Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979
Add to Shopping Cart

Autism: Family Life - Tactics for Getting Normal Again
Autism continuing education psychologist CEUs

Section 10
Religious Coping in Families of Children with Autism

CEU Question 10 | CEU Test | Table of Contents | Autism
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

We assessed the role of religion in the coping of families of children with autism. Forty-five parents completed the Brief RCOPE; identified stressors of autism; and completed measures of psychological adjustment (depression and anxiety), stress-related growth, and religious outcome. A subsample (n = 21) of parents was interviewed about their use of religious coping. Religious coping accounted for unique variance in measures of adjustment. Positive religious coping was associated with better religious outcome (e.g., changes in closeness to God/church and spiritual growth) and greater stress-related growth, whereas negative religious coping was associated with greater depressive affect and lower religious outcome. Interviews identified other ways that religion affected the coping process of these families beyond those already established in existing measures. These results will be useful to professionals working with families of children with autism and in designing interventions to meet the needs of parents for whom religion plays an important role.

Autism, first identified by Leo Kanner (1943), is a pervasive developmental disorder characterized by qualitative impairments in reciprocal social interaction and communication and by restricted, repetitive, and stereotyped patterns of behavior, interests, or activity (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders [4th ed.; DSM-IV], 1994). The intellectual functioning of nearly 75% of autistic children falls in the mentally retarded range (Frith, 1989). In most studies, the incidence of autism appears to be around 4 to 10 autistic children in every 10,000 births (Happe, 1994).

The child with autism typically requires vast amounts of parental time and energy. This drain of resources can affect the marital relationship and the functioning of individual family members (Rodrigue, Morgan, & Geffken, 1990). How well family members adjust to having a child with autism in their home may depend on the ways they cope with the stress engendered by raising such a child. Research suggests that the effectiveness of coping depends on the particular coping strategies used by the parents, the resources available within the family, and the availability of social support (Boyce, Behl, Mortensen, & Akers, 1991; Bristol, 1979, 1984). Another potentially important resource is religion. A growing number of studies have indicated that religion offers a variety of methods of coping that can help people during stressful times (see Pargament, 1997, for a review). However, those who have studied families of children with disabilities, including families of children with autism, have largely neglected the role of religion as a coping resource. The purpose of the current study is to understand better the roles that religion plays in the coping process of families with a child with autism.

Stressors Experienced by Families with Children with Autism
Several studies indicate that families of children with disabilities experience more stressors and resultant distress than do similar families of typical children and young adults (Boyce, et al., 1991; Kazak & Marvin, 1984; Pahl & Quine, 1987). Furthermore, it appears that families of children with autism report a greater number of stressors (e.g., parental depression and anxiety, difficulties in daily management of the child, financial worries, and concerns over adequate educational and professional resources) than those with children with other disabilities (DeMyer & Goldberg, 1983; Gray, 1994; Holroyd & McArthur, 1976; O'Moore, 1978; Rodrigue et al., 1990).

However, not all family members appraise the stressors of raising a child with special needs as entirely detrimental. Studies indicate that many parents and siblings come to perceive their lives with a disabled relative as mutually beneficial (e.g., Simons, 1987). Koegel, Schreibman, Johnson, O'Neill, & Burke (1983) studied various aspects of parental functioning in 49 mothers and fathers of children with autism. The researchers did not find any differences in stress levels and psychological functioning between these families and well-functioning control families. Some marriages may be strengthened in part through cooperation and a joint sense of purpose of parenting a child with a handicap (e.g., Akerley, 1984; Kazak & Marvin, 1984).

Coping in Families of Children with Autism
Research has highlighted a number of specific coping strategies and coping resources that families with children with disabilities use for successful adaptation. In a study of 45 mothers of autistic children, Bristol (1984) reported that parents felt that positive evaluations of direct services to their child (e.g., "believing that my child's program has my family's best interests in mind") was the most helpful resource in coping with the challenges of autism. A number of other studies have pointed to other family attributes that help families "regenerate" themselves after a crisis, such as family integration, organization, and adaptability (Boyce et al., 1991; Dyson, 1997; Gavidia-Payne & Stoneman, 1997).

