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One of the core features of Autism Spectrum Disorder (ASD), social communication impairment, presents in a variety of ways, including reduced functional language use and social initiations, which often warrant intensive intervention services. Additionally, parents of children with ASD demonstrate increased levels of parenting stress when compared to parents of typically developing children and children with developmental delays (Hayes and Watson, 2013). Elevated parenting stress has been shown to diminish positive treatment outcomes (Osborne et al., 2008), which lends support to develop methodologies to concomitantly target child and parent behaviors. The current randomized control trial (RCT) uses a dual-pronged approach to directly target both child communication deficits and parenting stress within a group format. This RCT combined an empirically supported behavioral therapy, Pivotal Response Treatment (PRT), with components from Acceptance and Commitment Therapy and Mindful Parenting for reducing parenting stress. Fifteen pairs of caregivers and their minimally or pre-verbal child with diagnosed or suspected ASD were randomly assigned to one of the following supplemental conditions: mindfulness-enhanced PRT (mPRT; n = 8) or psychoeducation-enhanced PRT (pPRT; n = 7) as an active control condition. Of these, five pairs completed each condition. The current study assessed feasibility and acceptability in addition to demonstrating proof of concept in regard to additive effects of mPRT compared to pPRT. Results provided mixed support for feasibility and efficacy of a multi-component group treatment approach. There was a low retention rate and the small sample sizes significantly decreased power. However, parents endorsed high satisfaction, demonstrated fidelity of PRT implementation, and children significantly increased their expressive language abilities. In regard to group-level analyses for primary and exploratory aims, the mPRT group showed significant decreases in parenting stress and increases in mindfulness. At the individual level, some parents in both groups showed positive changes in mindfulness, positive feelings toward child, and child problem behavior. Future directions should continue to explore the additive effects of mindfulness-based intervention on group-based parent-mediated treatments using larger sample sizes. / Doctor of Philosophy / Social communication difficulties are one of the core components of Autism Spectrum Disorder (ASD) and many treatments are specifically designed to target these challenges. Additionally, parents of children with ASD report higher levels of parenting stress when compared to parents of typically developing children and children with developmental delays (Hayes & Watson, 2013). High parenting stress has been shown to decrease the likelihood of positive treatment outcomes (Osborne et al., 2008). As a result, creating a treatment that targets both parent and child difficulties simultaneously may lead to important outcomes for the family unit. The current study combined treatments that have been shown to increase child language and decrease parenting stress. Fifteen pairs of caregivers and their child with language delays and ASD were randomly assigned (i.e., similar to a flip of a coin) to receive Pivotal Response Treatment (PRT) and one of the following: mindfulness (mPRT; n = 8) or psychoeducation (pPRT; n = 7). Ten total families completed the treatment (5 per group). The current study measured the practicality and usefulness of adding either mindfulness or psychoeducation to PRT. Results provided mixed support for the practicality of a group treatment approach that combined two treatments. Approximately two-thirds of the families who started treatment finished treatment. The parents who completed treatment showed high satisfaction ratings and demonstrated that they could accurately perform the treatment techniques taught in group sessions. In addition, children increased their language abilities. Parents in the mindfulness group showed significant decreases in parenting stress and increases in mindfulness. At the individual level, some parents in both groups showed positive changes in mindfulness, positive feelings toward child, and child problem behavior. Future directions include measuring these changes with a larger number of families.

Background: Parents of children with developmental disorders (DD) or disabilities report greater parenting stress than parents of typically developing children. To minimise this stress, stressful factors need to be known and stress needs to be recognised early. The present cross-sectional study aims to systematically assess and compare parenting stress in families of children with various types of disabilities. In addition, the assessment of parenting stress by attending paediatricians will be evaluated. Methods: We surveyed 611 parents about their parenting stress at the Children's Development Center (CDC). Three questionnaires, including the German versions of the Parenting Stress Index (PSI) and Impact on Family Scale (IOFS), were used to evaluate parenting stress. Furthermore, attending paediatricians assessed of the child's type of disability and their perception of parenting stress in a separate questionnaire. Results: Fifty-five percent of all parents reported stress at a clinically relevant level, 65% in the child domain and 39% in the parent domain of the PSI. Parenting stress differed significantly across diagnostic categories (p < 0.01) and was associated with childhood disability related issues of behaviour, sleep or feeding issues. Parenting stress was often underestimated by the paediatricians, especially when the children had disabilities perceived as less severe. In one-third of parents with clinically relevant total stress, paediatricians reported low stress levels. Parent-reported financial problems, social isolation, and partnership conflicts were not suspected by paediatricians in ≥85% of cases. Conclusions: Clinically relevant parenting stress was found more often than in comparable studies. An assessment of parenting stress by paediatricians may be complicated by time constraints in medical appointments, the mainly child-centred consultation, or restricted expression of parents' stress. Paediatricians should move from a purely child-centred to a holistic, family-centred approach to treatment. Routine screening of parenting stress using standardised questionnaires could be helpful to identify affected families.

