Benjamin Zablotsky

The Association Between Mental Health, Stress, and Coping Supports in Mothers of Children with Autism Spectrum Disorders

Raising a child with an autism spectrum disorder (ASD) can be a stressful experience for parents. When left unmanaged, high stress levels can lead to the development of depressive symptomatology, highlighting the importance of coping supports. The current paper examined the stress level and psychological wellbeing of mothers with a child with ASD in a national survey. After adjusting for child, mother and family level characteristics, it was determined that mothers of children with ASDs were at greater risk for poor mental health and high stress levels compared to mothers of children without ASDs. The presence of maternal coping strategies, in the form of emotional and neighborhood social supports, as well as strong coping skills, reduced these risks between models.

Risk factors for bullying among children with autism spectrum disorders

Although children with disabilities have been found to be at an increased risk of bullying, there are limited studies investigating predictors of bullying involvement in children with autism spectrum disorders. The current study presents findings from 1221 parents of children diagnosed with autism spectrum disorder who were selected from a national web-based registry. Parents completed a survey dedicated to the school and bullying experiences of their child, and multivariate logistic regression analyses were conducted to identify child and school risk factors for involvement as victim, bully, or bully–victim. Additional analyses examined the risk of bullying involvement based on the amount of time spent in general education classrooms. Children diagnosed with Asperger’s disorder, attending a public school or a school with a general education population, were at the greatest risk of being victimized in the past month. Children with comorbid conditions and a high level of autistic traits were the most likely to be victims, bullies, and bully–victims. Finally, children in full inclusion classrooms were more likely to be victimized than those who spend the majority of their time in special education settings. Future research studies should be invested in finding appropriate supports for children with autism spectrum disorder placed in inclusive settings.

The association between bullying and the psychological functioning of children with autism spectrum disorders

Objective: Bullying has become a major national concern, particularly as it affects children with disabilities. The current study aimed to determine the association between psychiatric comorbid conditions, involvement in bullying (victim, bully, or bully–victim), and the immediate psychological correlates of bullying among children with autism spectrum disorders (ASDs). Methods: A national sample of 1221 parents completed a survey dedicated to the bullying and school experiences of their child with ASD, reporting on the immediate consequences of bullying involvement, including their childs psychological well-being and any psychiatric comorbidity. Multivariate logistic regressions were performed to determine whether specific psychiatric comorbidities were associated with an increased risk of involvement as victim, bully, or bully–victim. Analyses of variance determined the relationship between bullying frequency and psychological functioning. All models adjusted for child and school covariates. Results: Children who were frequently victimized were more likely to present with internalizing symptoms, whereas children who frequently bullied others were more likely to exhibit emotion regulation problems. Children who were identified as frequent bully–victims presented with both internalizing symptoms and emotion regulation problems. Children with attention-deficit hyperactivity disorder (ADHD) and depression were more likely to have been victimized, whereas children with conduct disorder (CD) or oppositional defiant disorder (ODD) were more likely to have bullied other children. Children identified as bully–victims were more likely to have ADHD, CD, or ODD. Conclusions: Children with ASDs who had displayed bullying behaviors in the past month exhibited psychological impairments, including psychiatric comorbidity. The frequency of bullying behaviors was significantly associated with the level of impairment.

Psychiatric-related emergency department visits among children with an autism spectrum disorder.

Objective This study aimed to examine the prevalence and characteristics of psychiatry-related emergency department (ED) visits among children with an autism spectrum disorder (ASD), including the specific reason for visit, as well as the influence of insurance type. Methods Data used for this cross-sectional, observational study were obtained from the 2008 National Emergency Department Sample, the largest all-payer ED database in the United States. Psychiatry-related visits to the ED among children with ASD were identified using International Classification of Diseases, Ninth Revision, billing codes. A total of 3,974,332 visits (unweighted) were present for youth 3–17 years, of which 13,191 involved a child with ASD. Results Thirteen percent of visits among children with ASD were due to a psychiatric problem, as compared with 2% of all visits by youths without ASD. Results from the multivariate analyses revealed that the likelihood for a psychiatric ED visit was increased 9-fold (odds ratio [OR], 9.13; 95% confidence interval [CI], 8.61–9.70) among pediatric ASD visits, compared with non-ASD visits. Children with ASD who were covered by private insurance, compared with those with medical assistance, were at even greater risk for a psychiatric ED visit (OR, 1.58; 95% CI, 1.53–1.63). Visits among children with ASD were more likely to be due to externalizing (OR, 1.62; 95% CI, 1.44–1.83) and psychotic (OR, 1.93; 95% CI, 1.58–2.35) disorders compared with visits among non-ASD children. Conclusions This study highlights the need for improving community-based psychiatric systems of care for youths with ASD to divert psychiatry-related ED visits, particularly for those children with private insurance.

The association between child autism symptomatology, maternal quality of life, and risk for depression

Parents raising children with autism spectrum disorders (ASDs) have been shown to experience high levels of stress and report a lower quality of life. The current study examined the association between child autism symptomatology, mother’s quality of life, and mother’s risk for depression in a sample of 1,110 mothers recruited from a web-based registry of families with children with an ASD. Higher autism symptomatology and a greater number of co-occurring psychiatric disorders in the child were associated with an increased risk for current treatment of maternal depression and a lower maternal quality of life. The results highlight the importance of screening for depression, particularly in mothers of children with ASD and mental health and behavioral challenges.

