Article written by Stephanie A. Hayes and Shelley L. Watson
Published online July 13 2012
Reviewed by Chelsea Graham
This article is a ‘meta-analysis’ of studies. A ‘meta-analysis’ is the statistical procedure for combining data from multiple studies. When the treatment effect (or effect size) is consistent from one study to the next, meta–analysis can be used to identify this common effect. The authors reviewed studies about Parenting Stress in parents of children WITH ASD and parents of children WITHOUT ASD.
Prior to explaining their methods of search and selection criteria for the studies included in this meta-analysis, the authors defined ‘Parenting Stress’ and summarized the research regarding the impact of ASD on Parenting Stress. The discussion detailing the definition of stress raised interesting ideas. Stress results from the interaction of a family and their environment. When stressors occur, a family will use their existing coping mechanisms in attempts to return the family to a functional place. If their coping mechanisms are not sufficient, the outcome is stress.
Why do a meta-analysis? The authors gave several rationale for completing a systematic review of the parenting stress literature comparing families of children with autism to children with typical development or those with other disabilities. Firstly, it has not been done. Secondly, it can provide researchers with guidance for where further research is needed. Thirdly, to summarize the variability among the outcomes of stress as reported by families. And fourthly, to answer questions about the magnitiude, variability, and generalizability of findings.
This meta-analysis selected only studies that measured parental stress, and not depression. The included studies used the following established measures of parenting stress: Family Impact Questionnaire, Questionnaire on Resources and Stress (QRS) and Parenting Stress Index (PSI).
After selecting the studies to include in the analysis, the effect size was calculated. The effect size is an indicator of the strength of the relationship between two outcome variables and allows for comparison of measures that employ different scales. The effect size was calculated comparing the Parents of Children with ASD and the comparison group (typically developing children or those with other disabilities). Mathematical equations were used to establish effect sizes for each study, so that the outcomes of the studies could be compared.
Results of the Meta-Analysis:
In comparing outcome measures and effect size of numerous studies regarding parenting stress among parents of children with ASD vs parents of typically developing children, the authors concluded there is a ‘true difference between the experience of parents of children with ASD in comparison to those with children who have typical development on comprehensive measures of parenting stress,’ AND there is also a true difference between ASD parents in comparison to parents of children with other disabilities.
“The overall effect size calculated was large,” and “suggests that parenting stress in families with a child diagnosed with ASD is a significant experience that warrants attention and intervention.”
Suggestions for further research were proposed by the authors. Not many studies differentiated between the different stress experiences of fathers vs mothers of children with ASD. Research should focus on differentiating the levels of ASD and the reported stress for each level. Often children with ASD have co-morbid conditions, could these conditions be affecting the stress levels?
My initial reaction to reading this article was less about the content of the analysis, and more related to the EFFORT it took to read this type of research. I needed to reset my brain back to my grad school days when I was a bit sharper, and in the practice of interpreting academic language. After preparing myself for the rigors of reading and interpreting the data, I was able to make connections between the results of the studies and my professional experiences.
In response to the content and results of the meta-analysis, I’m not surprised with the outcome. Providing speech therapy to a child with ASD is frequently stressful, I had no doubt that parents would report high levels of stress.
This meta-analysis was an important review because of the conclusions it was able to draw for further research. We all know parents of children with ASD are stressed, but HOW CAN WE HELP? That’s the research and evidence based practice we need.