Abstract
Symptoms of autism influence families’ participation in daily activities, but few studies have broadly explored the types of accommodations caregivers make to their family’s routines after their child is diagnosed with autism. The current study used a mixed-methods approach to characterize the rate and types of accommodations made by 171 families and the child and family characteristics that predicted accommodations. Most families (91%) endorsed making accommodations in the past year. Lower income, older child age, marginalized racial/ethnic identity, and higher levels of child problem behavior predicted accommodations in a greater number of domains. Thematic analysis illuminated the types of accommodations caregivers made and their motivation for making these lifestyle adjustments. Findings have important implications for parent-mediated interventions and policy.
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References
Almalki, S. (2016). Integrating quantitative and qualitative data in mixed methods research–challenges and benefits. Journal of Education and Learning, 5(3), 288–296
Baldridge, D. C., Beatty, J. E., Konrad, A. M., & Moore, M. E. (2016). People with disabilities. In The Oxford Handbook of Diversity in Organizations
Bauman, M. L. (2010). Medical comorbidities in autism: challenges to diagnosis and treatment. Neurotherapeutics 7(3), 320–327
Bearss, K., Johnson, C., Smith, T., Lecavalier, L., Swiezy, N., Aman, M. … Scahill, L. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: a randomized clinical trial. JAMA, 313(15), 1524–1533
Bernheimer, L. P., Gallimore, R., & Weisner, T. S. (1990).Ecocultural theory as a context for the individual family service plan.Journal of Early Intervention, 14(3),219–233
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology.Qualitative Research in Psychology, 3(2):77–101. DOI: https://doi.org/10.1191/1478088706qp063oa
Buescher, A. V. S., Cidav, Z., Knapp, M., et al. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. Journal of the American Medical Association Pediatrics 168:721–728
Carter, A. S., Briggs-Gowan, M. J., Jones, S. M., & Little, T. D. (2003).The Infant-Toddler Social and Emotional Assessment, I. T. S. E. A. : Factor Structure, Reliability, and Validity. Journal of Abnormal Child Psychology, 31,495–514
Cidav, Z., Marcus, S. C., & Mandell, D. S. (2012).Implications of childhood autism for parental employment and earnings. Pediatrics 129:617–623
Davis, N. O., & Carter, A. S. (2008). Parenting stress in mothers and fathers of toddlers with autism spectrum disorders: Associations with child characteristics.Journal of Autism and Developmental Disorders, 38(7): 1278–1291
DeGrace, B. W. (2004). The everyday occupation of families with children with autism. The American Journal of Occupational Therapy 58(5): 543–550
Farrugia, D. (2009). Exploring stigma: Medical knowledge and the stigmatisation of parents of children diagnosed with autism spectrum disorder.Sociology of Health and Illness, 31(7),1011–1027. doi:https://doi.org/10.1111/j.1467-9566.2009.01174.x
Feldman, I., Koller, J., Lebowitz, E. R., Shulman, C., & Itzchak, E. B. (2019). & Zachor, D. A. Family accommodation in autism spectrum disorder.Journal of Autism and Developmental Disorders, 49(9): 3602–3610
Fletcher, P. C., Markoulakis, R., & Bryden, P. J. (2012).The costs of caring for a child with an autism spectrum disorder. Issues in Comprehensive Pediatric Nursing, 35(1),45–69
Fong, L., Wilgosh, L., & Sobsey, D. (1993). The experience of parenting an adolescent with autism. International Journal of Disability, Development and Education, 40(2), 105–113. doi:https://doi.org/10.1080/0156655930400204
Fronczek, P. (2009). Income, earnings, and poverty from the 2004 American Community Survey. DIANE Publishing.
