Substantial empirical evidence suggests links between psychological stress and poor well- being of parents and parenting a child with ASD (e.g. Chong & Kua, 2017; Davis & Carter, 2008; Estes et al., 2009; Hayes & Watson, 2013; Pottie & Ingram, 2008). Research findings have studied parenting stress in parents of children with ASD in comparison with parents of typically developing children and those with non-ASD disorders such as intellectual disabilities and other developmental disorders.
2.5.1 The impact of ASD children compared to typically developing children on stress in parents
Hayes and Watson, (2013) identified several studies that have investigated stress and poor well- being of parents of children with ASD in comparison to parents of typically developing children (e.g. Brobst et al., 2009; Hoffman, Sweeney, Hodge, Lopez-Wagner, & Looney, 2009;
Lee, 2009; Rao & Beidel, 2009), the findings are discussed in categories below.
2.5.2 The impact of ASD children compared to typically developing children and children with other developmental disorders on stress in parents
The pervasive and severe deficits present in children with ASD are related to a number of strains in parents that differ from those experienced by parents of typically developing children and children with other developmental disorders (Karst & Van Hecke, 2012).
A meta-analysis by Hayes and Watson (2013) analysed previous research conducted that compared stress in parents of children with ASD, children with other developmental disabilities (non-ASD) and typically developing children. They found that the overall effect size calculated was large, suggesting that stress in families with a child with ASD was significant and thus warranted intervention and support.
2.5.3 The impact of ASD children compared to children with other developmental disorders on stress in parents
Hayes and Watson (2013) reported that several studies compared stress in parents of children with ASD in comparison with stress in parents of children diagnosed with other developmental disorders. These included those children diagnosed with Down syndrome (DS), intellectual
28 disability (with no known aetiology; ID), cerebral palsy, fragile X syndrome, cystic fibrosis, fetal alcohol spectrum disorder (FASD), or externalizing behaviours (e.g., Abbeduto et al., 2004; Blacher & McIntyre, 2006; Bouma & Schweitzer, 1990; Dabrowska & Pisula, 2010;
Donenberg & Baker, 1993; Eisenhower et al., 2005; Estes et al., 2009; Griffith et al., 2010;
Hamlyn-Wright et al., 2007; Konstantareas & Homatidis, 1992; Pisula, 2007; Stewart et al., 2017; Watson et al., 2012; Wolf et al., 1989).
2.5.4 The impact of ASD children compared to typically developing children and children with non-ASD disabilities on stress and well-being in parents
According to a number of studies (Davis & Carter, 2008; Falk, 2014; Huang et al., 2013; Lee, Lopata, Volker, Thomeer, Nida, Toomey, Chow, & Smerbeck, 2009; Jones, Totsika, Hastings
& Petalas, 2013; Mount & Dillion, 2014; Weiss, Cappadocia, MacMullin, Viecili, & Lunsky, 2012), being a caregiver of a child with ASD was found to involve encountering problems and demands daily that caused substantial amounts of stress and impacted mental health and well- being negatively, more than that of parents of typically developing children or non-ASD disabilities.
In their review of literature, Meadan, Halle and Ebata (2010) found that parents of children with ASD reported greater stress than parents of children with down syndrome and parents of typically developing children (e.g. Hastings & Johnson, 2001; Perry et al., 2004; Poston et al., 2003).
2.5.5 The impact of ASD children compared to typically developing children, children with non-ASD disabilities and other psychiatric disorders on stress and well-being in parents
According to Estes et al. (2013) the risk for increased levels of stress and mental health problems is much greater in parents of children with ASD when compared to parents of typically developing children and children with psychiatric and non-ASD developmental disorders (Estes et al., 2009; Griffith et al., 2010; Naseef, 2001; Schieve et al., 2007).
Findings emerging from their study, were found to be consistent with this as mothers of toddlers with ASD reported higher parenting-related stress than mothers of toddlers with non- ASD developmental delays (DD) and typical development. However, when measuring psychological distress- characterised by anxiety and depressive symptomology- their findings contrasted this assumption as, psychological distress was not significantly dissimilar amongst
29 the sample of mothers of ASD and non-ASD toddlers. This suggests that mental health concerns relating to psychological distress may be present among mothers of toddlers regardless of diagnosis.
Falk, Norris and Quinn (2014) report that existing literature has recognised that parents of children with ASD present with greater mental health concerns than the parents of children in other clinical and/or non-clinical groups (e.g. Benjak, 2009; Bitsika & Sharpley, 2004;
Kuusikko-Gauffun et al., 2013; Micali et al., 2004; Singer, 2006).
The abovementioned study by Hayes and Watson (2013) supported this suggestion, reporting that a number of researchers have identified greater incidences of depression and anxiety (e.g.
Dumas et al., 1991; Eisenhower et al., 2005; Hamlyn-Wright et al., 2007; Koegel et al., 1992) and lower overall well-being (Blacher & McIntyre, 2006) in parents of children with ASD.
2.5.6 The impact of ASD children compared to children with non-ASD disabilities and non-ASD intellectual disability on stress and well-being in parents
Research findings have indicated that parents of children with ASD consistently report more psychological stress and poorer well-being than parents of non-ASD children or parents of children with other intellectual disabilities (e.g. Estes et al., 2013; Hastings & Johnson, 2001;
Hayes & Watson, 2013; Meadan, Halle, & Ebata, 2010; Stewart et al., 2017).
These findings collectively suggest that having a child with ASD is linked to higher levels of stress and poorer mental health than those seen in parents of non-ASD children, highlighting the need for parental support and intervention.
As ASD presents a unique series of challenges, it is not sufficient enough to base our understanding of parental experiences on the experiences of parents of typically developing children or those with disabilities other than ASD. The psychosocial experiences of parents with children who have ASD need to be understood as unique and dependent on the context they are found in.
In conclusion, arguments have been presented around differential experiences of parenting children with developmental/mental illness states. Whilst generalizability of experiences cannot be assured due to the differences in psychosocial adaptation regarding conditions mentioned above, it would be of great value to investigate lived experiences of parent/s of a child with ASD so as to: 1) identify similar forms of adaption when compared to managing a
30 child with other forms of disabilities and 2) identify unique forms of adaptation that parents subscribe to in a given context.
2.6 PARENTS EXPERIENCES/ CHALLENGES INTRINSICALLY RELATED TO