Anat Zaidman-Zait

An Item Response Theory Analysis of the Parenting Stress Index-Short Form with Parents of Children with Autism Spectrum Disorders.

BACKGROUND The Parenting Stress Index-Short Form (PSI-SF) is one of the most widely used instruments for measuring parenting stress in families of children with autism spectrum disorders (ASD). However, no research to date has examined the psychometric properties of the PSI-SF in a sample of parents of young children with ASD. In this regard, item response theory (IRT) can be used to estimate how much information or discrimination each item of a scale offers across the entire range of the latent variable being measured, by creating individual item information curves or profiles. The purpose of this study was to use IRT to examine the discriminability of PSI-SF items in a sample of parents of young children with ASD who experience varying levels of parental stress. METHODS The study involved the parents of 141 children with autism spectrum disorders (91.4% mothers; mean age 36.2 years) who completed the PSI-SF following diagnosis. Item characteristic curves were constructed for each of the PSI-SF items and examined with regard to item functioning. RESULTS Results indicated that, for the most part, changes in parental distress severity were reflected in changes on item scores. However, several items on the subscales measuring parent-child dysfunctional interactions and child behavior difficulty functioned poorly to discriminate parents across a range of total stress severity. CONCLUSIONS The parent-child dysfunctional interaction and difficult child subscales of the PSI-SF scale should be used with caution with parents of young children with ASD. More research is required to examine PSI-SF content validity, at least among parents of children with ASD and perhaps parents of children with other disabilities as well.

Everyday Problems and Stress Faced by Parents of Children With Cochlear Implants

Objectives: To explore everyday problems associated with parenting children who undergo cochlear implantation (CI), to investigate parents’ interpersonal relationships as a resource for collaborative problem solving, and to examine links among parents’ everyday problems, stress, and life satisfaction. Method: 31 parents of deaf children with CI responded to open-ended questions regarding types of everyday problems encountered within the specific context of parenting those children. Parents also completed the Parental Stress Index/Short Form and the Life Satisfaction Scale. Results: Problems were categorized in 9 domains: implant drawbacks, communication difficulties, child’s behavior and character, socialization, habilitation demands and parenting role, financial difficulties, services, educating others and/or advocacy, and academic concerns. Professionals, spouses, and other parents of deaf children were frequently nominated partners for collaborative everyday problem solving and coping. Significant correlations emerged among parents’ everyday problems, stress, and life satisfaction. Conclusions: Findings enhance understanding regarding the contextual specificity of everyday problems associated with raising deaf children with CI, beyond that obtained from a general measure of parental stress. This, in turn, can guide habilitation teams in working with families of implanted children.

Transition to Adulthood as a Parent-Youth Project: Governance Transfer, Career Promotion, and Relational Processes.

This study determined how youth (ages 17-21) and their parents jointly constructed and acted on goals and strategies pertinent to the transition to adulthood. Twenty parent-youth dyads were followed over an 8-month period using the qualitative action-project method. Data included their joint conversations, video recall of internal processes, self-monitoring logs, and researcher telephone monitoring. Detailed and repeated analysis of elements, functional steps, and goals resulted in the identification of an explicit joint project for each dyad that the participants saw as pertinent to the transition to adulthood. These projects referred broadly to the youth development of identity and social inclusion in the adult world and included the specific projects of career promotion, governance transfer, and parent-youth relational processes. The findings illustrate the complexity of the transition-to-adulthood process as well as its joint construction by parent and youth. Implications for practice include identifying and following the joint parent-youth transition project.