Gallimore, R., Coots, J., Weisner, T., Garnier, H., & Guthrie, D. (1996). Family responses to children with early developmental delays II: Accommodation intensity and activity in early and middle childhood. American Journal on Mental Retardation, 101, 215–232
Gray, D. E. (2002). ‘Everybody just freezes. Everybody is just embarrassed’:. Felt and enacted stigma among parents of children with high functioning autism. Sociology of Health & Illness, 24(6),734–749
Hartley, S. L., Sikora, D. M., & McCoy, R. Prevalence and risk factors of maladaptive behaviour in Young children with autistic disorder (2008). J Intellect Disabil Res. 52(10):819–829
Houting, J. D. (2019). Neurodiversity: An insider’s perspective. Autism, 23(2), 271–273. https://doi.org/10.1177/1362361318820762
IBM Corp (2021). IBM SPSS statistics for Macintosh (Version 28.0)
Kagan, E. R., Frank, H. E., & Kendall, P. C. (2017). Accommodation in youth with OCD and anxiety. Clinical Psychology :Science and Practice, 24(1),78
Kielinen, M., Rantala, H., Timonen, E., Linna, S. L., & Moilanen, I. (2004). Associated medical disorders and disabilities in children with autistic disorder: a population-based study. Autism, 8(1),49–60
Lasser, J., & Corley, K. (2008). Constructing normalcy. A qualitative study of parenting children with Asperger’s disorder. Educational Psychology in Practice, 24(4),335–346. doi:https://doi.org/10.1080/02667360802488773
Lebowitz, E. R., & Bloch, M. (2012). Family accommodation in pediatric obsessive-compulsive disorder. Expert Review of Neurotherapeutics, 12(2),229–238
Lebowitz, E. R., Scharfstein, L. A., & Jones, J. (2014b). Comparing family accommodation in pediatric obsessive-compulsive disorder, anxiety disorders, and nonanxious children.Depression and Anxiety, 31(12),1018–1025
Lebowitz, E. R., Woolston, J., Bar-Haim, Y., Calvocoressi, L., Dauser, C., Warnick,E., … Leckman, J. F. (2013) Family accommodation in pediatric anxiety disorders. Depression and Anxiety, 30(1),47–54
Levitt, H. M., Bamberg, M., Creswell, J. W., Frost, D. M., & Josselson, R. (2018). & Suárez-Orozco, C. Journal article reporting standards for qualitative primary, qualitative meta-analytic,and mixed methods research in psychology: The APA Publications and Communications Board task force report. American Psychologist, 73(1),26
Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., & Lainhart (2006). J. E. Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36(7),849–861
Lord, C., Risi, S., Lambrecht, L., Cook, E., Leventhal, B., DiLavore, P. … Rutter, M. (2000). The Autism Diagnostic Observation Schedule – Generic:A standard measure of social and communication deficits associated with the spectrum of autism.Journal of Autism and Developmental Disorders, 30, 205-223
Lord, C., Rutter, M., & LeCouteur, A. (1994). Autism Diagnostic Interview – Revised:A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685
Ludlow, A., Skelly, C., & Rohleder, P. (2011). Challenges faced by parents of children diagnosed with autism spectrum disorder. Journal of Health & Psychology, 17(5), 702–711. doi:10.1177/1359105311422955
Marquenie, K., Rodger, S., Mangohig, K., & Cronin, A. (2011). Dinnertime and bedtime routines and rituals in families with a young child with an autism spectrum disorder. Australian Occupational Therapy Journal, 58. (3), 145–154. doi:10.1111/j.1440-1630.2010.00896.x
Mathew, N. E., Burton, K. L., Schierbeek, A., Črnčec, R., Walter, A., & Eapen, V.(2019). Parenting preschoolers with autism: Socioeconomic influences on wellbeing and sense of competence. World Journal of Psychiatry, 9(2), 30
Maul, C. A., & Singer, G. H. (2009). “Just good different things” specific accommodations families make to positively adapt to their children with developmental disabilities. Topics in Early Childhood Special Education, 29(3), 155–170
Mazumder, R., & Thompson-Hodgetts, S. (2019). Stigmatization of children and adolescents with autism spectrum disorders and their families: A scoping study. Review Journal of Autism and Developmental Disorders, 6(1), 96–107.
Mazurek MO, Kanne SM, Wodka EL. Physical aggression in children and adolescents with Autism spectrum disorders. Res Autism Spectrum Disorders. 2013; 7:455–465.
McCourt, C. (2006). Becoming a parent. The New Midwifery: Science and Sensitivity in Practice. Edinburgh: Churchill Livingstone, 49–71
Midence, K., & O’Neill, M. (1999). The experience of parents in the diagnosis of autism.Autism, 3(3), 273–285. doi:10.1177/1362361399003003005
Munroe, K., Hammond, L., & Cole, S. (2016). The experiences of African immigrant mothers living in the United Kingdom with a child diagnosed with an autism spectrum disorder: An interpretive phenomenological analysis. Disability & Society, 31(6), 798–819.