An evaluation of school involvement and satisfaction of parents of children with autism spectrum disorders.

Parental school involvement and satisfaction are unstudied in families raising a child with an autism spectrum disorder (ASD). To fill this gap, the current study utilized a national sample of families (N  =  8,978) from the 2007 Parent and Family Involvement in Education survey ( U.S. Department of Education, National Center for Education Statistics, 2006-2007 ). Parents of children with ASDs were found to be more likely than parents of children without the disorder to attend parent-teacher conferences, meet with school guidance counselors, and help with homework. Parents of children with ASD were also more dissatisfied with the level of communication provided by the school. There was a significant positive correlation between parental school involvement and parental school satisfaction. These findings have important implications for how schools interact with families with children with ASD.

Health Care Experiences and Perceived Financial Impact Among Families of Children With an Autism Spectrum Disorder

OBJECTIVE The authors compared the health care experiences of families raising a child with autism spectrum disorder (ASD), an intellectual disability disorder (IDD), or attention-deficit hyperactivity disorder (ADHD). METHODS Children with a current diagnosis of ASD (N=3,005), ADHD (N=9,662), or IDD (N=949) were identified in the 2009-2010 National Survey of Children With Special Health Care Needs. Weighted structural equation modeling was used to determine the association between family satisfaction with medical care, timeliness of care, and medical insurance coverage and the impact of the childs condition on the familys financial situation. RESULTS Families of children diagnosed as having ASD comorbid with either ADHD or IDD or comorbid with both conditions reported the highest levels of dissatisfaction across all health care quality variables and experienced the greatest impact on the familys financial situation. CONCLUSIONS The findings underscore the need for comprehensive and accessible health care services for children with ASD, particularly those with comorbid conditions.

Involvement in Bullying among Children with Autism Spectrum Disorders: Parents' Perspectives on the Influence of School Factors

Children with developmental disabilities are at an increased risk for involvement in bullying, and children with autism spectrum disorders (ASDs) may be at particular risk because of challenges with social skills and difficulty maintaining friendships, yet there has been little empirical research on involvement in bullying among children with ASD. The current study presents findings from a cross-sectional national survey of 1,221 parents of children with ASDs regarding their childrens experience with bullying (as both a victim and a perpetrator), as well as the parents’ perceptions of the school and their involvement in school-based prevention efforts. Structural equation modeling analyses revealed parents rate their childs school climate more negatively if their children had been bullied in the past month. Parents who viewed the school more positively were more likely to be involved in their childs school. These findings highlight the potential role a positive school climate may play in protecting children with ASDs from the harmful effects of bullying, as well as the potential benefits of involving parents in school-based activities. Moreover, the current study identifies children with Aspergers to be at particular risk for being bullied when compared with children with other ASDs.

Sex differences in co-occurring conditions of children with autism spectrum disorders

This study investigated differences in co-occurring diagnoses made in females compared to males with autism spectrum disorders in 913 children (746 males and 167 females) living in the United States with a current autism spectrum disorder diagnosis identified via caregiver-reported data from the National Survey of Children’s Health 2007. The results indicated that overall, females had significantly fewer reported autism spectrum disorder co-occurring conditions than males. Females, compared to males, with a current autism spectrum disorder diagnosis had lower rates of past learning disorder, current mild learning disorder, and past anxiety diagnoses. Females with a current autism spectrum disorder diagnosis were more likely than males to have been diagnosed with a speech problem in the past, while males with a current autism spectrum disorder diagnosis were more likely than females to have a current diagnosis of a mild learning disability and a past diagnosis of learning disability. In addition, males with a current autism spectrum disorder diagnosis were more likely than females to have two or more co-occurring diagnoses. These findings provide insight into trends in sex differences in autism spectrum disorder co-occurring conditions.

Ten-Year Trends in Bullying and Related Attitudes Among 4th- to 12th-Graders

The prevalence of bullying and related behaviors decreased significantly between 2005 and 2014; the most recent years showed the greatest improvements in school climate and reductions in bullying. BACKGROUND AND OBJECTIVES: Bullying is a significant public health concern, and it has received considerable attention from the media and policymakers over the past decade, which has led some to believe that it is increasing. However, there are limited surveillance data on bullying to inform our understanding of such trends over the course of multiple years. The current study examined the prevalence of bullying and related behaviors between 2005 and 2014 and explored whether any such changes varied across schools or as a function of school-level covariates. METHODS: Youth self-reports of 13 indicators of bullying and related behaviors were collected from 246 306 students in 109 Maryland schools across 10 years. The data were weighted to reflect the school populations and were analyzed by using longitudinal hierarchical linear modeling to examine changes over time. RESULTS: The covariate-adjusted models indicated a significant improvement over bullying and related concerns in 10 out of 13 indicators (including a decrease in bullying and victimization) for in-person forms (ie, physical, verbal, relational) and cyberbullying. Results also showed an increase in the perceptions that adults do enough to stop bullying and students’ feelings of safety and belonging at school. CONCLUSIONS: Prevalence of bullying and related behaviors generally decreased over this 10-year period with the most recent years showing the greatest improvements in school climate and reductions in bullying. Additional research is needed to identify factors that contributed to this declining trend.