Social support in the form of parental training programs has been shown to help parents teach their autistic children functional skills and appropriate behavior (Bondy & Frost, 1994; Harris & Handleman, 1994; Lovaas, 1981; Marcus & Schopler, 1989; Talpins & Kabot, 1996). Support from family and friends also plays an important role (Randall & Parker, 1999). Studies have found that mothers who report low stress also report greater perceived support from spouse, immediate and extended family, friends, and other parents of children with disabilities (Bristol, 1979; Bristol, 1987; Bristol & Schopler, 1983).

Religion as a Coping Resource in Families of Children with Autism
Framework of Religious Coping

Religion can mean very different things to different people. Pargament (1997) defined religion as "a search for significance in ways related to the sacred." The search for significance involves different pathways leading to different religious destinations (Pargament & Park, 1995). Some people look to religion for meaning, some for comfort, some for intimacy with others, some in search of the self, and some for physical, psychological, and emotional well-being.
Research has pointed to a variety of religious coping methods that serve various ends. For example, Pargament et al. (1988) have distinguished three different approaches to responsibility and coping in a stressful situation:

  1. the self-directing approach, in which the individual relies on self rather than on God,
  2. the deferring approach, where the individual places the responsibility for coping on God, and
  3. the collaborative coping approach, where the individual and God are both active partners in coping.

In addition, Pargament (1997) has identified other forms of religious coping, such as benevolent religious appraisals, seeking support from clergy or church members, seeking spiritual support, discontent with congregation and God, negative religious refraining, and expressing interpersonal religious discontent.

Some forms of religious coping, such as perceiving illness as the will of God or as an opportunity for spiritual growth (Jenkins & Pargament, 1988), use of collaborative religious coping (Pargament et al, 1990), and seeking spiritual support (Wright, Pratt, & Schmall, 1985), are tied to better outcomes (e.g., higher self-reported self-esteem, better psychological adjustment) for the individual. On the other hand, certain forms of religious coping, such as expressions of religious discontent with congregation and God, are associated with poorer outcomes (e.g., poor mental health status, poor resolution of the negative event; Pargament, 1997).

Religious Coping and Families with Children with Disabilities
Surprisingly, only a few studies have examined the relationship between the use of religious coping in meeting the stressors of raising children with disabilities and outcomes, such as psychological adjustment or personal growth. A few studies indicate that parents of children with special needs report gaining significantly more support from their personal beliefs than from organized religion (Coulthard & Fitzgerald, 1999; Fewell, 1986). One qualitative study by Haworth, Hill & Glidden (1996), however, indicated that mothers of children with developmental disabilities made more positive than negative comments regarding both spiritual beliefs and organizational experience. In a fairly comprehensive study, with 52 African American families who were caregivers of a child with mental retardation, Rogers-Dulan (1998) found that church attendance and scores on the Religious Connectedness Domain were negatively related to depression, family stress, and impact of child's disability on the family.

A few recent studies reported data from qualitative interviews that explored the role of religion in parenting children with special needs. Overall, the results suggest that religion can serve as a source of support for these families (Bennett, Deluca, & Allen, 1995). Religion reportedly helped families accept their difficulties as a gift from God (Skinner, Bailey, Correa, & Rodriguez, 1999), as part of God's plan (Bristol, 1984), and as an opportunity for families to become closer and attain higher spiritual levels (Skinner et al.). In some cases, religion seemed to offer meaning to the misfortune and suffering for these parents (Weisner, Beizer, & Stolze, 1991) and gave them hope, strength, and patience (Barsch, 1968).

