Parenting and Coping Strategies among Parents of Children with and without Autism: The Role of Anxiety and Emotional Expressiveness in the Family

Research Article

Austin J Autism & Relat Disabil. 2020; 6(1): 1054.

Parenting and Coping Strategies among Parents of Children with and without Autism: The Role of Anxiety and Emotional Expressiveness in the Family

Antonopoulou K1*, Manta N1, Maridaki-Kassotaki K1†, Kouvava S1 and Stampoltzis A2

¹Harokopio University of Athens, Greece

²School of Pedagogical and Technological Education (ASPETE), Athens, Greece

*Corresponding author:Katerina Antonopoulou, Assistant Professor in Communication and Learning, Harokopio University, Department of Home Economics and Ecology, 70, El. Venizelou Str., 176 71, Athens, Greece; Email: kantonop@hua.gr

Received: December 02, 2019; Accepted: January 03, 2020; Published: January 10, 2020

Abstract

The present study examines the associations between anxiety, emotional expressiveness in the family, coping strategies and parenting styles among 50 parents of children on the autism spectrum and 50 parents of typically developing children (M parental age = 41.2 years, SD = 5.4). Self-reported measures were administered. Parents of children on the autism spectrum reported greater negative emotional expressiveness, higher levels of anxiety and described themselves as less authoritative in their rearing practices when compared to parents of children with typical development. No differences in coping strategies were found between the two groups of parents. Low levels of anxiety and positive emotional expressiveness in the family were found to predict effective coping strategies and supportive parenting styles for both groups of parents. Findings highlight the need for family psychosocial provision, especially for parents who bring up children on the autism spectrum.

Keywords: Anxiety; Emotional expressiveness, Coping strategies; Parenting; Autism

Introduction

A number of studies has shown that parents of children on the autism spectrum are more likely than parents of typically developing children or children with other developmental or medical conditions to exhibit various psychosocial difficulties including anxiety, emotional discomfort, low levels of emotional well-being and quality of family life, as well as adjustment problems and strained marital relationships [1-18]. Possible causes include medical and financial issues in relation to the child’s condition [19], lack of flexibility in family life, job and career adjustments in order to care for the autistic child, little time left for personal and social activities [20], child behaviour, socialization and communication challenges [21-24], the permanency of autistic condition, the insufficient provision of social and professional support [25], together with the frequent lack of adequate child education facilities [26].

Many of the aforementioned studies have focused on the examination of how parental anxiety affects family functioning [6,10] in families experiencing an imbalance in demands and resources due to child autism [27-28] and relate parental anxiety to various factors, namely the experience of parenthood and the responsibilities of child upbringing [23,29], harsh, inconsistent and ineffective parenting practices [30] or negative coping strategies use [22,31,32]. More specifically, studies have repeatedly evidenced parents’ proneness to authoritarian and punitive measures of autistic child discipline, attributed to, among other factors, the high levels of anxiety experienced by these parents and, also, the lack of parental psychoemotional support [33-36]. Furthermore, when parents of children on the autism spectrum manage to regulate their anxiety and to develop a positive sense of family cohesion and support, they tend to adopt supportive and less directive parenting styles trying to stimulate the development of their children [20], or generally are likely to adhere to the authoritative and supportive parenting style [25,37-40].

High levels of anxiety have been proven to, also, relate to negative coping strategies such as escape-avoidance in families of children on the autism spectrum, while high levels of well-being and family resilience are likely to evoke positive coping behaviours such as positive reappraisal or social support seeking [31]. [41] point out that in these families the most popular coping mechanism is withdrawal from other family relatives, friends, and the community to avoid the social stigma [22]. As a result, parents are likely to suffer increased anxiety and the emergence of various psychological problems [32].

As discussed earlier, parental anxiety, coping strategies and parenting style have been studied in parents of typically developing children and of children on the autism spectrum in a number of studies, each addressing separately the above characteristics in parental behavior. An additional, however, aspect of parent emotional response to family interaction, namely, parental emotional expressiveness in the family, has not been widely examined in relation to parental behaviours. Emotional self-expressiveness in the family reflects an individual’s patterns of positive or negative emotion expressions within the family context [42]. Research on parental self-expressiveness in the family focuses on its relation to various aspects, both positive and negative, of child development, such as social and emotional competence [43], behavioural adjustment [44] or social anxiety [45]. Extant literature has shown a lower prevalence of expressed emotions in mothers of children with autism, compared to mothers of children with personality disorders [46] or with intellectual disabilities [47].

Only a few studies examine possible associations between parental emotional expressiveness in the family, coping strategies and parenting style in families of typically developing children and children on the autism spectrum. For example, it has been found that parents’ ability to cope with stressful events is positively linked to the way they express their positive emotions in their families [48]. [49] supported that family self-expressivity and parenting style, although distinct constructs, jointly affect children’s social adjustment skills and play an important role in the whole family system. Similarly, [25] point out that emotional closeness and reduced parental stress in parent-child interaction can improve family climate as well as parents’ ability to manage their autistic children’s behaviour.

Based on the above discussed research evidence, the present study aimed to compare parents of children on the autism spectrum and parents of children with typical development with regard to parental anxiety, emotional self-expressiveness, coping strategies, and parenting styles. Additionally, the possible influence of anxiety and emotional expressiveness in the family on parents’ coping strategies and parenting styles was concurrently investigated.

