Skip to main content

Parenting stress in Chinese mothers of children with autism spectrum disorders

Abstract

Objective

Elevated parenting stress has been observed among mothers of children with autism spectrum disorders (ASDs) in western countries, but little is known about mothers of Han Chinese children. The aim of the current study was to further the knowledge about stress experienced by Chinese mothers of children with ASD by examining maternal parenting stress in Heilongjiang province of China.

Methods

In this cross-sectional study, data about participants’ demographic characteristics, parenting stress, anxiety, depression, child’s behavioral problems, coping strategies, and social support were collected though a questionnaire survey. The participants included 150 families with ASD children, who were consecutively admitted to the clinics of the Children Development and Behavior Research Center in Harbin Medical University, Heilongjiang Disabled Persons Federation, and Mudanjiang Child Welfare Home.

Results

The participants reported elevated parenting stress. Mothers’ parenting stress was associated with levels of depression and anxiety, and child’s behavioral symptoms. Child’s behavioral symptoms, maternal anxiety, maternal depressive symptoms, and lack of governmental financial support were associated with overall parenting stress.

Conclusions

Government support may play an important role in reducing parenting stress in this population.

This is a preview of subscription content, access via your institution.

Abbreviations

ASD:

Autism spectrum disorder

PSI-SF:

Parenting Stress Index-Short Form

References

  1. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (4th edn, text revision). Washington, DC: American Psychiatric Association

  2. Kim YS, Leventhal BL, Koh YJ, Fombonne E, Laska E, Lim EC, Cheon KA, Kim SJ, Kim YK, Lee H, Song DH, Grinker RR (2011) Prevalence of autism spectrum disorders in a total population sample. Am J Psychiatr 168(9):904–912

    PubMed  Article  Google Scholar 

  3. Zaroff CM, Uhm SY (2012) Prevalence of autism spectrum disorders and influence of country of measurement and ethnicity. Soc Psychiatr Psychiatr Epidemiol 47(3):395–398

    Article  Google Scholar 

  4. Lotter V (1967) Epidemiology of autistic conditions in young children. Soc Psychiatr Psychiatr Epidemiol 1(4):163–173

    Google Scholar 

  5. Tao KT (1987) Brief report: infantile autism in China. J Autism Dev Disord 17:289–296

    PubMed  Article  CAS  Google Scholar 

  6. Zhang X, Ji CY, Li JS (2004) The investigation of autism in children aged 2 to 6 years old in Tianjin. Chin J Reprod Health 15:206–208

    Google Scholar 

  7. Wang WH, Zhai LW, Zheng L (2003) Epidemiological investigation of autism children of Jiangsu province. Chin J Behav Med Sci 12:173–175

    Google Scholar 

  8. Liu J, Yang XL, Jia MX (2007) Survey on pervasive developmental disorder in 2–6 year-old children in Beijing. Chin Mental Health J 05:290–293

    Google Scholar 

  9. Yu C, Xia W, Sun C, Zhou Y, Liu L, Zou X, Wu L (2010) Survey on autistic spectrum disorder in 2 to 6 years old children in Harbin city. Chin J Child Health Care 18:750–753

    Google Scholar 

  10. Wang J, Zhou X, Xia W, Sun C, Wu L, Wang J (2012) Autism awareness and attitudes towards treatment in caregivers of children aged 3–6 years in Harbin. China Soc Psychiatr Psychiatr Epidemiol 47:1301–1308

    Article  Google Scholar 

  11. Kasari C, Sigman M (1997) Linking parental perceptions to interactions in young children with autism. J Autism Dev Disord 27:39–57

    PubMed  Article  CAS  Google Scholar 

  12. Hastings RP (2003) Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism. J Intellect Disabil Res 47:231–237

    PubMed  Article  CAS  Google Scholar 

  13. Hastings RP, Kovshoff H, Ward NJ, Espinosa FD, Brown T, Remington B (2005) Systems analysis of stress and positive perceptions in mothers and fathers of pre-school children with autism. J Autism Dev Disord 35:635–644