Neely-Barnes, S. L., Hall, H. R., Roberts, R. J., & Graff, J. C. (2011). Parenting a child with an autism spectrum disorder: Public perceptions and parental conceptualizetions. Journal of Family and Social Work, 14(3), 208. –225. doi:1 0.1080/10522158.2011.571539
Norman, K. R., Silverman, W. K., & Lebowitz, E. R. (2015). Family accommodation of child and adolescent anxiety: Mechanisms, assessment, and treatment. Journal of Child and Adolescent Psychiatric Nursing, 28(3), 131–140.
Oono, I. P., Honey, E. J., & McConachie, H. (2013). Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, 4, CD009774.https://doi.org/10.1002/14651858.CD009774.pub2.
Safe, A., Joosten, A., & Molineux, M. (2012). The experiences of mothers of children with autism: Managing multiple roles. Journal of Intellectual Developmental Disabilities, 37(4), 294–302. doi:10.3109/13668250.2012.736614
Saxbe, D., Rossin-Slater, M., & Goldenberg, D. (2018). The transition to parenthood as a critical window
for adult health. American Psychologist, 73(9), 1190.
Seltzer, M. M., Greenberg, J. S., Floyd, F. J., & Hong, J. (2004). Accommodative coping and well-being of midlife parents of children with mental health problems or developmental disabilities. American Journal of Orthopsychiatry, 74(2), 187–195.
Schaaf RC, Toth-Cohen S, Johnson SL, et al. (2011) The every- day routines of families of children with autism: examining the impact of sensory processing difficulties on the family. Autism 15: 373–389.
Schnabel, L., & Bock, S. (2017). The persistent and exceptional intensity of American religion: A response to recent research. Sociological Science, 4, 686–700.
Schuck, R. K., Tagavi, D. M., Baiden, K. M., Dwyer, P., Williams, Z. J., Osuna, A.,… Vernon, T. W. (2021). Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework. Journal of Autism and Developmental Disorders, 1–21.
Shalev, R. A., Lavine, C., & Di Martino, A. (2020). A systematic review of the role of parent characteristics in parent-mediated interventions for children with autism spectrum disorder. Journal of Developmental andPhysical Disabilities, 32(1), 1–21.
Shorey, S., Ng, E. D., Haugan, G., & Law, E. (2020). The parenting experiences and needs of Asian primary caregivers of children with autism: A meta-synthesis. Autism, 24(3), 591–604.
Song, J., Mailick, M. R., & Greenberg, J. S. (2018). Health of parents of individuals with developmental disorders or mental health problems: Impacts of stigma. Social Science & Medicine, 217, 152–158.
Storch, E. A., Zavrou, S., Collier, A. B., Ung, D., Arnold, E. B., Mutch, P. J., …Murphy, T. K. 2015. Preliminary study of family accommodation in youth with autism spectrum disorders and anxiety: Incidence, clinical correlates, and behavioral treatment response. Journal of Anxiety Disorders, 34, 94–99.
Thompson-Hollands, J., Kerns, C. E., Pincus, D. B., & Comer, J. S. (2014). Parental accommodation of child anxiety and related symptoms: Range, impact, and correlates. Journal of Anxiety Disorders, 28(8), 765–773.
Tint, A., & Weiss, J. A. (2016). Family wellbeing of individuals with autism spectrum disorder: A scoping review. Autism, 20(3), 262–275.
Vernhet, C., Michelon, C., Dellapiazza, F., Rattaz, C., Geoffray, M. M., Roeyers,H., … Baghdadli, A. (2021). Perceptions of parents of the impact of autism spectrum disorder on their quality of life and correlates: comparison between mothers and fathers. Quality of Life Research, 1–10.
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Dr. Carter is the co-creator of the Infant -Toddler Social and Emotional Assessment (ITSEA) and the Brief Infant -Toddler Social and Emotional Assessment (BITSEA). She receives royalties on the sale of the ITSEA and BITSEA. Dr. Dai does not have any conflict of interest.
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Dai, Y.G., Carter, A.S. Characterizing Accommodations by Parents of Young Children with Autism: A Mixed Methods Analysis. J Autism Dev Disord 53, 3380–3393 (2023). https://doi.org/10.1007/s10803-022-05652-6
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DOI: https://doi.org/10.1007/s10803-022-05652-6