Method

One hundred parents (M age = 41.2 years, SD = 5.4) participated in the present study, 50 (16 fathers and 34 mothers) of whom had children on the autism spectrum and the other 50 (10 fathers and 40 mothers) had children with typical development.All participants came from the regional unit of Euboea in Central Greece and formed a convenience sample. Participants had to satisfy the following criteria: parents who had at least one child, either on the autism spectrum or with typical development, aged between 4 to 12 years attending nursery or primary school and no other children with disabilities in the family. Children on the autism spectrum had an official diagnosis from national assessment multidisciplinary centers based on the DSM-5 criteria for Autism Spectrum Disorder [50], were high functioning or diagnosed as having Asperger Syndrome, and had no comorbid disorders or any intellectual impairment.

Most parents reported being married (90% autism group, 96% typical development group), described their family as a nuclear family (64% autism group, 66% typical development group), held either postsecondary non tertiary or tertiary degrees (58% autism group, 70% typical development group), had low to medium annual income (94% autism group, 100% typical development group) and lived in urban and suburban areas (96% autism group, 100% typical development group). No significant differences in the above demographic characteristics between parents of children on the autism spectrum and parents of typically developing children were found. Both groups of parents were matched in age and number of children. The mean age of their autistic children was 7.58 years old (SD=2.1, age range: 4-12 years). Finally, most parents of children on the autism spectrum (92%) reported that their children received intensive clinic-based educational and psychological support.

Measures

Parental anxiety was measured using the Trait subscale of the Greek version of the State-Trait Anxiety Inventory-STAI [51,52]. The STAI Trait subscale includes 20 items which assess anxiety symptoms as personality characteristic (trait anxiety). Answers defining the degree of agreement or disagreement for each item of this subscale were given on a 4-point Likert scale (1=‘almost never’ to 4=‘almost always’). Cronbach’s a of the Trait subscale of the STAI in this study was 0.76. Higher scores indicate lower levels of anxiety.

The Greek version of Ways of Coping [53,54], which consists of 38 questions, was used to examine how often parents use the following coping strategies: a) positive reappraisal, b) seeking social support, c) wishful thinking, d) escape-avoidance, and e) confrontive problem solving. Answers are given on a 4-point Likert scale, ranging from 0 (never) to 3 (often). Cronbach’s a were 0.73 for the positive reappraisal subscale, 0.74 for the social support seeking subscale, 0.76 for the wishful thinking subscale, 0.67 for the escape-avoidance subscale and 0.68 for the confrontive problem solving subscale.

The Greek version of the Parenting Styles and Dimensions Questionnaire-PSDQ [55,56] was used to examine parents’ rearing practices.Participants respond to 29 questions (13 questions refer to authoritative parents, 7 questions refer to authoritarian parents, 5 questions refer to permissive parents and 4 questions refer to strict parents) on a 5-point Likert scale (1=never to 5=always). For the present study, Cronbach’s a was 0.89 for the authoritative type, 0.79 for the authoritarian type, 0.68 for the strict type and 0.79 for the permissive type of parent.

The Self-Expressiveness in the Family Questionnaire – SEFQ [57,58] was used to assess parents’ views regarding the verbal and nonverbal expression of their emotions in the family context.It is a self-report questionnaire which comprises 40 questions grouped in two scales, the positive expressiveness scale including 23 items (e.g. ‘Telling family members how happy you are’), and the negative expressiveness scale, including 17 items (e.g. ‘Quarreling with a family member’). Answers were given on a 9-point Likert scale, ranging from 1 = ‘not at all frequently’ to 9 = ‘very frequently’, to indicate the frequency with which parents express a wide range of emotions in a variety of everyday situations within their family. Internal consistency of both scales in the present study was high (a = 0.87).

For the purposes of the present study, a questionnaire with demographic and personal data for both parents and children was developed.Parents had to provide personal information about their age, gender, type of family, number of family members, educational background, and income. They, also, had to provide information about their children’s age, gender, and school year. The type of support provided to the child on the autism spectrum was also reported.

Procedure

A pilot study was carried out with four parents, in order to estimate the amount of time required for the completion of all the questionnaires, as well as to verify possible ambiguous questions. There were minor changes in certain abstruse words and phrases. Subsequently, Parents of the participating children were allocated via the schools their children attended or the support services they visited.Those who volunteered to participate in the present study, after being informed of its purposes, were given all the required information in order to answer the questionnaires. The completion of the questionnaires, which lasted approximately 25 minutes, took place at the participants’ houses. The anonymity and the confidentiality of their reports were ascertained.

Results

Parents of children on the autism spectrum reported higher levels of anxiety and higher negative emotional expressiveness in their families than did parents of typically developing children. Furthermore, parents of children with autism described themselves as being less authoritative and strict in their child rearing practices than did parents of typically developing peers. No other statistical differences were observed between the two groups of parents (Table 1).

Citation: Antonopoulou K, Manta N, Maridaki-Kassotaki K, Kouvava S and Stampoltzis A. Parenting and Coping Strategies among Parents of Children with and without Autism: The Role of Anxiety and Emotional Expressiveness in the Family. Austin J Autism & Relat Disabil. 2020; 6(1): 1054.