    PubMed  Article  Google Scholar 

  14. Montes G, Halterman JS (2007) Psychological functioning and coping among children with autism: a population-based study. Pediatrics 119:1040–1046

    Article  Google Scholar 

  15. Bailey D, Simeonsson R, Winton P, Le Couteur A, Gottesman I, Bolton P, Simonoff E, Yuzda E, Rutter M (1986) Family focused intervention: a functional model for planning, implementing, and evaluating individualized family services in early intervention. J Div Early Child 10(1):156–171

    CAS  Google Scholar 

  16. Lecavalier L, Leone S, Wiltz J (2006) The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders. J Intell Disabil Res 50:172–183

    Article  CAS  Google Scholar 

  17. Hastings RP, Kovshoff H, Brown T, Ward NJ, Espinosa FD, Remington B (2005) Coping strategies in mothers and fathers of preschool and school-age children with autism. Autism 9(4):377–391

    PubMed  Article  Google Scholar 

  18. Weiss MJ (2002) Hardiness and social support as predictors of stress in mothers of typical children, children with autism and children with mental retardation. Autism 6(1):115–130

    PubMed  Article  Google Scholar 

  19. Bishop SL, Richler J, Cain AC, Lord C (2007) Predictors of perceived negative impact in mothers of children with autism spectrum disorder. Am J Mental Retard 112:450–461

    Article  Google Scholar 

  20. Bromley J, Hare DJ, Davison K, Emerson E (2004) Mothers supporting children with autism spectrum disorders-Social support, mental health status and satisfaction with services. Autism 8:409–423

    PubMed  Article  Google Scholar 

  21. Ekas NV, Lickenbrock DM, Whitman TL (2010) Optimism, social support, and well-being in mothers of children with autism spectrum disorder. J Autism Dev Disord 40:1274–1284

    PubMed  Article  Google Scholar 

  22. Dunn ME, Burbine T, Bowers CA, Tantleff-Dunn S (2001) Moderators of stress in parents of children with autism. Community Mental Health J 37:39–52

    Article  CAS  Google Scholar 

  23. Wang P, Michaels CA, Day MS (2011) Stresses and coping strategies of Chinese families with children with autism and other developmental disabilities. J Autism Dev Disord 41:783–795

    PubMed  Article  CAS  Google Scholar 

  24. McCabe H (2007) Parent advocacy in the face of adversity: autism and families in the People’s Republic of China. Focus Autism Other Dev Disabil 22(1):39–50

    Article  Google Scholar 

  25. Abidin RR (1995) Parenting stress index, 3rd edn. Psychological Assessment Resource, Odessa, FL

    Google Scholar 

  26. Pearson V, Chan TWL (1993) The relationship between parenting stress and social support in parents of children with learning disabilities: a Chinese experience. Soc Sci Med 37:267–274

    PubMed  Article  CAS  Google Scholar 

  27. Li YT (2010) Mothers of asthmatic children: Perception of parenting stress and its influence factors. Dissertation, University of Sun Yat-sen

  28. Chan YC (1994) Parenting stress and social support of mothers who physically abuse their children in Hong Kong. Child Abuse Neglect 18:261–269

    PubMed  Article  CAS  Google Scholar 

  29. Tam KK, Chan YC, Wong CKM (1994) Validation of the parenting stress index among Chinese mothers in Hong Kong. J Community Psychol 22:211–223

    Article  Google Scholar 

  30. Qin X, Su X, Gao L (2008) Investigation on the parents’ stress of children with autism. China J Nurs 43(10):931–933

    Google Scholar 

  31. Zung W (1971) A rating instrument for anxiety disorders. Psychosomatics 12:371–379

    PubMed  CAS  Google Scholar 

  32. Wu WY (1990) The revised self-rating anxiety scale (SAS). Shanghai Arch Psychiatr 2:44

    Google Scholar 

  33. Liu X (1997) The revised self-rating anxiety scale for research in the teen-agers in China. Chin Mental Health J 11(2):75–77

