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PWS Smart-Start is a behavioral caregiver training program developed specifically for caregivers of children with Prader-Willi syndrome (PWS) ages 3 to 14. The purpose of the current study was to evaluate the acceptability and preliminary efficacy of the program. Thirty-four caregivers of children with PWS received the PWS Smart-Start training using online live video-coaching across a 10-week period. The impact of the training on a variety of variables including caregiver and child behavior, caregiver stress and burnout, and family functioning were evaluated using a quasi-experimental pretest posttest design. Results indicated statistically significant decreases across child behavior challenges and parental stress and burnout following the training. Statistically significant improvements were also seen in parenting practices, the quality of the parent-child relationship, and family quality of life. Results of social validity measures indicated caregiver satisfaction with the program. These preliminary results indicate that the PWS Smart-Start program has the potential to not only support children with PWS through behavioral challenges but also reduce caregiver stress and burnout and improve a variety of aspects of family life. Future research is needed to replicate and further validate these results and to extend the exploration of other behavior analytic interventions for this population.

This study examines the unique challenges of raising gifted children, focusing on two child-related risk factors for parental stress: cognitive asynchrony and stress management abilities. Path analysis revealed that poor stress management in children is associated with greater parental stress, as measured by the Difficult Child (DC) and Parent-Child Dysfunctional Interaction (PCDI) scales of the Parenting Stress Index. Cognitive discrepancies, particularly between Verbal Comprehension Index (VCI) and Processing Speed Index (PSI), were found to increase maternal stress but not paternal stress, highlighting a differential impact on parents. Additionally, the study identified a spillover effect, in which stress in one parent influences the other, amplifying family stress. These findings suggest that cognitive and emotional factors act as independent sources of stress, underscoring the need for interventions tailored to families of gifted children, with a focus on enhancing emotional competence to promote resilience and family well-being.

Introduction: Parents of children with attention-deficit/hyperactivity disorder (ADHD) endorse increased parenting stress and lower levels of parenting efficacy and satisfaction as compared to parents of children without ADHD. Additionally, maternal ADHD and depression differentiate children with and without ADHD, with children with ADHD being more likely to have a mother with psychopathology. Method: With a focus on an understudied population, we investigated the extent to which maternal self-reported ADHD and depression were associated with self-reported parenting stress and parenting cognitions in 70 Black mothers of children with (maternal M[subscript age] = 35.52, SD = 6.49) and without ADHD (maternal M[subscript age] = 35.39, SD = 6.53) recruited from a metropolitan area in the southeastern United States. Results: Analyses indicated that Black mothers of children with ADHD reported higher levels of parenting stress, lower levels of parenting efficacy, and lower levels of parenting satisfaction. However, there were no significant differences between groups on measures of maternal ADHD or depression. Maternal depression significantly accounted for variability in both parenting satisfaction and parenting stress beyond child ADHD and maternal education. With maternal depression in the models, the association between maternal ADHD and parenting stress and parenting satisfaction lost significance. Discussion: Given the racial disparities in the treatment of ADHD, future research should focus on investigating the linkages between maternal depression, parenting stress, parenting satisfaction, and parenting behaviors in Black mothers in order to delineate whether there are cultural adaptations that may improve treatment utilization rates for child ADHD within this population.

Gastrointestinal (GI) symptoms are a common comorbidity in children and adolescents with autism spectrum disorder (ASD). Little is known about the impact that GI symptoms have on parental well-being. Parents of 409 children and adolescents with ASD completed the GI Symptoms Inventory, Parenting Stress Index-Short Form, World Health Organization Quality of Life Abbreviated Version, Hospital Anxiety and Depression Scale, and the Multidimensional Scale of Perceived Social Support. High levels of stress were demonstrated by parents with 40.1% receiving clinically significant scores. A relationship was found between parental stress and GI symptoms. Parental anxiety and depression were found at high levels but were not more common in parents of individuals with GI symptoms than those without. Lower levels of quality of life were found in parents of individuals with GI symptoms compared to parents of individuals without GI symptoms. Parents of children with GI symptoms were less satisfied with their personal and social relationships with others. Parents of children with GI symptoms had lower scores on a measure of perceived social support than parents of children and adolescents without GI symptoms. GI symptoms are stressful for parents and future research is needed to determine how to alleviate this stress and to improve the quality of life of parents of individuals with ASD.

Pediatric feeding disorders are common and are often associated with chronic medical conditions and developmental disorders. A multidisciplinary treatment approach may be offered through outpatient or intensive programs. Benefit has been demonstrated with intensive programs, but there is little data regarding outpatient approaches. We described outcomes from a well-established outpatient feeding assessment program related to the referral base and program outcomes. Study packets collecting demographics and self-reported feeding skills were distributed to the referral population and redistributed three months later. Standardized surveys implemented included Montreal Children's Hospital Feeding Scale (MCH-FS) and parenting stress index (PSI-SF). One hundred and ninety-eight subjects completed the initial packet. MCH-FS was elevated in all subjects indicating a broad range of feeding concerns. PSI elevation was present in a broad range of comorbidities compared to group without comorbidities. At 3 months (n = 55), MCH-FS and feeding skills improved without change in PSI-SF. The quality of therapy overall was deemed excellent to above average by most subjects. A multidisciplinary outpatient program has a role in managing infants and children with feeding disorders regardless of comorbidity. Severely affected individuals may benefit from more intensive programs and/or may require long-term care to effect significant change.

