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The study purpose was to examine the effect of emotional support on the overall mental health and stress for caregivers of children with autism spectrum disorder (ASD). A cross-sectional retrospective study using secondary data from the 2016–2019 National Survey of Children's Health was conducted using single variable and multivariable linear regression analyses. More informal emotional support sources were associated with better overall mental health (β = 0.124, SE = 0.015, p <.001) and reduced stress (β = −0.261, SE = 0.039, p <.001) for caregivers of children with ASD, controlling for covariates. The number of formal emotional support sources was not significantly associated with caregiver overall mental health or stress when controlling for covariates. Increased amounts of total emotional support sources were significantly associated with increased overall mental health (β = 0.042, SE = 0.010, p <.001) and reduced stress (β = −0.093, SE = 0.024, p <.001) for caregivers. Other factors significantly associated with caregiver outcomes included caregiver sex, caregiver marital status, caregiver education level, economic hardship, child sex, child race/ethnicity, ASD severity, and child receipt of ASD treatment. More emotional support sources, in particular informal support sources, may be a protective factor for well-being for caregivers of children with ASD. Health care providers should evaluate the impact of their formal support services on caregivers of children with ASD and advocate for increased informal and formal support resources for these caregivers. • More informal support sources was associated with lower caregiver stress. • More informal support sources was associated with better caregiver mental health. • Over 75% of caregivers reported having 2 or fewer informal support sources. • Over half of the caregivers reported having no formal support sources. [ABSTRACT FROM AUTHOR]

The Developmental Psychobiological Model of Experiential Canalization (DPMEC) proposes that conditions of poverty-related adversity influence child self-regulation through parental caregiving, stress hormones, and the child's genetics. However, empirical findings investigating these relationships with prolonged stress hormones are mixed. Further, the relationships among conditions of adversity with prolonged stress hormones have seldom been investigated in toddlers living in poverty. Guided by the DPMEC, we examined the relationships among maternal caregiving, prolonged stress, and self-regulation in toddlers living in poverty in the United States, to include examining whether toddler prolonged stress mediated relations between maternal caregiving and child self-regulation. Participants were mothers and toddlers (20 to 24 months of age) living in poverty, who provided hair samples to measure four months of average cortisol concentration to estimate prolonged stress. We used observational measures to examine maternal caregiving and indirect report to measure children's self-regulation. Findings did not support the role of toddler prolonged stress in mediating the relationship between maternal caregiving and toddler self-regulation. However, multiple linear regression models showed that higher levels of maternal emotionally supportive caregiving significantly predicted better toddler soothability (b = 0.90; p =.03; 95% CI [0.10, 1.69]; partial correlation = 0.26). This study adds partial support for the DPMEC to represent associations between maternal caregiving and toddler self-regulation for mothers and toddlers experiencing poverty. While these data come from an observational study, pediatric nurses may consider assessing maternal supportive caregiving upon reports of poor toddler soothability. • We tested toddlers' stress hormones and self-regulation responses to adversity. • The sample comprised 94 mothers and toddlers living in poverty in the United States. • Toddler stress did not mediate parental caregiving and child self-regulation. • Toddlers had better soothability if mothers were more emotionally supportive. [ABSTRACT FROM AUTHOR]

Caregivers of children with Autism Spectrum Disorder (ASD) report high levels of stress, social isolation, and poor mental health. Social and emotional support may buffer negative effects of stress for caregivers of children with ASD, however, those living in rural areas may be disadvantaged due to social isolation and increased distance from resources. This scoping review examined the literature regarding the mental health and impact of support for rural caregivers of children with ASD. Articles were limited to those available in the English language and conducted in a high income country. Articles had to include a population of rural caregivers of children with ASD and focus on caregiver mental health and/or the impact of support on caregiver mental health. Searches were conducted with Embase, PubMed, CINAHL, ERIC, and PsycINFO and 22 articles were included. Study findings indicate overall poor mental health for rural caregivers of children with ASD. Formal and informal support appear to be beneficial in decreasing stress for rural caregivers of children with ASD. However, a few studies indicated that formal support may add stress to rural caregivers. There is limited information regarding support needs and the impact of support services on the mental health of rural caregivers of children with ASD. There is a need to increase access to support resources in rural areas for caregivers of children with ASD. Healthcare professionals, including nurses, can play a fundamental role in supporting, educating, and connecting caregivers to other support services. • Urban and rural caregivers of children with ASD have high levels of stress. • Some rural caregivers reported not feeling respected by healthcare professionals. • Navigating ASD resources can be difficult and increase stress for some caregivers. • Rural caregivers felt like they were left to navigate resources on their own. • Parent-intervention programs decrease stress for caregivers. [ABSTRACT FROM AUTHOR]

Children with Cerebral Palsy (CP) commonly experience unpleasant symptoms such as pain, anger, and sadness. The purpose of this quasi-experimental study, guided by the Theory of Unpleasant Symptoms (TOUS), was to examine the practicality and impact of delivering Reiki Therapy (RT) in homes over an 8-week intervention phase to children with CP. Thirteen pediatric participants were recruited, ranging in age from 5 to 16 years. Reiki Therapy was administered by a Level 3 Reiki Therapist in the home for 8 consecutive weeks. Parents completed on-line questionnaires addressing their children's unpleasant symptoms. Hair cortisol was measured as an indicator of stress. Nearly all study procedures were completed by the participants, indicating that the methods are feasible for a larger study. Reiki Therapy significantly decreased pain while lying down (3.09 vs. 2.00; p =.002) but not while sitting (2.55 vs. 2.09; p =.40). Anger symptoms showed a trend towards improvement in the participants. These preliminary findings demonstrate that Reiki is a therapeutic modality worthy of further investigation in the CP pediatric population. • Home-based Reiki Therapy was well tolerated in children with Cerebral Palsy. • RT was well-received and associated with a decrease in some measures of pain with a trend toward improvement in other symptoms. • Further studies are needed to evaluate RT in populations of children with Cerebral Palsy and other chronic conditions. [ABSTRACT FROM AUTHOR]