Factor analysis of the Parenting Stress Index‐Short Form with parents of young children with autism spectrum disorders

The primary purpose of this study was to examine the underlying factor structure of the Parenting Stress Index‐Short Form (PSI‐SF) in a large cohort of parents of young children with autism spectrum disorder (ASD). A secondary goal was to examine relationships between PSI‐SF factors and autism severity, child behavior problems, and parental mental health variables that have been shown to be related to parental stress in previous research. A confirmatory factor analysis (CFA) was used to examine the three‐factor structure described in the PSI‐SF manual [Abidin, 1995 ]: parental distress, parent–child dysfunctional interaction, and difficult child. Results of the CFA indicated that the three‐factor structure was unacceptable when applied to the study sample. Thus, an exploratory factor analysis was conducted and suggested a six‐factor model as the best alternative for the PSI‐SF index. Spearmans correlations revealed significant positive correlations with moderate to large effect sizes between the revised PSI‐SF factors and autism severity, externalizing and internalizing child behaviors, and an index of parent mental health. The revised factors represent more narrowly defined aspects of the three original subscales of the PSI‐SF and might prove to be advantageous in both research and clinical applications. Autism Res 2011,4:336–346.

Adolescent Possible Selves as Jointly Constructed in Parent-Adolescent Career Conversations and Related Activities

The purpose of this research project is to describe the possible selves that parents and adolescents introduce and jointly adjust, adopt, maintain, or abandon in conversations about potential careers and related activities over an 8-month period. Data were gathered from 19 parent-adolescent dyads through observation of (a) parents and adolescents during videotaped conversations about the adolescents career-related future, (b) parents and adolescents during video recall of conversations, and (c) logs and telephone monitoring. Findings reveal two broad sets of processes pertaining to the construction of possible selves: “exploring options” and “trying on a possible self.”

Impact of personal and social resources on parenting stress in mothers of children with autism spectrum disorder

This study examined the longitudinal associations between child behavior problems, coping strategies, social resources, and parenting stress in mothers of young children with autism spectrum disorder. Participants were 283 mothers who completed self- and child-report measures at the time of diagnosis and 2 years later. Hierarchical multiple regression was conducted to predict overall parenting stress. At diagnosis, the final model indicated that high levels of social support and mothers’ use of active engaged coping strategies were associated with lower levels of parenting stress. Conversely, high levels of child externalizing behavior problems, family dysfunction, and mothers’ use of disengaged coping strategies were associated with higher parenting stress. Two years later, high levels of parenting stress at diagnosis predicted increased parenting stress. In addition, high or increasing levels of social support predicted a decrease in parenting stress, while high or increasing levels of family dysfunction predicted increased stress. Finally, increased use of disengaged coping strategies and decreased use of active coping strategies over time predicted higher levels of parenting stress. Results are discussed in terms of their implications for the provision of targeted supports that are designed to enhance the personal and social resources available to mothers of children with autism spectrum disorder.

Social Support for Parents of Deaf Children: Moving Toward Contextualized Understanding

In light of claims that social support needs to be defined within specific context, we conducted a metasynthesis to identify ways that social support has been studied and contextualized in research focused on hearing parents of children with hearing loss. A literature search of published articles was conducted to identify research studies related to support and hearing parents of children with hearing loss. Our search yielded 108 items from Psycinfo and 154 items from Web of Science; 26 studies met our inclusion criteria. Our analyses involved summary and integration of information regarding research methods, guiding theoretical frameworks, and findings in relation to diverse support contexts. We found that it is the multidimensionality of social support and its specific functions, individually and in combination, that are particularly relevant in informing family-centered service provision. Further understanding of the multidimensional and dynamic nature of support could occur through investigation of diverse functions of support within and across ecological contexts. Findings from this study contributed to a descriptive framework that can be used to explore the multidimensionality of support; facilitate use of methods that assess specific support functions; and also inform the development of interventions that are responsive and match the needs of parents.

Cochlear Implantation among Deaf Children with Additional Disabilities: Parental Perceptions of Benefits, Challenges, and Service Provision.

