Thesis (Ph. D.)--Oregon State University, 2010. / Printout. Includes bibliographical references (leaves 93-102). Also available on the World Wide Web.

Thesis--Auburn University, 2009. / Abstract. Includes bibliographical references (p. 81-93).

Thesis (M.Sc.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science in Rehabilitation Science, Faculty of Rehabilitation Medicine. Title from pdf file main screen (viewed on October 24, 2009). Includes bibliographical references.

Thesis (PH.D.) -- Syracuse University, 2006. / "Publication number AAT 3316570"

Background. Mothers of children with Autism Spectrum Disorder (ASD) report high levels of stress, depression, and poor well-being, with little sense of social support due to the high demands of their child’s care. The Incredible Years® for Autism and Language Delays (IY-ASLD) program offers a unique model in that there is a dual focus on both child and parent outcomes. However, there is a dearth of literature on whether IY-ASLD can improve parental mental health outcomes. While there is some evidence to suggest that in-vivo therapist-to-parent supportive statements reduce parental resistance to treatment, there remains a gap in the literature regarding whether these behaviors directly impact parental mental health outcomes. Therefore, the present study investigated the degree to which exposure to the IY-ASLD telehealth curriculum (total minutes in attendance across sessions) along with in-vivo therapist-parent group verbal support was related to parental mental health outcomes and parental verbal approval statements of the child at post-treatment after controlling for baseline mental health and verbal approval. Methods. Participants were seventeen mother-child dyads, with children ages 2-years-8-months to 5-years-old recruited from a preschool utilizing an Applied Behavior Analysis (ABA) approach to schooling. All or virtually all children referred to this school by their school district are at-risk for or have been diagnosed with ASD. All of the children had an IEP or IFSP with mandated speech services, 71% of the children met criteria for ASD (N = 12) on the Childhood Autism Rating Scale- 2-SF, and 2/3 of the sample had adaptive behavior composites below a standard score of 70 on the Vineland Adaptive Behavior Scales- Third Edition Comprehensive Teacher Form (Sparrow et al., 2016). Participants were assigned to one of four treatment groups based on language level of the child and convenience of the group meeting time. Groups met for 12-weekly IY-ASLD sessions via telehealth. Data were collected at the beginning, mid-point, and end of treatment in the form of a parent questionnaire covering demographics, parental well-being (World Health Organization- Five Well-Being Index; WHO, 1998), depressive symptoms (Patient Health Questionnaire; Kroenke et al., 2001), and parenting stress (Parenting Stress Index-Fourth Edition, Short Form; Abidin, 2012). At post-treatment, parents reported satisfaction with the IY-ASLD-T program (IY-ASLD Parent Program Satisfaction Questionnaire). Data were also collected throughout treatment by recording IY-ASLD parent sessions. From the recorded parent sessions, two primary variables were developed. The first was treatment dosage, calculated as the total minutes each parent attended over the course of the 12-week intervention. The second was exposure to supportive therapist verbalizations during the first 10-minutes of each session, which was coded using the Therapy Process Code (TPC) to measure therapist supportive verbalizations during therapist-parent interaction (Chamberlain et al., 1986). Additionally, data were collected via a virtual parent-child play session (PCI) at the beginning, mid-point, and end of treatment, and later coded using the Verbal Behavior Developmental Language Coding System (VBDT) to measure parental verbal approval to child (Greer & Ross, 2008). Results. Mothers in this study had low levels of depression (PHQ-9; M = 4.59, SD = 4.69), average parenting stress (PSI-4-SF; M = 78.12, SD = 23.78), and low levels of well-being (WHO-5; M = 12.82, SD = 4.47). There were no statistically significant changes in parental depression, parental stress, or observed verbal approval from pre- to post-treatment and the effect sizes were small based on the partial eta squared and Kendall’s W values as per Cohen’s (1988, 1994) guidelines (small = .20-.49, medium = .50-.79, large > .80). However, there was a statistically significant change in caregiver well-being from baseline, mid-treatment, to post-treatment and a small effect size based on Kendall’s W (W = .31). A Friedman test indicated that caregivers demonstrated significant improvements in well-being from baseline to mid-treatment, and the improvement remained at post-treatment, χ2 (2) = 10.04, p < .01. There was no significant relationship between treatment dosage or supportive verbalizations and change in caregiver well-being. There was a significant negative correlation between treatment dosage and well-being at mid-treatment (r = -.493, p = .044), trending in the same direction at post-treatment (r = -.369, p = .146), possibly suggesting that parents with lower well-being, and therefore in greater need of support, attended IY-ASLD more frequently. An additional unexpected finding indicated that parents who were exposed to more supportive verbalizations had statistically significantly lower well-being at post-treatment. One explanation proposed by the authors is that parents who had lower well-being, and attended IY-ASLD sessions more frequently, received more supportive therapist verbalizations, possibly because they pulled for supportive verbalizations from the therapist. Results from the Incredible Years satisfaction questionnaire indicated there was high satisfaction with the program and the group leaders. High ratings of satisfaction with the group leaders and the program overall indicated that group leaders in the program may have successfully accomplished providing a “good enough” sense of support and reinforcement to parents over the course of the intervention. Therefore, it’s possible that specific therapist-to-parent supportive verbalizations were less related to improvements in parental well-being, and rather, the overall sense of support from the therapist to the parents in the group, along with support between the parents in the group, were sufficient to result in improvements in maternal well-being over the course of the intervention. Conclusions. Over the course of the IY-ASLD-T intervention, mothers demonstrated significant improvements in their overall well-being. While exposure to treatment and to supportive verbalizations from therapist to parents were not related to residualized change in well-being, these seem to be important factors in understanding the needs of parents with young children with ASD (e.g., parents with low well-being had higher attendance and received more supportive verbalizations). Taken together, the results suggest maternal well-being is an important and promising target for evidence-based behavioral parenting interventions such as IY-ASLD.