Mindfulness strategies can have a large impact on emotional regulation, emotional intelligence, and interpersonal relationships. Parents of children on the autism spectrum may experience greater stress, depression, and strained interpersonal relationships than those with typically developing children or those with children experiencing other developmental delays. The purpose of the current study was to evaluate the feasibility, acceptability, and initial effects of a virtual Mindful Self-Compassion workshop for parents of children on the autism spectrum and the impact on stress, self-compassion, parenting self-efficacy, and mindfulness. This pilot study used a mixed-method approach to test this hypothesis. Participants completed surveys before and after the brief workshop and participated in a 1-hr focus group within 1 week of completing the surveys. The findings indicate that a short, 3-day virtual workshop may be effective toward improving parents' mindfulness and self-compassion. Parents reported feeling more mindful in their day-to-day life, more self-compassionate during difficult times, and more patient with themselves and other people in their family. A brief, virtual workshop may be effective for short-term improvements in outcomes for parents of children on the autism spectrum.

Emotion regulation (ER) is a source of risk and resilience for psychological development and everyday functioning. Despite extensive research on various early contextual predictors of child ER capacity, few studies have integrated them into the same study. Therefore, our longitudinal study investigated the joint and independent contributions of several prominent contextual predictors of child ER capacity. We followed typically developing children and their caregivers (N = 118, 47% girls) at three time points (children ages 10, 12, and 18 months). At 10 months, mothers reported household chaos, social support, and parenting stress, and maternal sensitivity was observed and coded with the Ainsworth's Maternal Sensitivity Scales. At 12 months, child-mother attachment security was assessed using the Strange Situation Procedure. Finally, at 18 months, child ER was obtained with a Laboratory Temperament Assessment Battery frustration task. Correlational analyses revealed that household chaos and maternal sensitivity were significantly positively associated with child ER. Multiple regression analyses showed independent effects of household chaos and maternal sensitivity on child ER. Our partly counterintuitive results underscore the significance of cumulative risk and protective factors for ER development and suggest that household chaos and maternal sensitivity may contribute uniquely to better ER in typical toddlerhood.

Parents of children with Autism Spectrum Disorder (ASD) have higher levels of stress compared to parents of children with other disabilities and parents of typically developing children. According to the Centers for Disease Control and Prevention, the prevalence of ASD in U.S. children increased from 1 in 150 in 2000 to 1 in 54 in 2016, which means that for every 1 out of 54 children, there might be at least one parent who is facing higher levels of stress. Parents use some coping strategies to manage their stress. Studies that have investigated the association between stress levels of parents and their coping strategies have often grouped coping strategies together and have not examined them individually. This study surveyed 144 parents to investigate the association between stress levels of parents and the individual coping strategies they use. The Parental Stress Index-Short Form-fourth edition (PSI-4-SF) and the adapted Brief COPE inventory were used to gather the data. Descriptive statistics and the chi-square test of independence were employed for the analysis of the data. Results of the study indicated that there was a statistically significant association between parental stress and six coping strategies including behavioral disengagement, self-blame, humor, venting, instrumental support, and denial.

This study examined longitudinal associations between parental psychological distress (stress and depression) when the child was 2 to 4 years and a child's emotional and behavioural problems at ages 3 to 4, and social functioning (loneliness and social competence) at age 11 in very preterm born children. The participants were Finnish families of 172 very preterm infants (gestational age < 32 weeks and/or birth weight [less than or equal to] 1500 g). In girls, higher levels of maternal depression were associated with higher levels of social and emotional loneliness. Furthermore, higher levels of maternal stress and children's externalizing problems were associated with lower levels of experienced empathy. In boys, higher levels of paternal depression were associated with lower levels of social loneliness and impulsive behaviour. In conclusion, early parental psychological distress is associated with early socioemotional development and the later experienced social functioning in former very preterm infants. The sex of the child moderates these associations.

To explore the relationship between family resilience and preschool children's problem behaviours and the role of maternal parenting stress and parenting self-efficacy in this relationship, a total of 1282 mothers of preschool children were surveyed. The results showed that: (1) family resilience could significantly negatively predict preschool children's problem behaviours. (2) Maternal parenting stress completely mediated the relationship between family resilience and preschool children's problem behaviours. (3) Maternal parenting self-efficacy completely mediated the relationship between family resilience and preschool children's problem behaviours. (4) Maternal parenting stress and parenting self-efficacy played a mediating chain role between family resilience and preschool children's problem behaviours. This study deepened the understanding of the relationship between family resilience and children's social adjustment by discussing and outlining the relationship between family resilience to its influence on children's problem behaviours.

Emerging research shows that Acceptance and Commitment Therapy (ACT) may improve mental health for caregivers. Parents of autistic children, adolescents, and adults (N = 54) were randomly assigned to either complete a brief group-based ACT intervention or remain on the waitlist. Participants completed surveys immediately prior to randomization, and 3-, 7-, and 17-weeks post-randomization. The primary outcome was depression symptoms and secondary outcomes included stress, goal attainment, positive affect, ACT psychological processes, child mental health, and family functioning. Mixed effects linear models testing Group × Time interaction indicated the Treatment group (n = 27) demonstrated greater post-intervention improvements than the Waitlist group (n = 27) in parent depression (p = 0.03, d = -0.64) and family distress (p = 0.04, d = -0.57). Treatment group parents also reported greater short-term gains in positive affect (p =< 0.001, d = 0.77) and personal goal attainment (p = 0.007, d = 0.80), compared to the Waitlist group. Although there was no significant Group × Time interaction for other outcomes, stress (b = -2.58, p = 0.01), defusion (b = -3.78, p = 0.001), and experiential avoidance (b = -4.22, p = 0.01) showed improvement for the Treatment group, but not the Waitlist group, at post-intervention. All Treatment group improvements were maintained at follow-up. Results suggest that a brief ACT group intervention is efficacious for improving some aspects of mental health for parents of autistic children.