Although increasing numbers of children with additional disabilities are receiving cochlear implants (CIs), little is known about family perspectives of the benefits and the challenges of cochlear implantation in this pediatric population. This study examines perceptions among parents of deaf children with additional disabilities regarding satisfaction with service provision, benefits, and challenges of the CI process. This was a mixed-methods study, which included a survey and interviews. Twenty-three families of deaf children with additional disabilities participated in this study, and 17 of these parents participated in in-depth interviews regarding their childs experience with the CI, including benefits and challenges. Interviews were analyzed through inductive thematic analysis. Parent-perceived benefits of cochlear implantation included childrens improved sound awareness, communication skills, and greater well-being compared to preimplantation status. However, the majority of families felt that they and their children were not receiving enough services. Major challenges included managing funding; coping with limited availability of specialized services, particularly in rural areas; and continuing concerns about the childs communication, social skills, and academic performance. Results suggest that children with additional disabilities benefit from CIs, but they and their families also face unique challenges that professionals should consider when working with these families.

Parenting projects as children transition to adulthood

This investigation describes the joint goal-directed series of actions, or projects, of 20 parents whose children were entering adulthood. Data were collected over an eight-month period using the qualitative action-project method. Data included joint parent–youth conversations, video recall interviews, and self-report logs. Detailed within-case analysis of the elements, functional steps, and goals revealed the parenting project each parent was engaged in. Comparing across cases, similar parenting projects were grouped together into three sets: (a) striving for child–environment fit: forecasting, coordinating, and assessing; (b) pressing for acceptable change: stepping back or stepping up; and (c) separating: adjusting relations and managing emotions. These descriptive findings illustrate the complexity of parenting during the transition to adulthood and how parenting projects are jointly constructed between parents and young adult children.

Health-Related Quality of Life Among Young Children With Cochlear Implants and Developmental Disabilities.

Supplemental Digital Content is available in the text. Objectives: We developed a framework for objectively comparing hearing aids, independent of brand, type, or product family. This was done using a large dataset of commercially available hearing aids. To achieve this, we investigated which hearing aid features are suitable for comparison, and are also relevant for the rehabilitation of hearing impairment. To compare hearing aids objectively, we distinguished populations of hearing aids based on a set of key hearing aid features. Finally, we describe these hearing aid subpopulations so that these could potentially be used as a supporting tool for the selection of an appropriate hearing aid. Design: In this study, we used technical (meta-)data from 3911 hearing aids (available on the Dutch market in March 2018). The dataset contained about 50 of the most important characteristics of a hearing aid. After cleaning and handling the data via a well-defined knowledge discovery in database procedure, a total 3083 hearing aids were included. Subsequently, a set of well-defined key hearing aid features were used as input for further analysis. The data were split into an in-the-ear style hearing aid subset and a behind-the-ear style subset, for separate analyses. The knowledge discovery in databases procedure was also used as an objective guiding tool for applying an exploratory cluster analysis to expose subpopulations of hearing aids within the dataset. The latter was done using Latent Class Tree Analysis, which is an extension to the better-known Latent Class Analysis clustering method: with the important addition of a hierarchical structure. Results: A total of 10 hearing aid features were identified as relevant for audiological rehabilitation: compression, sound processing, noise reduction (NR), expansion, wind NR, impulse (noise) reduction, active feedback management, directionality, NR environments, and ear-to-ear communication. These features had the greatest impact on results yielded by the Latent Class Tree cluster analysis. At the first level in the hierarchical cluster model, the two subpopulations of hearing aids could be divided into 3 main branches, mainly distinguishable by the overall availability or technology level of hearing aid features. Higher-level results of the cluster analysis yielded a set of mutually exclusive hearing aid populations, called modalities. In total, nine behind-the-ear and seven in-the-ear modalities were found. These modalities were characterized by particular profiles of (complex) interplay between the selected key features. A technical comparison of features (e.g., implementation) is beyond the scope of this research. Conclusions: Combining a large dataset of hearing aids with a probabilistic hierarchical clustering method enables analysis of hearing aid characteristics which extends beyond product families and manufacturers. Furthermore, this study found that the resulting hearing aid modalities can be thought of as a generic alternative to the manufacturer-dependent proprietary “concepts,” and could potentially aid the selection of an appropriate hearing aid for technical rehabilitation. This study is in line with a growing need for justification of hearing aid selection and the increasing demand for evidence-based practice.