Thesis(MEdPsych)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Autism or Autism Spectrum Disorder (ASD) is a condition that, at present, affects approximately one out of every 100 children globally and indications are that the prevalence thereof is steadily on the rise. ASD is a complex neurological condition that impairs social interaction, communication and behaviour. Research on the wide-ranging effects of ASD and its unique characteristics in each child with ASD is widely available. Several studies refer to the fact that ASD has an impact on the family unit, but very few researchers have investigated the support that families from different cultural groups in South Africa are enjoying whilst raising a child with autism. The current situation being what it is means that professionals and families have very little data on the subject and inadequate support is available to address the specific needs of families who are raising a child with autism. The aim of this study was to investigate the support structures of three families from three different cultural groups in South Africa who were raising a child with autism. The central issue that was researched was the support structures available to parents raising a child with autism, and how parents access that support. This is a qualitative study within an interpretive research paradigm. In this case study, the methods of data collection comprised semi-structured interviews, observations and reflective journals. This design embraced qualitative research methods that could expose the uniqueness of each family’s experience and allowed participants the freedom to express this. The three families, who were purposefully selected for this study, were from different cultural backgrounds. One of the children in each family met the criteria published in the Diagnostic and statistical manual of mental disorders, fourth edition, text revision (American Psychiatric Association, 2000) for Autism or Pervasive Developmental Disorder not Otherwise Specified (PDD-NOS). The study found that the parents in the three families received support from their spouses and the neuro-typical siblings. The families also enjoyed physical support, financial support and emotional support from different sources. Parents reported feeling supported when others show acceptance and understanding of their children’s deficits and when such others are prepared to ‘go the extra mile’. The three families also perceived information and guidance as a valuable source of support. Even though they had firm support structures in place, they also reported on the lack of support available to them. All three families enjoyed these forms of support, but it was interesting to find out that the families received the support from different sources. / AFRIKAANSE OPSOMMING: Outisme of outisme spektrum versteuring (OSV) is 'n toestand wat tans ongeveer een uit elke 100 kinders wêreldwyd affekteer en daar is aanduidings dat die voorkoms daarvan steeds toeneem. OSV is 'n komplekse neurologiese toestand wat swak sosiale interaksie, kommunikasie en gedrag tot gevolg het. Navorsingsresultate oor die breë gevolge van OSV en die unieke eienskappe daarvan in elke kind met OSV is algemeen beskikbaar. Verskeie studies verwys na die feit dat OSV 'n impak het op die gesinseenheid, maar tot dusver het baie min navorsers die ondersteuning ondersoek wat gesinne uit verskillende kulturele groepe in Suid-Afrika tydens die opvoeding van 'n kind met outisme geniet . Die huidige situasie voorsien professionele mense en gesinne van baie min data oor die onderwerp en onvoldoende ondersteuning is beskikbaar om die spesifieke behoeftes van gesinne met 'n kind met outisme aan te spreek. Die doel van hierdie studie was om ondersoek in te stel na die ondersteuning wat gesinne in verskillende kultuurgroepe in Suid-Afrika tydens die opvoeding van ‘n kind met outisme geniet. Die sentrale ondersoekvraag het betrekking gehad op ondersteuningstrukture vir gesinne met ‘n kind met outisme binne hul kultuurgroep, sowel as die wyse waarop die gesinne toegang tot die ondersteuning verkry. Die studie was kwalitatief van aard binne 'n interpretatiewe navorsingsparadigma en ’n gevallestudie is as navorsingsontwerp gekies. Data is deur middel van semi-gestruktureerde onderhoude, waarnemings en reflektiewe joernale ingesamel. Die kwalitatiewe navorsingsmetodes omvat die uniekheid van elke gesin se ervaring en laat deelnemers die vryheid om uitdrukking daaraan te gee. Drie gesinne is doelbewus vir hierdie studie gekies. Die gesinne moes oor die volgende kenmerke beskik: Hulle moes uit verskillende kulturele agtergronde (Afrikaan, Wit en Indiër) kom. Hul kind moes voldoen aan die kriteria in die Diagnostiese en Statistiese Handleiding van geestesversteurings, vierde uitgawe, teks hersiening (2000) vir Outisme of pervasieve ontwikkelingsstoornis nie anders gespesifiseer nie (PDD-NOS). Verskeie etiese beginsels is vir hierdie studie nagekom om te verseker dat die navorsing eties was. Die studie het bevind dat die ouers in die drie gesinne ondersteuning van hul gades en die neurotipiese broers en susters van die kind met outisme ontvang het. Die gesinne het ook fisiese ondersteuning, finansiële steun en emosionele ondersteuning vanuit verskillende bronne geniet. Die gesinne het aangedui dat hul ondersteun voel wanneer hul kinders se afwykings aanvaar word, begrip daarvoor getoon word en andere bereid was om die ‘ekstra myl te loop’. Die drie gesinne het ook inligting en leiding as waardevolle bronne van ondersteuning ervaar. Selfs al het die families sterk ondersteuningstrukture in plek gehad, het hulle ook die gebrek aan ondersteuning uitgelig. Al drie gesinne geniet die bogenoemde vorme van ondersteuning, maar dit was interessant om uit te vind dat die families hierdie ondersteuning vanuit verskillende bronne ontvang het.