Introduction: The present study build on previous research that found a bidirectional relation of parenting stress and negative behavioural outcomes in children with Autism Spectrum Disorders. Aim: To investigate the mediating role of parenting self-efficacy in the relationship of parenting stress and children's behavioural and emotional problems. Materials and methods: The sample included 32 young children and their families. Sociodemographic and clinical data were collected. Hierarchical regression analysis revealed direct and indirect mediating effects. Results: Parenting self-efficacy mediated the relationship between parenting stress and children's behavioural and emotional problems in fathers only. Conclusions: We discuss potential ways targeted parenting self-efficacy intervention can support fathers. Results contribute to gain father-informed knowledge in, a research branch generally focused on mothers.

The parents of 413 children with typical development (TD) or special educational needs (SEN) filled in an online survey to investigate the associations between the restrictions introduced to face COVID-19 and parenting stress and parental disciplinary practices. The parents of children with SEN showed a significantly higher stress level than TD children's parents. However, they showed a lower inclination to overreact. In both groups, the parents who feel less supported, feel their needs threatened, and report having a child with more difficulties were more likely to exhibit parenting stress. Data on the associations between COVID-19 restrictions and the stress perceived by parents could help to focus the attention of the public health system on their parents' needs, leading to practices aimed to prevent parenting stress and burnout.

Secondary analysis of the Early Head Start Family and Child Experiences Survey 2018 data set (Baby FACES 2018) explored links between family risk events and referral-making and referral uptake among families receiving Early Head Start (EHS) services. Referrals to both behavioral health and entitlement programs were considered. Results showed that referrals to behavioral health programs were much more likely to be given to families receiving care from home-based care than center-based care, and that referrals were slightly more likely to be given to families who did not have any family risk events. Several factors also moderated the relationship between family risk and referrals, including perceived closeness of the parent/caregiver--EHS staff relationship, family conflict, and caregiver depression. There were no observed effects for referrals to entitlement programs. Caregiver depression weakened the link between family risk and service uptake for entitlement programs.

Few studies have examined the relationship between attention problems (AP) and observed parenting in families of children with autism spectrum disorder (ASD). Participants were 41 mother-child dyads with ASD recruited from an Applied Behavior Analysis (ABA) U.S. preschool and whose behaviors were observed during parent-child interactions. Children with ASD and elevated AP (n = 19) on the Child Behavior Checklist had significantly lower verbal ability, and mothers reported significantly more stress than children with ASD only (n = 22). Causal modeling was used to examine the directionality of the expected relationship between AP and parenting behavior as partially or wholly mediated by parenting stress. Mothers who exhibited less positive parenting experienced higher parenting stress and their children demonstrated increased AP and decreased engagement during dyadic interactions. The strength of this relationship varied according to child verbal ability. These findings have practical implications for identifying and implementing appropriate intervention.

This study investigated the role of resilience as a mediator and the place of residence as a moderator of parenting stress and parental burnout. The Parenting Stress Index-Short Form, Parental Burnout Assessment, and Connor-Davidson Resilience Scale were administered to 249 Chinese parents of children with ASD (M = 33.95 years, SD = 7.6). Results show that resilience partially mediates the relation between parenting stress and parental burnout. Besides, both the effect of parenting stress on parental burnout and the mediating effect of resilience are moderated by rural/urban residence. This study highlights parenting stress is a risk factor for parental burnout and resilience is the potential mechanism underlying this relation. These findings provide implications for family services for parents of children with ASD.

Background: Increased parental stress is strongly related to the severity of autism spectrum disorder (ASD) symptomatology. Parents' coping strategies and social support issues add to the complexity of this relationship. Aim: The present study investigated the relationship between self-regulation skills and parenting stress in parents of nonverbal children with ASD. Methods and procedure: The Parenting Stress Index--Short Form (PSI-SF) was administered to 75 families, and self-regulation scores on a Motor Behavior Checklist for children (MBC) were recorded by students' class teachers (level of functioning-behavioral problems). In addition, interviews were conducted with a focus group of six parents (four mothers and two fathers) to explore the underline factors of parental stress in-depth. Results: Correlation analyses revealed that parenting stress was positively correlated with elevated scores on MBC children's self-regulation subscale. On the other hand, parenting stress was negatively correlated with the level of social functional support reported. Qualitative data were analyzed using transcripts, revealing additional stressors for families and parents, and resulting in recommendations to overcome these factors. Conclusions and implications: Aiming at developing strategies to improve self-regulation skills in nonverbal children with ASD may be particularly important in reducing parental stress for families having nonverbal children with autism and other developmental disabilities. Parents' stressors and suggestions during interviews are also discussed.

This exploratory mixed method research aimed to develop parent and child forms of a scale to measure parents' practices to reward and punish their children. For the qualitative strand, semi-structured interviews were conducted with parents (n = 54) and their children (n = 39). The qualitative analysis revealed four major themes regarding parental rewarding practices (material rewards, activity-based rewards, permission, and verbal and emotional rewards) and three major themes regarding parental punishment practices (response cost, verbal and emotional punishment, and corporal punishment), which were used to develop two sets of prospective items. At the quantitative strand, EFA and CFA analysis were performed using data obtained from a total of 701 parents and 620 children to test the psychometric properties. As a result of the research, both Parent (PRPS-P) and Child (PRPS-C) forms of Parental Reward and Punishment Scale (PRPS) were developed for use at the K-12 level with favorable psychometric properties.