This study investigated the association between Chinese immigrant mothers' reports of parenting stress and two sources of parenting support: fathers' support and social support. Five independent-samples t-tests were first computed to examine whether there were discrepancies between Chinese immigrant mothers' and fathers' perceptions of fathers' involvement across five domains of fathers' involvement in early child care: (1) fathers' warmth and attunement; (2) control and process responsibility; (3) emotional involvement; (4) indirect care; and (5) positive engagement. Then regression analyses were conducted to understand how and to what extent the five domains of father involvement reported by mothers and mothers' perceived social support influenced Chinese immigrant mothers' parenting stress. In addition, an indirect effects of mothers' self-efficacy on the relation between fathers' involvement and mothers' parenting stress was also tested. The results showed that Chinese mothers reported significantly greater level of fathers' emotional involvement than the same type of involvement reported by Chinese immigrant fathers. This study also found that fathers' emotional involvement reported by Chinese immigrant mothers was a significant predictor of Chinese immigrant mothers' parenting stress. However, mothers' perceived social support was a stronger predictor, accounting for more variance in their parenting stress than their reports of fathers' involvement across all the five dimensions. Mothers' self-efficacy did not account for the association between Chinese immigrant mothers' reports of fathers' involvement across five dimensions and mothers' parenting stress.

The purpose of this study was to explore the differences in how parents of ADHD children and non-ADHD parents attribute undesirable and prosocial child behavior, and to determine if attributions about undesirable child behavior influence parents' perceived levels of parenting stress. Parent attributions from 69 parent-child dyads, half with a child ADHD diagnosis, were measured coding videotaped interactions. Results indicated that parents of ADHD children do not make significantly more stable attributions about undesirable child behavior than non-ADHD parents. Additionally, compared to non-ADHD parents, parents of ADHD children did not make significantly more unstable attributions about their children's prosocial behaviors. Regarding parenting stress, individuals who generated higher frequencies of stable attributions also appeared to maintain more negative views of their children's behaviors in comparison to other children.

To date, researchers who have explored the complexity of childhood bereavement have utilized unstandardized assessment instruments and/or have independently evaluated specific constructs rather than factoring in the dimensionality of loss. The purpose of this study was to use parents' completion of established instruments--the Child Behavior Checklist and the Parenting Stress Index--to examine the multivariate shared relationship between characteristics of bereaved children referred for counseling--their ages, genders, ethnicities, types of loss, and life stressors--and their behavioral manifestations as well as the relationship between these characteristics and levels of parent-child relational stress. Utilizing archival clinical files, I examined these characteristics from bereaved children (N = 98) whose parents sought counseling services from two university-based counseling clinics. The sample consisted of 67 boys and 31 girls between the ages 3 and 11 years old (M = 6.28). The majority of participants (67%, n = 66) identified as Caucasian, 10% (n = 10) as African American, 10% (n = 10) as Hispanic/Latino, 6% as Bi-racial (n = 6), 4% as Native American (n = 4), and 2% as Asian (n = 2). A canonical correlational analyses (CCA) was conducted to examine relationship between characteristics of children and their subsequent behavioral manifestations. The full model was found to be statistically significant using the Wilks’s λ = .611 criterion, F(25, 328.41) = 1.862, p = .008. The R2 type effect size was .389, which indicates the full model explains about 39% of the variance shared between the two variable sets. A second CCA was conducted to explore the relationship between characteristics of bereaved children and levels of parent-child relational stress. The full model was found statistically to be significant using the Wilks’s λ = .790 criterion, F(10, 154) = 1.926, p = .045. The R2 type effect size was .210, which indicates the full model explains about 21% of the variance shared between the two variable sets. Overall, correlational findings from this study provided insight into bereaved children’s manifestations of loss and levels of parent-child relational stress as contingent upon specific characteristics. Specifically, results indicated a strong relationship between age and bereaved children’s behavioral manifestations. This finding reinforced the importance for clinicians to understand developmental implications when working with bereaved children. Furthermore, caregivers who reported minimal overall external stressors also reported less parent-child relational interference. This finding further emphasizes the importance for caregivers to maintain utmost stability for bereaved children.

Recently, researchers have begun to explore the associated impacts of ADHD on parent and family functioning, with an increasing focus on parenting stress. Accumulating empirical evidence is mixed, suggesting that parents of children with ADHD report increased levels of parenting stress when compared to parents of children with learning disabilities, and parents of non-referred children, but report equally stressful parenting levels when compared to parents of children with externalizing behavior problems. Results of the present study comparing reported parenting stress levels between parents of children with ADHD, children with internalizing behavior problems, and nonreferred children, were partially supportive of results found in past studies indicating higher levels of parenting stress among parents of children with ADHD. However, strong gender effects were found between mothers and fathers, which mediated the overall results.

Parents of children with autism spectrum disorder (ASD) often exhibit high parental stress which may be caused by parent-child behaviors, child behaviors, and parent distress. Awareness and understanding of ASD is critical for parents and educators to connect students with support services and resources. The purpose of this bounded, descriptive case study was to identify perceived parental stressors and to determine the primary stressors of parents with low socioeconomic status who are raising a child with ASD in a rural area. The foundation of family systems theory framed this study. Ten parents raising a child with ASD were purposefully selected and volunteered to participate in this study. The quantitative data were collected using the Parental Stress Index-Short Form, a 36-item Likert scale with items related to parent-child dysfunctional relationships, parenting distress, and child behavior. Descriptive analysis determined which domain and items were most stressful and were the basis for developing 6 semistructured interview questions. Interview data were open-coded and analyzed thematically to identify the greatest stressors to parents. Based on these findings, it is recommended that school personnel coordinate an autism support group to include educators, parents of children with ASD, and professional service providers to share formal and informal supports within the school district and the community. These endeavors may contribute to positive social change by providing parents and educators access to resources and therapeutic and social supports, thus allowing students with ASD to receive appropriate and timely support and to reduce parental stress.