+ When Deep Breaths Don’t Work: The Impact of Parental Stress on Challenging Behaviors for Those with ASD Takeshia Williams, M.A., Ph.D. Candidate Eastern Virginia Medical School Child REACH Conference May 27, 2016
+ Disclosures No disclosures to report
+ Hello from EVMS! Eastern Virginia Medical School Autism Spectrum Disorder Program Website: ____ EVMS Autism Spectrum Disorder Program
+ Objectives Discuss the unique stressors caregivers face through the lifespan Discuss caregiver stress and it’s impact on the child Learn techniques to assist with stress management Clinical Case Discussion
+ Parenting is Tough Work! 5
+ Child Behavior Impacts Stress ASD Related behaviors make parenting more challenging (Griffith, Hastings, Nash, & Hill, 2010) 6
+ Unique ASD Challenges Across the Lifespan & Parental Stress 7 Middle Childhood 6-11 years Adolescence & Beyond 12 + years Early Childhood 0-5 years (Bryant & Zick, 1996; Azad, Blacher, & Marcoulides, 2013)
+ Early Childhood Young Child with ASD in The Mall
+ Unique ASD Challenges Across the Lifespan & Parental Stress 9 Middle Childhood 6-11 years Adolescence & Beyond 12 + years Early Childhood 0-5 years
+ Middle Childhood Having Autism At School- Sensory Experience
+ Unique ASD Challenges Across the Lifespan & Parental Stress 11 Middle Childhood 6-11 years Adolescence & Beyond 12 + years Early Childhood 0-5 years (Carr and Lord, 2013; Tehee, Honan, &Hevey, 2009)
+ Adolescence/Young Adulthood Illustration of Difficulties Helping a Teen with ASD Complete Activities of Daily Living Autism in Love Trailer
+ Unique ASD Challenges Across the Lifespan & Parental Stress 13 Middle Childhood 6-11 years Adolescence & Beyond 12 + years Early Childhood 0-5 years (McStay et al., 2014)
+ Why is extra stress bad and What can we do about it?
+ Stress & Caring for a Child with ASD Stress leads to negative impacts on the family (Chang et al., 2004) Parental depression, substance use, and anxiety Relationship instability Difficulties at school Maladaptive coping behaviors 15
+ Intervening with Stress Stressor Parent Response Child Response Context
+ Stressor/Context Level Interventions Stressor Parent Response Child Response
+ Intervening at the Stressor Level Identifying stressors External Internal ExternalInternal Aversive sensory experiences New/different people School Unexpected events Weather Prejudice Strong Emotions Memories Fears Uncomfortable body sensations
+ Intervening at the Stressor Level Stress Prevention Preparing for Unexpected Changes/Events Bolstering Social Support Connecting with Community Resources Retrieved from Autism Speaks
+ Child Level Interventions Stressor Parent Response Child Response
+ How did you learn to eat?
+ Intervening at the Child Level Provide a common language for emotion identification and intensity A 5 Could Make Me Lose Control
+ Intervening at the Child Level
+ Provide alternatives for maladaptive coping behaviors Retrieved from Autism Speaks
+ Intervening at the Child Level Books that help with maladaptive coping behaviors
+ Intervening at the Child Level Higher Level Books/Materials
+ Intervening at the Child Level Paced Breathing Exercise SSTi4
+ Intervening at the Child Level Progressive Muscle Relaxation Guided Imagery Retrieved from Autism Speaks
+ Parent Level Interventions Stressor Parent Response Child Response
+ Assessing Parental Stress
+ Assessing Parent Coping How are parents coping? Is it adaptive for the circumstance?
+ Assessing Coping Common parent coping errors Increase in intensity of their emotional experience Exerting control Rigidity/Inflexibility Punish behavior Permissive/Avoidant
+ Regulating Adult Emotional Experiences Mindful journaling Paced breathing Progressive Muscle relaxation Grounding techniques Self Care
+ Mindful Journaling Exercise Take 3 minutes to journal Write whatever is on your mind without judgement
+ Punitive or Permissive Parenting
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+ Clinical Case
+ “Jane” 4 years old Diagnosed ASD & ADHD Mom, Dad, 2 older siblings Military Family Daily fits/tantrums ~20 minutes, 3-4 times daily Difficulty Sleeping, Food Aversions What other information would you like to know? What would you do to help?
+ Let’s Talk! Takeshia Williams Eastern Virginia Medical School Autism Spectrum Disorder Program