This article examined the associations between family processes and children's development among mothers and their children participating in early intervention (EI) services. Data from mothers and their infants and toddlers (n = 100) participating in EI were analyzed using regression methods to test the predictive power of maternal depressive symptoms, self-efficacy, and quality of mother-child interactions on children's behavior problems and social and emotional competence. Mother-child interactions were the most robust predictor of child behavior problems and competence. The presence of clinically elevated maternal depressive symptoms was high (30%) and associated with more child behavior problems. Stronger endorsement of self-efficacy also was related to higher levels of child social and emotional competence. We discuss our findings related to opportunities and challenges to support mothers experiencing depressive symptoms. EI services that strive toward an integrated approach could identify mothers with depressive symptoms and play an increased role in directly addressing their needs.

Dimensions of family-school partnerships, including parent-teacher relationship quality and family educational involvement, are associated with positive outcomes for youth. Family-school partnerships are important for autistic youth, who may particularly benefit from cross-setting supports. Coordinated family-school partnerships may help maximize child outcomes. This study investigated the extent to which child behavioral and physical health (emotional, behavioral, and medical problems) and parent mental health (parenting stress, parent mental health history, and parent depressive symptoms) were associated with parent-teacher relationship quality and family involvement in a sample of 68 families of school-aged autistic children. Families were recruited through invitation letters disseminated at local early intervention and early childhood programs. Children in the sample were primarily boys, primarily White, and approximately 8 years old. Results suggest that (a) child emotional problems and parenting stress were negatively associated with parent-teacher relationship quality (large effects) and (b) parent history of mental health problems was negatively associated with family involvement (large effect). Intervention recommendations and future research directions are discussed. For example, it would be helpful for future research to include the perspectives of ethnically diverse samples when examining family-school partnerships among families with autistic children.

Background: Raising a child with developmental disorder is often related to higher stress levels for both mothers and fathers. The aim of the present study was to investigate relationships between resilience, family hardiness, life satisfaction and parental stress among parents of children with and without disabilities. Method: Twenty-eight pairs of parents of a child with Autism Spectrum Disorder, 15 of a child with Down Syndrome and 25 of a child without disability took part in the study. All parents completed four questionnaires independently. Results: Significant differences between groups emerged in parental resilience, stress, and life satisfaction. Correlational analyses showed that parental hardiness and resilience were negatively related to parental stress through all the three groups. Conclusions: These findings point to increased evidence that the presence of a disability may not directly affect the sense of family hardiness. Practical implications were discussed.

In this study, the relationships between child social functioning, parenting stress, and Part C Early Intervention (EI) enrollment were examined in 227 ethnically and racially diverse, low-income families of 15- to 27-month-old children. All toddlers in the sample were identified with or at high risk for developmental delay via universal screening in primary care; 41.4% were enrolled in EI at the time of study data collection and 83.3% ultimately enrolled in EI before turning 3 years old. Generalized linear mixed model results indicated no direct relationship between EI enrollment and parenting stress, but a significant inverse association was found between child social functioning and parenting stress ([beta] = -0.61, p = 0.005) that was moderated by EI enrollment (p < 0.001). This suggests potential benefits of timely referral and access to EI for families of children at risk of developmental delay in historically underserved communities. Furthermore, exploratory bivariate analyses indicated that clinically elevated parenting stress related to higher worry about the child's development and higher M-CHAT-R/F scores; EI enrollment was related to parents not working outside the home, older age of both parent and child, and lower child social functioning level.

Being school-ready when transitioning to the primary school system has been associated with favourable outcomes during schooling and adult life. While children living in socio-economically disadvantaged areas may be at a higher risk of being less school-ready, research in the area has highlighted that not all children experience such a delay. This study examined a range of factors that may account for differences in outcomes across five school readiness domains (physical health and well-being, social competence, emotional maturity, language and cognitive development, and communications skills and general knowledge) within a sample of children living in socio-economically disadvantaged areas. Drawing on data from a sample of five-year-old children involved in the Preparing for Life (PFL) evaluation in Ireland, this study explored the role of child and early environmental factors in facilitating or hindering children's development across these school readiness domains. Statistical analysis identified child's sex, parental involvement and learning materials at home, parent-child interactions, mother's attempt to breastfeed, and mother-child attachment as significant predictors of school readiness after accounting for other factors. Findings contribute to the Irish and international literature on the role of early demographical and environmental factors in shaping school readiness, especially for children from socio-economically disadvantaged areas.

Purpose: Caregivers of autistic children present with high stress levels, which have been associated with poorer child outcomes in several domains, including language development. However, prior to this study, it was unknown whether elevated caregiver stress was associated with language development in infant siblings of autistic children (Sibs-autism), who are at increased likelihood of receiving a future diagnosis of autism and/or language impairment compared to infant siblings of non-autistic children. This study explored the degree to which, as well as the mechanisms by which, caregiver stress was linked with later language outcomes of Sibs-autism and infant siblings of non-autistic children (Sibs-NA). Method: Participants were 50 infants (28 Sibs-autism; 22 Sibs-NA) aged 12-- 18 months at the first time point in this study (Time 1). Infants were seen again 9 months later, at 21--27 months of age (Time 2). Caregiver stress was measured via a validated self-report measure at Time 1. Caregiver language input, the putative mechanism by which caregiver stress may influence later language outcomes, was collected via two daylong recordings from digital recording (Language ENvironment Analysis) devices worn by the child at this same time point. Child language outcomes were measured via standardized and caregiver report measures at Time 2. Results: Several models testing hypothesized indirect effects of caregiver stress on later child language outcomes through caregiver language input were statistically significant. Specifically, significant indirect effects suggest that (a) caregivers with increased stress tend to speak less to their infants, and (b) this reduced language input tends to covary with reduced child language outcomes later in life for Sibs-autism and Sibs-NA. Conclusions: This study provides new insights into links between caregiver stress, caregiver language input, and language outcomes in Sibs-autism and Sibs-NA. Further work is necessary to understand how to best support caregivers and optimize the language learning environments for infants.