    Google Scholar 

  34. Liu X (1995) Factor analysis of the revised self-Rating anxiety scale. Acta Acad Med Shandong 33(4):303–306

    Google Scholar 

  35. Lei M, Li C, Xiao X, Qiu J (2012) Evaluation of the psychometric properties of the Chinese version of the Resilience Scale in Wenchuan earthquake survivors. Compr Psychiatr 53(5):616–622

    Article  Google Scholar 

  36. Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401

    Article  Google Scholar 

  37. Radloff LS (1991) The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults. J Youth Adolesc 20(2):149–166

    Article  Google Scholar 

  38. Yang HJ, Soong WT, Kuo PH, Chang HL, Chen WJ (2004) Using the CES-D in a two-phase survey for depressive disorders among non-referred adolescents in Taipei: a stratum-specific likelihood ratio analysis. J Affect Disord 82:419–430

    PubMed  Google Scholar 

  39. Zhang J, Wu Z, Fang G, Li J, Han B, Chen Z (2010) Development of the Chinese age norms of CES-D in urban area. Chin Mental Health J 24(2):139–143

    Google Scholar 

  40. Krug DA, Arick JR, Almond PJ (1980) Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior. J Child Psychol Psychiatr 21:221–229

    Article  CAS  Google Scholar 

  41. Li JH, Zhong JM, Cai LY, Chen Y, Zhou MZ (2005) Comparison of clinical application of three autism rating scales. Chin J Contemp Pediatr 7:59–62

    CAS  Google Scholar 

  42. Ministry of Health of the People’s Republic of China (2010) Children's autism diagnosis and treatment and rehabilitation guidelines in China. Beijing, China

  43. Jie Y (1998) Reliability and validity of the implified coping style questionnaire (SCSQ). Chin J Clin Psychol 2:114–115

    Google Scholar 

  44. Zimet GD, Dahlem NW, Zimet SG, Farley GK (1988) The multidimensional scale of perceived social support. J Pers Assess 52:30–41

    Article  Google Scholar 

  45. Hastings RP (2002) Parental stress and behaviour problems of children with developmental disability. J Intell Dev Disabil 27:149–160

    Article  Google Scholar 

  46. Bennett T, Boyle M, Georgiades K, Georgiades S, Thompson A, Duku E, Bryson S, Fombonne E, Vaillancourt T, Zwaigenbaum L, Smith I, Mirenda P, Roberts W, Volden J, Waddell C & Pathways in ASD Study Team, Szatmari P (2012) Influence of reporting effects on the association between maternal depression and child autism spectrum disorder behaviors. J Child Psychol Psychiatr 53(1): 89–96

    Google Scholar 

  47. McCabe H (2008) Autism and family in the People’s Republic of China: learning from parents’ perspective. Res Pract Pers Severe Disabil 33(1–2):37–47

    Google Scholar 

  48. Estes A, Munson J, Dawson G, Koehler E, Zhou XH, Abbott R (2009) Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism 13(4):375–387

    PubMed  Article  Google Scholar 

  49. Davis NO, Carter AS (2008) Parenting Stress in Mothers and Fathers of Toddlers with Autism Spectrum Disorders: associations with Child Characteristics. J Autism Dev Disord 38(7):1278–1291

    PubMed  Article  Google Scholar 

  50. Holroyd EE (2003) Chinese cultural influences on parental caregiving obligations toward children with disabilities. Qual Health Res 13:4–19

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

The authors are grateful to the Heilongjiang Disabled Persons Federation and Mudanjiang Child Welfare Home. The authors are also grateful to all those who participated in the study.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to LiJie Wu or JianLi Wang.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Wang, J., Hu, Y., Wang, Y. et al. Parenting stress in Chinese mothers of children with autism spectrum disorders. Soc Psychiatry Psychiatr Epidemiol 48, 575–582 (2013). https://doi.org/10.1007/s00127-012-0569-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-012-0569-7

Keywords

  • Autism spectrum disorders
  • Parenting stress
  • China