The effect of a comprehensive support program on the stress level of mothers in a neonatal intensive care unit

Background & Aim: Parents of neonates hospitalized in the neonatal intensive care unit may experience a high level of stress. Although many approaches were applied to reduce stress, little is known about the effect of a comprehensive support program. This study aims to investigate the effect of a comprehensive supportive program on maternal stress levels in a NICU. Methods & Materials: This is a quasi-experimental study that lasted for about eleven months, 62 mothers whose premature neonates were hospitalized in a NICU in Edirne, Turkey, were selected and assigned into intervention and control groups non-randomly. A comprehensive support program was applied for the mothers in the intervention group, whereas the mothers in the control group received the standard routine care. Data were collected using the Parental Information Form, Newborn Information Form, and Parent Stress Scale in NICU and analyzed using SPSS software. Results: The maternal stress level of the mothers in the intervention group (mean=2.95±.72) was found significantly lower than the control group (mean=3.74±.82) (p≤001) in the post-test. Similarly, the average scores obtained by the mothers in the intervention group in the Parent Stress Scale’s subcategories of images and sounds, neonates’ appearance, and change in parental roles were also found to be significantly lower than that obtained by the mother’s in the control group (p≤001). Conclusion: A comprehensive support program is significantly effective in reducing maternal stress levels. So, it is highly recommended that nurses use these comprehensive approaches in practice and especially support mothers by facilitating interaction between parents experiencing similar problems.

Understanding Stability and Change in Perceived Social Support in Parents of Autistic Children and Adolescents

Parents of children with autism often have their own support needs. Informal social support can be an important component of managing parenting-related stressors. We know very little about the factors that lead to higher levels of perceived social support or the potential reciprocal relationship social support has with other factors in parents of children with autism. The current longitudinal study examined the reciprocal relations of perceived social support and parent stress and child behavior problems across a 1-year period, using three time points. There was remarkable stability in variables over time. Baseline perceived social support significantly predicted changes in child behavior and parent stress at the 6-month time point, but neither of those variables significantly predicted social support. This study adds to our understanding of social support and clarifies how perceived social support relates to other factors longitudinally.

Parent Ratings of Generalized and Indirect Effects of Functional Communication Training for Children with Autism Spectrum Disorder

Functional communication training (FCT) is a behavioral treatment that has been shown to reduce problem behavior and increase appropriate communication in young children with autism spectrum disorder (ASD). In this study, we assessed the effects of FCT on targeted and nontargeted problem behaviors outside of the training context, as well as parent stress, for 30 young children with ASD and their parents. Indirect measures of generalization treatment effects were administered prior to and following FCT treatment delivered via telehealth. Children demonstrated significant improvement on both targeted (measured via observation) and nontargeted (measured via checklist) problem behaviors, both within and outside of the training context, and parent stress was significantly reduced following treatment. These results suggest that the impact of FCT may extend beyond the training context for both the children being treated and the parents delivering treatment, even when generalization is not specifically programmed for during treatment.

The effect of early autism intervention on parental sense of efficacy in a randomized trial depends on the initial level of parent stress

This study examined whether style or intensity of child-focused intervention had a secondary effect on parental sense of efficacy and whether these effects varied by baseline level of parent stress. We randomized 87 children with autism, age 13–30 months, into one of four conditions: 15 versus 25 intervention hours crossed with 12 months of Early Intensive Behavioral Intervention versus Early Start Denver Model. Baseline parent stress was the putative moderator. Parent sense of efficacy, collected at baseline and the end of treatment, was the dependent variable. Analyses used generalized linear mixed model with full information maximum likelihood estimation. We tested main effects and interactions involving time, treatment intensity and style, and baseline parent stress to test moderation effects. Changes in parent efficacy across 12 months were related to intervention intensity but not style; this effect was moderated by level of parent stress at baseline. Parents with higher stress at the beginning of a 1-year, home-based, comprehensive intervention program had a higher sense of parenting efficacy if their child received lower intensity intervention; parents with lower stress at baseline had a higher sense of efficacy if their child received higher intensity intervention. Lay abstract This is a study of the secondary effects of interventions for young children with autism on their parents. Specifically, we were interested in the impact on parent’s sense of efficacy, or how confident and competent a parent feels about themselves as a parent. We tested three ideas: (1) that the style of the intervention, whether it was more or less structured and whether the parent had a more or less formal role, would impact a parent’s sense of efficacy; (2) that the intensity of the intervention, how many hours per week the intervention was delivered, would impact parental efficacy; and (3) that the parent’s level of stress prior to intervention would impact how intensity and style effected efficacy. We randomly assigned 87 children with autism, age 13–30 months, into one of four conditions: 15 versus 25 intervention hours crossed with two different styles of intervention. We used statistical tests to examine these ideas. We found that parental efficacy was related to intervention intensity but not style. Parents with higher stress at the beginning of a 1-year, home-based, comprehensive intervention program had a higher sense of parenting efficacy if their child received lower intensity intervention; parents with lower stress at baseline had a higher sense of efficacy if their child received higher intensity intervention. If a parent can emerge from the process of diagnosis and early intervention with an increased sense that they can make a difference in their child’s life (i.e. increased sense of efficacy), it may set the stage for meeting the long-term demands of parenting a child with autism.

