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The Family Adjustment Measure: Identifying Stress in Parents of Youth with Autism

Abstract

Objectives

Families caring for children and adolescents with autism spectrum disorder (ASD) have a unique parenting experience and often report high stress. Resilience factors such as coping and social support are linked to positive family outcomes and protect against stress. The Family Adjustment Measure (FAM) was developed as a screener for both parental stress and coping, and in the current study, we validated its use for ASD-affected families.

Methods

With data from parents of children and adolescents with rigorously-confirmed ASD diagnoses (n = 362), we also used receiver-operating characteristics (ROC) analyses to identify cut-off scores, sensitivity, and specificity for the FAM’s four subscales, which differed for parents of children versus parents of adolescents.

Results

For parents of children, FAM subscale cut-off scores were: Parental Distress = 16.5 (78% sensitivity, 64% specificity); Social Support = 30.5 (70% sensitivity, 52% specificity); Family-Based Support = 27.5 (73% sensitivity, 57% specificity); and Positive Coping = 24.5 (58% sensitivity, 54% specificity). For parents of adolescents, FAM subscale cut-points were: Parental Distress = 18.5 (83% sensitivity, 82% specificity); Social Support = 30.5 (73% sensitivity, 51% specificity); Family-Based Support = 28.5 (80% sensitivity, 62% specificity); and Positive Coping = 22.5 (70% sensitivity, 50% specificity).

Conclusions

Results support the validity of using the FAM subscales to predict clinically-significant stress within families of both children and adolescents with ASD, though the differing cut-off scores underscore the need for age-related considerations when working with ASD-affected families. Findings suggest potential clinical utility of using the FAM to identify unique risk and protective factors of families raising children and adolescents.

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Acknowledgements

We are grateful to all of the families at the participating Simons Simplex Collection (SSC) sites, as well as the principal investigators (A. Beaudet, R. Bernier, J. Constantino, E. Cook, E. Fombonne, D. Geschwind, R. Goin-Kochel, E. Hanson, D. Grice, (A) Klin, D. Ledbetter, C. Lord, C. Martin, D. Martin, R. Maxim, J. Miles, O. Ousley, K. Pelphrey, (B) Peterson, J. Piggot, (C) Saulnier, M. State, W. Stone, J. Sutcliffe, C. Walsh, Z. Warren, E. Wijsman). We are particularly grateful for the generosity of parents who participated in the current study. We appreciate the assistance of the SSC@IAN in recontacting SSC families for recruitment in this project.

Funding

This study was supported by a small grant, New Faculty Research Program, from the University of Houston awarded to Dr. Mire.

Author Contributions

S.L.M.: assisted with study execution, assisted with data analysis, and lead the writing of the paper. X.L.: conducted analyses, collaborated in writing the paper, particularly regarding analytic methods and results. D.M.T.: co-wrote several sections of the paper, collaborated in editing final manuscript. A.C.M.: collaborated in writing the paper. A.P.D.: collaborated with study design and assisted with final manuscript. S.S.M.: designed and executed the study, assisted with data analyses, co-wrote all sections of the paper.

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Correspondence to Sarah S. Mire.

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McKee, S.L., Liu, X., Truong, D.M. et al. The Family Adjustment Measure: Identifying Stress in Parents of Youth with Autism. J Child Fam Stud 29, 592–604 (2020). https://doi.org/10.1007/s10826-019-01569-4

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Keywords

  • Autism spectrum disorder
  • Parenting stress
  • Family support
  • Family adjustment
  • Receiver operating characteristics