Religious coping can also result in negative outcomes for families of children with disabilities. Explanations such as "God only sends special children to special parents" have reportedly caused distress for some of these parents (Fewell, 1986). In the study by Rogers-Dulan (1998), coding of open-ended responses indicated three negative categories through which religion affected the lives of these parents: God as unhelpful in parenting their child with mental retardation, perception of religious experiences as aversive to the coping process, and feelings of punishment or having doubts about the benevolence of God. Some parents of children with special needs have also indicated negative experiences with religious organizations (Haworth et al., 1996).

There are three major limitations to the studies that have examined the role of religious coping in families of children with special needs. First, most of them have focused their attention on the positive side of religion and have neglected to study its negative aspects (except for studies by Rogers-Dulan, 1998, & Haworth et al., 1996). Even when some parents responded to questions by saying that religion was not a source of support for them (e.g., Bennett et al., 1995), their experience (which may have been negative) was not explored further. Second, many studies relied mainly on interviews and hence did not subject their data to empirical scrutiny. As a result, we do not know whether the use of religious coping (positive or negative) is associated with better or poorer outcomes for caretakers of these children. Finally, many studies have measured religiousness using a framework that lacks specificity--focusing only on global organizational practices or spiritual beliefs. They have failed to consider the diverse, specific ways in which religion is involved in coping with life's challenges.
- Tarakeshwar, Nalini, & Kenneth Pargament, Religious coping in families of children with autism, Focus on Autism & Other Developmental Disabilities, Winter 2001, Vol. 16, Issue 4.
The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #3
The preceding section contained information about religious coping in families of children with autism.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 10
According to Pargament et al., what are the three different approaches to responsibility and coping in a stressful situation? Record the letter of the correct answer the CEU Test.

 
Others who bought this Autism Course
also bought…

Scroll DownScroll UpCourse Listing Bottom Cap

CEU Test for this course | Autism
Forward to Section 11
Back to Section 9
Table of Contents
Top

