of Belgrade – Faculty of special education and rehabilitation] ;; 2020
  • 9 Bertelli MO. ASD and intellectual disability. In: R Keller (eds) Psychopathology in adolescents and adults with autism spectrum disorders (163–190). Cham: Springer; 2019
  • 10 Van Dick R, Wagner U. Stress and strain in teaching: A structural equation approach. Br J Educ Psychol 2001; 71: 243-259
  • 11 Pastor-Cerezuela G, Fernández-Andrés MI, Tárraga-Mínguez R. et al. Parental stress and ASD: Relationship with autism symptom severity, IQ, and resilience. Focus Autism Other Dev Disabl 2016; 31: 300-311
  • 12 Samadi SA, McConkey R. The impact on Iranian mothers and fathers who have children with an autism spectrum disorder. J Intellect Disabil 2014; 58: 243-254
  • 13 McStay RL, Trembath D, Dissanayake C. Stress and family quality of life in parents of children with autism spectrum disorder: Parent gender and the double ABCX model. J Autism Dev Disord 2014; 44: 3101-3118
  • 14 Falk NH, Norris K, Quinn MG. The factors predicting stress, anxiety and depression in the parents of children with autism. J Autism Dev Disord 2014; 44: 3185-3203
  • 15 Hayes SA, Watson SL. The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. J Autism Dev Disord 2013; 43: 629-642
  • 16 Klosterkötter J. Die Covid-19-Pandemie: ein massiver Stress-Test für uns alle. Fortschr Neurol Psychiatr 2020; 88: 360-361
  • 17 Asiamah N, Opuni FF, Mends-Brew E. et al. Short-term changes in behaviors resulting from COVID-19-related social isolation and their influences on mental health in Ghana. Community Ment Health J 2021; 57: 79-92
  • 18 Official Gazette of the Republic of Serbia/Službeni glasnik Republike Srbije. Uredba o merama za vreme vanrednog stanja [Statute on measures during a state of emergency], 57/2020. Available from: https://www.pravno-informacioni-sistem.rs/SlGlasnikPortal/eli/rep/sgrs/vlada/uredba/2020/31/1/reg
  • 19 Silva LM, Schalock M. Autism parenting stress index: Initial psychometric evidence. J Autism Dev Disord 2012; 42: 566-574
  • 20 Gilliam JE. Gilliam Autism Rating Scale – Third edition. Austin: TX: PRO-ED. 2013
  • 21 Wechsler D. Wechsler preschool and primary scale of intelligence–Fourth edition. San Antonio, TX: The Psychological Corporation; 2012
  • 22 Ferguson CJ. An effect size primer: A guide for clinicians and researchers. Prof Psychol Res Pr 2009; 40: 532-538
  • 23 Manning J, Billian J, Matson J. et al. Perceptions of families of individuals with autism spectrum disorder during the COVID-19 crisis. J Autism Dev Disord 2020; DOI: 10.1007/s10803-020-04760-5.
  • 24 Liu G, Wang S, Liao J. et al. The efficacy of wechat-based parenting training on the psychological well-being of mothers with children with autism during the COVID-19 pandemic: Quasi-experimental study. JMIR Ment Health 2021; 8: e23917
  • 25 Alhuzimi T. Stress and emotional wellbeing of parents due to change in routine for children with Autism Spectrum Disorder (ASD) at home during COVID-19 pandemic in Saudi Arabia. Res Dev Disabil 2021; 108: 103822
  • 26 Singh NN, Lancioni GE, Winton ASW. et al. Mindfulness-based positive behavior support (MBPBS) for mothers of adolescents with autism spectrum disorder: Effects on adolescents’ behavior and parental stress. Mindfulness 2014; 5: 646-657
  • 27 Krakovich TM, McGrew JH, Yu Y. et al. Stress in parents of children with autism spectrum disorder: An exploration of demands and resources. J Autism Dev Disord 2016; 46: 2042-2053
  • 28 Curtin C, Hyman SL, Boas DD. et al. Weight management in primary care for children with autism: Expert recommendations. Pediatrics 2020; 145: S126-S139
  • 29 Valicenti-McDermott M, Lawson K, Hottinger K. et al. Parental stress in families of children with autism and other developmental disabilities. J Child Neurol 2015; 30: 1728-1735
  • 30 Miranda A, Mira A, Berenguer C. et al. Parenting stress in mothers of children with autism without intellectual disability. Mediation of behavioral problems and coping strategies. Front Psychol 2019; 10: 464
  • 31 Degli Espinosa F, Metko A, Raimondi M. et al. A model of support for families of children with autism living in the COVID-19 lockdown: Lessons from Italy. Behavior Analysis in Practice 2020; 13: 550-558