Parents Are Stressed! Patterns of Parent Stress Across COVID-19

Background: The Coronavirus Disease 2019 (COVID-19) pandemic has caused numerous unexpected challenges for many families, and these long-lasting demands likely contribute to higher stress for parents. The aim of this study was to describe changes in parent stress longitudinally from before (retrospective) to two timepoints during COVID-19. Stressors that influenced parenting and strategies to manage parenting difficulties at each timepoint during COVID-19 are also described.Methods: Parents (N = 433; 95% female) in the US with >1 child aged 5–18 years completed an online survey in May 2020 (T1; at the peak of stay-at-home mandates) and in September 2020 (T2; children's return to school). Surveys included the 10-item Perceived Stress Scale (PSS) and questions on parenting-specific stress, stressors that influenced parenting, and strategies to manage parenting difficulties during COVID-19. Retrospective report of pre-COVID-19 stress was assessed at T1; current stress was assessed at T1 and T2. Repeated measures analysis of variance examined changes in stress over time.Results: Parent's stress increased from before COVID-19 to T1 (PSS score: 16.3 ± 5.7 to 22.0 ± 6.4, respectively; p < 0.01), and decreased by T2 (19.2 ± 6.0), but remained elevated above pre-COVID-19 values (p < 0.01). Most parents (71.1%) reported an increase parenting-specific stress from before COVID-19 to T1, which continued to increase for 55% of parents at T2. Common stressors that impacted parenting during COVID-19 were changes in children's routines, worry about COVID-19, and online schooling demands. Common strategies parents used to manage parenting difficulties included doing family activities together, keeping in touch with family/friends virtually, and keeping children on daily routines.Conclusions: Parent stress increased substantially during COVID-19 and has not returned to pre-COVID-19 levels, suggesting the need for enhanced mental health resources and supports. Public health interventions should address parenting-specific stressors and effective strategies for managing parenting difficulties to mitigate their deleterious impact.

School's out: parenting stress and screen time use in school-age children during the COVID-19 pandemic

Background: During the COVID-19 pandemic, millions of children abruptly moved to online schooling, which required high levels of parental involvement. Family routines were disrupted, potentially increasing parental stress, and may be reflected in greater media screen time use in children.Objectives: To determine whether 1) parenting styles and 2) parenting stress were associated with children’s screen time use during the pandemic compared to the pre-pandemic period.Methods: Parents (>18 years of age) were recruited to complete an online survey regarding changes in their children’s (6-12 years) screen time use and daily activities before and during the pandemic. Stress and parental involvement were assessed using the Perceived Stress Scale (PSS) and Alabama Parenting Questionnaires respectively. General linear models assessed whether parenting style and parent stress was associated with children’s screen time during the pandemic, adjusting for demographic variables and daily activities.Results: 104 parents were enrolled, and 78 (75%) parents completed the surveys. Children’s screen time (e.g., watching television and playing video games) increased significantly, from 2.6 hours to 5.8 hours a day (p=.001) during pandemic-related school closures. Smaller changes in children’s screen time use were significantly associated with more parental involvement (p=.017). Parent stress (p=.018) significantly predicted children’s screen time use. Lower household income was associated with increased hours of screen time in both models (both, p<.05).Conclusions: Children’s screen time nearly doubled during the initial months of the pandemic. Parent stress and parenting styles may be modifiable risk factors to promote children’s wellbeing during the ongoing pandemic.