The article above contains foundational information. Articles below contain optional updates.
Impact of a digital Modified Checklist for Autism in Toddlers–Revised on likelihood and age of autism diagnosis and referral for developmental evaluation
Autism, Ahead of Print.
The present study is a single-site quality improvement project within pediatric primary care involving the implementation of a digital version of the Modified Checklist for Autism in Toddlers–Revised. We evaluated the impact of the digital screener on the likelihood of physician referral for a developmental evaluation or autism diagnosis, and the age of the patients at the time of the event. Patients were children 16–30  months old seen for 18 and 24 months’ well-child visits (1279 encounters), who screened positive for risk for autism spectrum disorder on the Modified Checklist for Autism in Toddlers–Revised without a previously documented autism spectrum disorder diagnosis. Comparisons were made between a cohort of children screened with the paper and pencil version of the Modified Checklist for Autism in Toddlers–Revised before the digital version was implemented and a cohort of children screened during the intervention period. Patients were followed until 48 months and referrals were obtained from electronic health records. Patients screened with the digital Modified Checklist for Autism in Toddlers–Revised were five times more likely to be referred for a developmental evaluation. The automatic scoring, risk assessment, and referral decision support features helped to improve screening outcomes. In this clinic, process change to a digital screening method with automatic guidance for next steps improved adherence to evidence-based clinical care.Lay abstractThis was a project in primary care for young children (1–2 years old). We tested a parent questionnaire on a tablet. This tablet questionnaire asked questions to see whether the child may have autism. We compared the paper and pencil version of the questionnaire to the tablet questionnaire. We read the medical charts for the children until they were 4 years old to see whether they ended up having autism. We found that doctors were more likely to recommend an autism evaluation when a parent used the tablet questionnaire. We think that the tablet’s automatic scoring feature helped the doctors. We also think that the doctors benefited from the advice the tablet gave them.
Implementing early intensive behavioral intervention in community settings
Autism, Ahead of Print.
Although research shows early intensive behavioral intervention is efficacious when delivered in university or private intervention centers, little is known about effectiveness or feasibility of disseminating early intensive behavioral intervention to larger communities. The Michigan State University Early Learning Institute was developed to address gaps in distribution of early intensive behavioral intervention to community settings, with an emphasis of serving children and families on Medicaid. This short report describes the Early Learning Institute’s approach and preliminary utilization data among Medicaid families. Results suggest the model has potential for dissemination within community settings and promote utilization among Medicaid children.Lay abstractAlthough research shows early intensive behavioral intervention can be very beneficial for children with autism spectrum disorder when delivered in university or private intervention centers, little is known about the best way to provide early intensive behavioral intervention within the broader community. The Michigan State University Early Learning Institute was developed to address challenges with providing early intensive behavioral intervention in community settings, with an emphasis on serving children and families on Medicaid. This short report describes the approach taken by the Early Learning Institute and reports data regarding enrollment and utilization among Medicaid families. Results suggest the model has potential to be used within community settings and that children on Medicaid are likely to consistently attend their treatment sessions.
Work, living, and the pursuit of happiness: Vocational and psychosocial outcomes for young adults with autism
Autism, Ahead of Print.
Longitudinal data on the functioning of adults referred for possible autism as children are sparse and possibly different from datasets consisting of adult clinical referrals. A total of 123 young adults, mean age of 26, referred for neurodevelopmental disorders in early childhood were categorized into three outcome groups: autism spectrum disorder (ASD) diagnosis at some point and current intelligence quotient (IQ) ⩾ 70 (Ever ASD-Higher IQ), ever ASD and current IQ < 70 (Ever ASD-Lower IQ), and individuals who never received an ASD diagnosis (Never ASD). Independence and well-being were assessed through direct testing, questionnaires, and interviews. Verbal IQ, beyond intellectual disability status, accounted for group differences in employment; autistic features (Autism Diagnostic Observation Schedule Calibrated Severity Score) were uniquely related to adaptive skills and friendships. In many ways, the Never ASD group had similar outcomes compared to the ASD groups. However, lower well-being and fewer positive emotions were related to ASD diagnosis across IQ. The Ever ASD-Lower IQ group had the highest levels of irritability, hyperactivity, and medications. Families played a major role in supporting adults with and without ASD at all intellectual levels. Realistic ways of increasing independence should be developed through working with adults and their families, while acknowledging the contribution of individual differences in mental health, intelligence, and autism symptoms across neurodevelopmental disorders.Lay abstractIt is important to better understand how adults with autism are functioning in adulthood. Studies that have tracked individuals across the lifespan can help identify developmental factors influence differences in adult outcomes. The present study examines the independence, well-being, and functioning of 123 adults that have been closely followed since early childhood. Autism diagnosis and cognitive assessments were given frequently throughout childhood and during adulthood. We examined differences between adults who had received an autism diagnosis at some point with higher cognitive abilities (Ever ASD-High IQ) and lower cognitive abilities (Ever ASD-Low IQ), as well as adults who never received a diagnosis of autism in the course of the study (Never ASD). We found that autistic features specifically related to adaptive skills and friendships, and verbal intelligence related to work outcomes. In many ways, the Never ASD group had similar outcomes compared to the ASD groups. However, adults with ASD tended to have lower well-being and fewer positive emotions. Families played a major role in supporting adults with and without ASD at all intellectual levels. The findings suggest that realistic ways of increasing independence need to be developed by working with adults and their families, while acknowledging the contribution of individual differences in mental health, intelligence and autism symptoms across neurodevelopmental disorders.
