Caregivers Strain And Related Factors Of Children With Autism Spectrum Disorders

Objectives:To explore caregivers' strain and its influential factors in caregivers of children with autism spectrum disorders(ASD),and to guild screening and intervention process in clinical practice for ASD caregivers based on results from the present study.Methods:168 DSM-5 defined ASD and 143 normal children who matched sex and age with the ASD group were recruited to the present study.Both groups filled out the self-developed questionnaire on demographic data and Caregivers Strain Questionnaire(CGSQ)which represent the level of caregivers'stress.Autism behavior checklist(ABC1)were applied to evaluate the clinical manifestations,and Aberrant Behavior Checklist(ABC2)and Conners Index of Hyperactivity(CIH)were used to assess aberrant behaviors of ASD patients,such as stereotypes,hyperactivity,self-injury and irritability.Besides,caregivers' emotional state were evaluated by the Hospital Anxiety and Depression Scale(HAD).Results:1.Caregivers of children with ASD experienced a significantly higher level of parenting stress in the total scores of CGSQ and all the dimensions of CGSQ,including Objective Caregiver Strain,Externalized Subjective Caregiver Strain,and Internalized Subjective Caregiver Strain,as compared with caregivers of the normal group(All P<0.05);2.According to HAD criteria,55(34.59%)and 57(35.85%)of ASD caregivers'were identified as exhibiting anxiety and depression mood,respectively,and 73(45.91%)having either anxiety or depression mood;No significant differences were found on HAD total score,anxiety/depression scores of HAD among the different ASD caregivers(mother,father and others)(All P>0.05)3.According to the self-developed standards,the rate of irritability,hyperactivity and self-injury was 67.26%,62.5%,and 14.29%respectively for the past four weeks;parenting stress of ASD patients with irritability,hyperactivity and self-injury were higher than those whose children are absent with above aberrant behaviors(All P<0.05);4.Correlation analysis revealed that:lower mother's education level and worse parental relationship correlated with higher total CGSQ score and scores of all the dimensions of CGSQ(All P<0.05);higher total score of ABC 1 and all the dimensions of ABC1 including movement/communication/feeling,correlated with higher total CGSQ score and scores of all the dimensions of CGSQ(All P<0.05);higher CIH score correlated with higher CGSQ total score and scores of all the dimensions of CGSQ(All P<0.05);higher ABC2 total score correlated with higher of CGSQ total score and scores of all the dimensions of CGSQ(P<0.05);higher ABC2 self-injury,hyperactivity,stereotypic behavior,inappropriate speech subscores correlated higher total CGSQ score and scores of all the dimensions of CGSQ(All P<0.05);5.Linear regression analysis presented that higher HAD score,higher ABC2 total score,worse parental relationship,receiving special education and training,higher self-injury score of ABC2 indicated a higher total CGSQ score(R2=0.531,p<0.05;R 2=0.509,p<0.05)and Objective Caregiver Strain score(R2=0.509,p<0.05);higher HAD score,higher irritability,and hyperactivity score of ABC2 indicated a higher score of externalized subjective caregiver strain of CGSQ(R2=0.393,P<0.05);higher HAD score,higher CIH score,existing walking and motor retardation indicated a higher score of internalized subjective caregiver strain of CGSQ(R2=0.468,p<0.05)?Conclusion:1.Caregivers of children with ASD generally experience a significantly higher parenting stress than caregivers of the normal group;2.Aberrant behaviors are prevalent in children with ASD and are the major factor that increase the parenting stress of caregivers;in addition to stereotypic behavior,rate of irritability,hyperactivity and self-injury was 67.26%,62.5%and 14.29%,respectively in ASD patients for the past 4 weeks;Furthermore,poor parental relationship,anxiety and depression mood of caregivers,receiving special education training,existing walking and motor retardation also can aggravate the caregivers strain of children with ASD.