A child's condition not being in line with the parent's expectations can cause mothers to experience pressures that can lead to them not parenting effectively. The condition of children with special needs in particular can cause some anxiety and pressure that may induce parenting stress. This research aims to understand the correlation between cognitive emotion regulation and parenting stress, as moderated by the need to belong. A quantitative approach was employed in this research, whose participants comprised 428 mothers of children with special needs. The data were collected using the Parenting Stress Index--Short Form, the Cognitive Emotion Regulation Questionnaire, and the Need to Belong Scale. The data were then analyzed using the PROCESS Macro Analysis moderation method. The results reveal a significant negative correlation between cognitive emotion regulation and parenting stress ([beta]= -0.55; p=0.00), while the need to belong significantly weakened the relationship between cognitive emotion regulation and parenting stress ([beta]= -0.29; p=0.04).

In 2020, the novel coronavirus SARS-CoV-2, and the resulting highly infectious disease COVID-19 led to restrictions based on the principal of social distancing to curb the spread of the virus among the population and to prevent an overload of health system capacities. These restrictions changed the daily lives of young children and parents dramatically. In a German questionnaire study, we aimed to investigate the impact of the COVID-19 pandemic on the magnitude of stress in parent-child systems and on social-emotional child development. Our sample consisted of 90 (39 male, 51 female) children (M = 17.2 months, SD = 9.7 months) aged 7=12 months (n = 38), 13-24 months (n = 31) and 25-38 months (n = 21). Parental stress was measured using the German version of the Parenting Stress Index, namely Eltern-Belastungs-Inventar. Additionally, social-emotional child development was measured using the Social-Emotional Questionnaire of the Bayley-III. Our findings show that parents experienced more stress during the COVID-19 pandemic in Germany compared to norms. Parental perceived stress was higher in parents of older children than younger ones. Interestingly, social-emotional child behavior scores significantly decreased with children's increasing age. Moreover, higher parental stress was associated with lower values of social-emotional child behavior. Our findings provide important novel data on parental perceived stress and social-emotional child development during the COVID-19 pandemic. However, further research investigating the long-term consequences of the pandemic is needed.

Purpose: This study examined relationships among family characteristics, caregiver change in use of strategies, and child growth in spoken language over the course of a parent-implemented language intervention (PILI) that was developed to address some of the challenges associated with the fragile X syndrome (FXS) phenotype. Method: Participants were 43 parent-child dyads from two different PILI studies, both of which taught parents various language facilitation strategies to support child language. Before starting the intervention, parents reported on their mental health, parenting stress, and parenting competence. This study focused on potential barriers to treatment gains by examining correlations between the measures of parent well-being and: (1) parent change in use of intervention strategies taught in the PILI; and (2) changes in child language outcomes from pre- to post-intervention. Results: Parents in this study had elevated mental health symptoms across several domains and increased rates of parenting stress. Furthermore, although PILI resulted in treatment gains for both parents and children, a variety of parent mental health symptoms were found to be significantly and negatively associated with change in use of strategies and growth in child language over the course of the intervention. Some inconsistent findings also emerged regarding the relationships between parenting stress and competence and change in parent strategy use and growth in child language. Conclusions: This study provides preliminary evidence that parents who are experiencing significant mental health challenges may have a more difficult time participating fully in PILIs and that there may be subsequent effects on child outcomes. Future PILIs could benefit from addressing parent well-being as a substantial part of the intervention program.

Maternal education is associated with early child outcomes. However, the several mechanisms that may explain this relationship remain underexplored. Using data from 1,097 children aged 12-15 months in Chile, we estimate the maternal education gap across child cognitive and language outcomes. Following a bioecological perspective, we explore potential pathways by which maternal education might influence child development, such as child characteristics, the quantity and quality of mother-child interactions, and the availability of home stimulation. We found an average maternal education gap between children with mothers with the lowest and the highest educational levels of 0.36, 0.31, and 0.25 standard deviation in child cognition, expressive language, and receptive language, respectively. The mediational analysis showed that maternal stress and depression and the quality of the home environment mediated the relation between maternal education and child language and cognitive development.

Challenging behavior exhibited by young children with neurodevelopmental disabilities is known to negatively affect their optimal development and families' quality of life. Although some support exists for English-speaking parents of children with autism who live in high-resource countries, it is scarce for others. Such disparity may also be heightened during the coronavirus disease 2019 (COVID-19) pandemic with its various societal restrictions. To mitigate the treatment gap, we developed and adapted a series of online training modules on behavioral principles and examined its effectiveness with 88 South Korean parents using a randomized controlled trial. We found significant interaction effects on increasing parents' knowledge of behavioral principles, increasing positive parenting practices, and decreasing parental stress. Qualitative social validity data also indicated that parents were highly satisfied with the goals, procedures, and outcomes and that the program positively affected their parenting styles.