Does implementing a new intervention disrupt use of existing evidence-based autism interventions?
Autism, Ahead of Print.
This study examines how the introduction of TeachTown:Basics, a computer-assisted intervention for students with autism spectrum disorder, influenced teachers’ use of other evidence-based practices. In a randomized controlled trial that enrolled 73 teachers nested within 58 schools, we used three-level hierarchical linear models to evaluate changes in teachers’ use of evidence-based practices across the school year for those who received TeachTown:Basics versus those assigned to control. Both groups received training and implementation support to deliver three well-established evidence-based practices for autism spectrum disorder. Qualitative interviews were conducted with 25 teachers who used TeachTown:Basics to better understand their experience. Compared with teachers in the control group, teachers in the TeachTown:Basics group reported significantly less growth over the 9-month period in their use of evidence-based practices that require one-to-one instruction (ps < 0.05), but no difference in their reported use of evidence-based practices that do not involve one-to-one instruction (p = 0.637). Qualitative interviews indicated that teachers viewed TeachTown:Basics as an effective substitute for one-to-one instruction because it was less burdensome, despite the lack of support for TeachTown:Basics’ effectiveness. Before introducing new practices, education leaders should carefully consider both evidence of effectiveness and the potential impact on the use of other evidence-based practices.Lay abstractInterventions for children with autism spectrum disorder are complex and often are not implemented successfully within schools. When new practices are introduced in schools, they often are layered on top of existing practices, with little attention paid to how introducing new practices affects the use of existing practices. This study evaluated how introducing a computer-assisted intervention, called TeachTown:Basics, affected the use of other evidence-based practices in autism support classrooms. We compared how often teachers reported using a set of evidence-based practices in classrooms that either had access to TeachTown:Basics or did not have the program. We found that teachers who had access to the computer-assisted intervention reported using the other evidence-based practices less often as the school year progressed. Teachers also reported that they liked the computer-assisted intervention, found it easy to use, and that it helped overcome challenges to implementing other evidence-based practices. This is important because the computer-assisted intervention did not improve child outcomes in a previous study and indicates that teachers may use interventions that are appealing and easier to implement, even when they do not have evidence to support their effectiveness. These findings support the idea of interventions’ complexity and how well the intervention fits within the classroom affect how teachers use it and highlight the need to develop school-based interventions that both appeal to the practitioner and improve child outcomes.
Autistic peer-to-peer information transfer is highly effective
Autism, Ahead of Print.
Effective information transfer requires social communication skills. As autism is clinically defined by social communication deficits, it may be expected that information transfer between autistic people would be particularly deficient. However, the Double Empathy theory would suggest that communication difficulties arise from a mismatch in neurotype; and thus information transfer between autistic people may be more successful than information transfer between an autistic and a non-autistic person. We investigate this by examining information transfer between autistic adults, non-autistic adults and mixed autistic-with-non-autistic pairs. Initial participants were told a story which they recounted to a second participant, who recounted the story to a third participant and so on, along a ‘diffusion chain’ of eight participants (n = 72). We found a significantly steeper decline in detail retention in the mixed chains, while autistic chains did not significantly differ from non-autistic chains. Participant rapport ratings revealed significantly lower scores for mixed chains. These results challenge the diagnostic criterion that autistic people lack the skills to interact successfully. Rather, autistic people effectively share information with each other. Information transfer selectively degrades more quickly in mixed pairs, in parallel with a reduction in rapport.Lay abstractSharing information with other people relies on the ability to communicate well. Autism is defined clinically by deficits in social communication. It may therefore be expected that autistic people find it difficult to share information with other people. We wanted to find out whether this was the case, and whether it was different when autistic people were sharing information with other autistic people or with non-autistic people. We recruited nine groups, each with eight people. In three of the groups, everyone was autistic; in three of the groups, everyone was non-autistic; and three of the groups were mixed groups where half the group was autistic and half the group was non-autistic. We told one person in each group a story and asked them to share it with another person, and for that person to share it again and so on, until everyone in the group had heard the story. We then looked at how many details of the story had been shared at each stage. We found that autistic people share information with other autistic people as well as non-autistic people do with other non-autistic people. However, when there are mixed groups of autistic and non-autistic people, much less information is shared. Participants were also asked how they felt they had got on with the other person in the interaction. The people in the mixed groups also experienced lower rapport with the person they were sharing the story with. This finding is important as it shows that autistic people have the skills to share information well with one another and experience good rapport, and that there are selective problems when autistic and non-autistic people are interacting.

CEU Continuing Education for
Psychology CEUs, Counselor CEUs, Social Worker CEUs, MFT CEUs



OnlineCEUcredit.com Login


Forget your Password Reset it!