The study evaluated the relationship between maternal anxiety, depression and parenting stress, and maternal mind-mindedness, styles of interaction, and mother-infant emotion regulation. At infant age 3 months, EPDS, STAI, and PSI-SF were administered to 73 mothers to respectively assess depression, anxiety, and parenting stress; mother-infant interaction was coded with the mind-mindedness coding system, the CARE-Index and the Infant Caregiver Engagement Phases (ICEP). Results showed that maternal anxiety had a positive correlation with non-attuned mind-related comments, with mother's controlling style, and with infant negative and mother negative emotional states. Maternal depression had a positive correlation with mother's controlling style and with mother-infant dyadic negative emotion regulation. Parenting stress was associated with mother-infant emotion mismatches. To sum up, anxiety was the maternal mental health risk condition that had the greatest effect on the considered dimensions of parenting. Mind-mindedness was shown to be related to mother-infant emotion regulation, but not to sensitive style.

Emotion dysregulation (ED) underlies psychiatric symptoms and impedes adaptive responses in autistic individuals. The Emotion Awareness and Skills Enhancement (EASE) program was the first mindfulness-based intervention designed to target emotion dysregulation in autistic adolescents (12-17 years old). This project partnered with stakeholders to adapt EASE for autistic adolescents and adults with co-occurring intellectual disability and autistic elementary-aged children, groups who often benefit from caregiver support in treatment. Over three adaptation phases, we: (1) elicited stakeholder and expert feedback to adapt the original EASE program for autistic individuals with intellectual disability; (2) redesigned the adapted manual and expanded the target age range following a small "micro-trial" with a sample of autistic adolescents and adults with intellectual disability (n = 6); and (3) demonstrated feasibility and acceptability of a caregiver-client team-based approach (EASE-Teams) in a sample of 10 autistic individuals with and without intellectual disability (ages 7-25) and their caregivers. EASE-Teams was both acceptable and helpful to families. Significant improvements were noted in participant emotion dysregulation, psychiatric symptoms, and caregiver stress from their child's dysregulation. Findings suggest that EASE-Teams may be appropriate for heterogeneous developmental and cognitive needs. Future research to establish efficacy and refine EASE-Teams with community providers is warranted.

Divorce often creates significant stress that can have an impact on parent-child relationship satisfaction. The purpose of this study was to examine the predictive relationship between parental stress as measured by the Parenting Stress Index, 4th Edition, Short Form (PSI-4-SF) and the parent-child relationship satisfaction as measured by the Parent-Child Relationship Inventory (PCRI) following a separation or divorce. A sample of 17 recently separated or divorced, custodial mothers who had at least one child between the ages 5-13 years were recruited through local schools. Participants completed the PSI-4-SF, the PCRI, and a demographics questionnaire online. A correlation and regression analysis were conducted to analyze the relationship between parental stress and the level of parent-child relationship satisfaction, which was found to possess a significant negative relationship. The stress of the mother was found to affect the parent-child relationship. Neither child gender or child age influenced the relationship between parental stress and parent-child relationship satisfaction. However, mother's with sons reported higher parental satisfaction than mothers with daughters.

Employing a cohort sequential design and multilevel modeling, the effects of child and family stressors and maternal depressed mood on the self-rated health of 110 mothers of children with autism spectrum disorder were assessed over a 12-year period when children in the study were 7-19 years old. Findings indicate a significant decline in self-rated health over time. In addition, child and family stressors, as well as maternal depressed mood, exerted significant between-persons effects on self-rated health such that mothers who reported more stressors and depressed mood across the study period were less likely to rate themselves in better health across that period. In addition, a significant within-person relationship between maternal depressed mood and self-rated health was found, indicating that at times when mothers reported higher levels of depressed mood than usual (their personal average across the study), they were significantly less likely to report better self-rated health. Finally, maternal depressed mood partially mediated the between-persons effects of child and family stressors on self-rated health such that increased stressors led to increased maternal depressed mood which, in turn, led to poorer maternal self-rated health. Findings suggest that chronic stressors erode maternal health over time and that depression may be an important mechanism linking stressors to decreased maternal health.

Parenting stress is correlated with negative child and parent outcomes. Accurate parenting stress assessments are critical to inform appropriate service delivery. This study used mixed methods to identify stressors influencing parents of Black children with autism. Twenty-two parents of Black children with autism participated in individual interviews; 19 of these parents also completed the "Parenting Stress Index" (4th edition). While we found some consistency between our qualitative and quantitative findings, the "Parenting Stress Index" did not capture key stressors parents described in interviews, including cultural factors (e.g., perception of provider pushback due to race), challenges related to single parenting, and neighborhood violence. We detail recommendations for family-centered and culturally relevant efforts to assess and address parenting stress in this population.

Internet-based intervention approach is one novel strategy to train. However, only a few clinical trials have compared internet-based parent training intervention with an equal face-to-face intervention for children with autism spectrum disorder (ASD)-like symptoms. The primary aim of this study was to compare treatment outcomes of an internet-based intervention with a face-to-face intervention for young children with excessive screen-time and ASD-like symptoms. A total of 40 mother-young children with excessive screen-time and ASD-like symptoms dyads were assigned to the Internet-based (n = 20) and to the face-to-face intervention (n = 20). Parents in both groups received intervention that involves 7 sessions (one session per week). Primary outcome measures were the Gilliam autism rating scale -- second edition (GARS-2), repetitive behavior scale--revised (RBS-R) and parenting stress index (PSI). The analysis yielded no significant between-group difference for any of the pre- to post-intervention measurements. At post-intervention both intervention conditions revealed significant symptoms changes compared to before the intervention. Also, the parental stress was significant related to the child's autism symptoms and repetitive behaviors severity. Internet-based parent training intervention for young children with excessive screen-time and ASD-like symptoms and their parents is equally beneficial to regular face-to-face parent training intervention. These findings support the potential for using telehealth to provide research-based parent training interventions to any family that has access to the Internet.

Language disorders may negatively affect children's behaviour and the maternal burden situation. This recent study examines the history of bullying and victimisation behaviour of children with language disorders and maternal burden in comparison to a reference group of typically developed peers. We measured the bullying and victimisation behaviour and maternal burden of a sample of N= 81 children with and without language disorders and their mothers at two measurement times. The results indicate that mothers of children with language disorders demonstrated high levels of burden, and the children are at higher risk of being victimised and involved in bullying as perpetrators. Furthermore, the maternal burden situation and children's behavioural problems decrease over time. From a long-term perspective, it seems important to identify children's behavioural problems and parental causes of stress to successfully support the entire family.

Parenting children with autism spectrum disorder (ASD) is challenging. Parents of such children reportedly experience high levels of stress and poor mental health. This study aimed to assess the parenting styles, parental stress, and caregivers' quality of life of children with ASD and compare them to those of children without ASD. Sixty-one and 63 caregivers of children with and without ASD, respectively, were recruited into the study and asked to complete parenting style, parental stress, and quality of life questionnaires. Of 124 caregivers, those of children with ASD reported lower authoritative scores, but higher permissive parenting style scores than those of children without ASD (p = 0.01 and p = 0.02, respectively). Significantly greater parental stress scores (p < 0.001) and poorer parental quality of life were reported by caregivers in ASD group. Furthermore, higher parental stress correlated moderately with following parenting styles: lower authoritative, higher authoritarian, and higher permissive. A negative correlation was found between the children with ASD's quality of life and some parenting styles, including authoritarian and permissive types. Our results suggest that promoting appropriate parenting styles and helping caregivers manage their parenting stress could be beneficial for caregivers of children with autism.

Background & Aims: Estimates suggest that one in 59 children receive a diagnosis of autism and that early intervention can be effective if applied consistently and intensively. Parent implemented intervention can increase intervention consistency and intensity however, availability of providers, geographical factors, time constraints, and parental stress levels can all act as barriers to service access. Limitations in understanding elements that support family engagement can also impact participation in intervention. Telepractice can increase availability of intervention services and decrease the time and costs associated with face-to-face delivery. Research focused on children with autism has shown that telepractice is acceptable to parents. Despite positive findings for telepractice services with individual clients, limited research has been conducted on telepractice services for parent groups; parent perceptions and preferences regarding intervention; and service delivery methods. This research aimed to investigate parent perceptions of a group intervention programme for autism; the telepractice approach; parent and child outcomes; and parental stress. The purpose of the investigation was to build an understanding of parent's intervention preferences to inform future service offerings, increase choice, and support participation. Methods: Eleven parents of preschool children with autism participated in a telepractice delivered group training programme called Hanen More Than Words (HMTW). The intervention is traditionally delivered face to face and teaches strategies to facilitate social-communication development in young children. Quantitative and qualitative measures were used to evaluate parent perceptions of the telepractice HMTW intervention. Data were collected via the Parenting Stress Index, HMTW programme evaluation forms, and online parent survey. Quantitative data was analysed using descriptive statistics. Pre- and post-intervention comparisons of parenting stress were conducted using paired T-Tests. Open comment field responses were analysed qualitatively using a directed content analysis. Results: Parents reported high levels of satisfaction with telepractice delivered HMTW across intervention and post programme evaluations. Interactive learning opportunities, group participation, video coaching, individualisation of service, and programme facilitation were identified as key supports to learning. Parents perceived increased insight into the interaction, learning, and behaviour of themselves and their children. They reported positive changes in strategy implementation and confidence. Parents also perceived improvements in their children's communication, responsiveness, interaction, and play following intervention. Parental stress measurements from pre- to post intervention, were not significantly different. Conclusions: Telepractice may reduce service barriers and improve access, particularly with the efficiency of a group delivery approach. Utilising technology to deliver group intervention was acceptable to parents and perceived to have positive outcomes for both parent and child. Further investigation into parent perceptions of intervention types and delivery approaches, could facilitate a broader understanding of family needs with respect to service access and engagement. Implications: Expansion of telepractice offerings can increase efficiencies and service choice for families and providers. Limitations in service availability and barriers to service access and engagement, confirm the importance of pursuing ongoing service improvements and evaluating the preferences of service users. Development of standardised tools to measure and compare parent perceptions across intervention types and service delivery approaches would be beneficial.

In this article, the association between parental and professional caregivers' perceptions of early life stress (ELS) and the level of preschool social participation was examined, as was the possible moderating effect of parental health. In a community-based study, both parents and professional caregivers of 346 children aged 3 years provided information about child and environmental factors. Results showed that children with ELS more often experienced distress (OR 1.3, p < 0.001), had more peer problems (SDQ: B=0.1, p < 0.01), and more often received extra support according to professional caregivers (OR 1.3, p < 0.01). Parents more often reported concerns (OR=1.3, p < 0.001), a greater number of concerns (B=0.3, p < 0.001), and perceived more difficulties in parenting ("parenting" VAS: B=-2.5, p < 0.001). Associations were stronger for children of parents with "poor health". For personalized family-centred health care, Preventive Child Health Care should systematically explore caregivers' perceptions and concerns of ELS, parental health and child social participation.

This study aimed to identify different profiles of children with autism spectrum disorder (ASD) without intellectual disability (ID) and maternal factors characteristic of these profiles. Participants were 89 children between 7 and 11 years old and their mothers, distributed in two groups, 52 children with ASD and 37 with typical development (TD). Based on the children's adaptive, behavioral, and pragmatic manifestations, three clusters were obtained in the ASD group. Children with the most serious difficulties in all the domains assessed were assigned to Cluster 1, whereas the children in Cluster 3 were characterized by relatively minor problems. Cluster 2 comprised children with moderate difficulties in the different domains. Compared to the TD group, group 1, with 'Serious Difficulties', and group 2, with 'Moderate Difficulties', showed significant differences on all the variables evaluated. Group 3, 'Slight Difficulties', was only significantly differentiated from the group with TD on ASD and attention deficit hyperactivity disorder (ADHD) symptoms, pragmatic competence, and applied theory of mind. Therefore, it was outlined as the purest group and basically manifested core ASD symptoms. In addition, mothers of children in the 'Serious Difficulties' group showed higher stress levels and less use of emotional and instrumental support and acceptance strategies, as well as more mental health problems, than mothers of children in the 'Slight Difficulties' group. The results support the need to assess the presentation of other possible problems in ASD children without ID, and design interventions for parents who may be at risk of experiencing higher levels of stress and have fewer coping strategies.

Theory of mind (ToM) allows people to understand their own and others' behaviour, crediting it with intentions, desires and beliefs. In the case of parenting, maternal reflective function unfolds within child-caregiver interactions, and previous studies have pointed out this variable as necessary for positive care. In the present study we sought to understand how high levels of stress could interfere with their reflective function capacity, and how this relates to children's ToM. A sample of 125 mothers and their preschool children (36-54 months) was assessed. It was hypothesized that the maternal reflective function would play a mediating role between the parental stress variable and the preschooler's ToM. The study found that parental stress exerted direct and significant effects on the mother's reflective function and direct but mild effects on the child's ToM. In addition, different elements of parental stress would act differently on the mother's reflective function.

Research suggests that child problem behavior and poor family-school partnerships contribute to maternal stress in families of children with autism spectrum disorder (ASD). However, most extant research focuses only on White families even though Latina mothers of children with ASD experience greater systemic barriers impacting parent well-being and access to school services. Using individual interviews, this study investigates the pattern between school perceptions, child behavior, and psychological well-being among 13 Latina mothers of school-aged children with ASD. This sample was selected based on their elevated scores on the Difficult Child subscale of the Parenting Stress Index. Findings indicate that all participants reported feeling fear, frustration, worry and stress due to their child's behavior. Specifically, participants worried about their child's safety and expressed frustration with their child's problem behavior. Notably, participants reported mixed responses regarding the schools' actions to address their children's behavior. Implications for research and practice are discussed with respect to family-school partnerships among Latina mothers.

Ongoing disturbances in parental psychological functioning are proposed as one of the mechanisms linking maternal PPD and adverse child development. We examined the effect of maternal PPD on mothers' and fathers' parenting stress and depressive symptoms at child age five. Depressive symptoms and parenting stress were assessed using self-report questionnaires at child age five in a sample of nonclinical mothers (n = 31) and mothers previously diagnosed with PPD (n = 12) and their partners. Maternal PPD diagnosis was associated with mothers' but not fathers' depressive symptoms at child age five. Maternal PPD diagnosis was associated with more parental distress in mothers and fathers, although, for mothers, this relationship was better explained by own concurrent depressive symptoms. Finally, maternal PPD diagnosis was associated with mothers reporting more difficult parent-child interactions. Overall, the study shows that maternal PPD diagnosis has long-term negative effects on both mothers' and fathers' parenting resources.

"Tuning in to Kids" (TIK) is a parenting program that focuses on emotion coaching and is evidenced to be effective in Western populations. This study used a randomized controlled trial to examine the intervention effects of TIK on Chinese parents of low to middle socioeconomic status in Hong Kong. One hundred four parents (99 mothers and five fathers; M[subscript age] in years = 37.92) of preschoolers aged 3-6 years were randomly assigned to the experimental (n = 54) or waitlist control group (n = 50). Parent and child outcomes were assessed at baseline (Time 1), immediately after the 6-week intervention (Time 2), and 6 weeks postintervention (Time 3), using the Alabama Parenting Questionnaire, Coping with Children's Negative Emotions Scale, Parenting Stress Index-Short Form, and Emotion Regulation Checklist. The experimental group reported significant reductions in punitive parenting and parenting stress at Time 2, and these effects were maintained at Time 3. Delayed improvements in parents' use of expressive encouragement and children's emotion lability/negativity were observed at Time 3 in the experimental group. The immediate intervention effects were replicated in the waitlist control group at Time 3 after they attended the training. This study represented one of the few randomized controlled trials of TIK conducted in a non-Western sample. Our results corroborated the findings of prior studies of TIK and provided preliminary support for its effectiveness across different cultural contexts.

A reliable autism spectrum disorder (ASD) diagnosis can occur as early as 18 months; however, the average age at diagnosis in the United States is over 2 years later. While there are numerous well-known barriers to seeking an ASD diagnosis, no research has examined if separation between a child's biological parents affects timing of ASD diagnosis for their child. Data for this study were obtained from 561 children (M age = 5.4 years, SD = 3.9 years) referred to an urban, outpatient ASD specialty clinic for their first ASD evaluation. Biological parents self-reported their relationship status during the evaluation, which was then categorized as either "together" (married or living together but not married) or "not together" (separated, divorced, or never married). An inverse-probability of exposure weighted linear regression model, which adjusted for 16 different child, family, and sociodemographic variables, was utilized to assess differences in child age of ASD diagnosis between groups. At the time of diagnosis, most children's biological parents were together (69%) versus not together (31%). In the fully adjusted model, children of parents who were together were diagnosed 1.4 years earlier than those who were not together (p < 0.001). Strategies for supporting these families and reducing age disparities are indicated.