**3. Results**

The *Checklist of Supports for Parents of the Handicapped* (CSPH; [74]) was used to evaluate the social support available to parents caring for a child with ASD. It is a 23-item rating scale that uses a 5-point item scale ranging from 0 (nothing useful) to 4 (very useful). The total score of the measure was used in this study. There is no information regarding the internal consistency

The *Positive Contribution Scale of the Kansas Inventory of Parental Perceptions* (KIPP; [51]) was chosen to evaluate the positive feelings of parents towards the child with ASD. The KIPP is a 50-item rating scale that ranges from 1 (strongly disagree) to 4 (strongly agree). Higher scores are associated with greater awareness of the positive perceptions. We also used measures of three subscales: a) source of happiness and fulfilment subscale (six items) to represent positive feelings towards the child; b) source of personal growth and maturity subscale (seven items) to indicate positive impact upon the respondent; and c) source of strength and family closeness (seven items) to represent the positive impact upon the family. The alpha reliability for the original Positive Contribution Scale was.80. For the subscales, the alpha reliability ranged from.84 and.86, indicating good psychometric characteristics. In the present study, Cronbach's

alpha for the total scale was.91, and for the subscales, the alpha ranged from.68 to.81.

The *Brief Coping Orientation of Problems Experienced* (Brief-COPE; [75]; adapted to Spanish by [76]) was used to obtain information on coping strategies used by parents raising an individual with ASD. The Brief-COPE has 14 two-item subscales. Each item is rated in terms of how often the responder utilises a particular coping strategy as measured on a 4-point scale, where 0 represents "I have not been doing this at all" and 3 represents "I've been doing this a lot".

To reduce the number of strategies, we performed a principal component factor analysis following the methodology used by Hastings et al. [30]. The results showed that two factors explained 28% of the variance; the two factors included items from the original Brief-COPE sub-scales. Factor 1, which is named "positive and problem-focused coping strategies", includes thirteen items for active coping, planning, seeking instrumental and emotional social support, positive reframing, and humour (items 2, 5, 7, 10, 12, 14, 15, 17, 18, 19, 21, 23 and 28). Factor 2, which is named "active avoidance coping strategies", includes nine items (items 1, 3, 6, 8, 9, 16, 20(-), 24(-) and 26). Only the scores for these two factors were used in the current study. Reliability was good for the total scale (α=.77), positive and problem-focused coping

The *Brief Psychological Well-being Spanish Version* [77] is a brief version of the original Psycho‐ logical Well-being Scale [78]. It is a 29-item scale with a 4-point item scale ranging from 1 (completely disagree) to 4 (completely agree). The 29 items are organised into six dimensions (self-acceptance, positive relations, autonomy, environmental mastery, purpose in life and personal growth). The measure of psychological well-being used in this study was the total score. The internal consistency of the brief version of the scale in the original study was good

The *Family Quality of Life Scale* (FQOL [79]; adapted for Spanish by [80] was used to assess parents' satisfaction with their family quality of life. This is a 25-item scale with five sub-scales (family interaction, emotional well-being, parenting, physical/material well-being and

strategies (α=.79), and active avoidance coping strategies (α=.71).

(α=.84). In the present study, Cronbach's alpha was.91.

of the original scale, but in the present study, Cronbach's alpha was.82.

60 Autism Spectrum Disorder - Recent Advances

### **3.1. Comparative analysis between fathers and mothers**

First, we were interested in exploring the data to know the average values of the variables that made up the study among both fathers and mothers. T-tests were applied to examine whether there were significant differences in the values of the variables between the two groups. The results of the comparisons of mean values are shown in Table 4.

As shown by the data in the table, we did not find significant differences between fathers and mothers in the perception of the severity of the behaviour problems presented by children with ASD. The same pattern was found with the social support total score and subscale scores (informal, formal, and informational). None of the criterion variables (psychological wellbeing and family quality of life) was found to be significantly different between the groups.

The study variables that showed significant differences between fathers and mothers were the positive contributions and coping strategies. In relation to the positive contributions that the child of ASD brings to the family, the data indicated that mothers perceive a higher amount of positive contributions than fathers (*t* (1, 215)=-2.97, *p*=.003; *M*=134.94, *M*=126.76, respective‐ ly). The same results were found with the subscale of strength and family closeness (*t (1, 215)*=-3.18; p=.002; *M*=21.84 for mothers, *M*=20.20 for fathers). The effect sizes of the differences were Cohen's *d*=.41, and.44 for the total scale and subscale scores, respectively.

With regard to coping strategies, t-tests showed that mothers reported higher use of both strategies: positive and problem-focused coping strategies (*t* (1, 215)=-3.50; *p*=.001; *M*=17.76 for mothers, *M*=15.14 for fathers; Cohen's *d=.49*) and active avoidance coping (*t* (1, 215)=-3.18; *p*=. 05; *M*=3.67 for mothers, *M*=2.87 for fathers; Cohen's *d=*.27).

Another aspect of active avoidance strategies to note is that the average value obtained in both groups is very small (*M*=3.67 for mothers, *M*=2.87 for fathers) because the potential range that this variable can reach is 0-21. These data indicate the limited use of this type of strategy for dealing with situations that arise in everyday life.


**Table 4.** Results of the comparisons of fathers and mothers' mean values on study variables

#### **3.2. Correlations**

Pearson correlations were used to explore bivariate associations between all of the variables considered. Correlations were calculated separately for fathers and mothers (see Tables 5a and 5b, respectively*)*. The correlations results are described below.

The table data show that psychological well-being has a significant positive relationship with family quality of life in both parents (*r=*.49 for fathers; *r*=.54 for mothers). For both parents, psychological well-being was negatively associated with behaviour problems (*r=*-.38 for fathers; *r*=-.20 for mothers) and with active avoidance coping (*r=*-.51 for fathers; *r*=-.33 for mothers), and positively correlated with positive contributions (*r=*.27 for fathers; *r*=.37 for mothers). For fathers, we also found a positive relationship with family income (*r=*.21). In the case of mothers, psychological well-being was positively correlated with social support (*r=*.24) and positive and problem-focused coping strategies (*r=*.19).

For fathers and mothers, the family quality of life was negatively associated with behaviour problems (*r=*-.29, *r*=-.21, respectively) and active avoidance coping (*r=*-.23, *r*=-.33, respectively). Additionally, for both parents, family quality of life was positively associated with social support (*r=*.23, *r*=.23, respectively). Only in the case of mothers was family quality of life

Coping Strategies and Parents' Positive Perceptions of Raising a Child with Autism Spectrum Disorders http://dx.doi.org/10.5772/58966 63


**Table 5.** (a) Pearson correlation coefficients for total measures of study variables in fathers; (b) Pearson correlation coefficients for total measures of study variables in mothers

**3.2. Correlations**

\*\* *P* < 0.01, \* *P* < 0.05

**Positive and problem-focused**

62 Autism Spectrum Disorder - Recent Advances

**coping**

Pearson correlations were used to explore bivariate associations between all of the variables considered. Correlations were calculated separately for fathers and mothers (see Tables 5a and

**Fathers** (*n* = 90) **Mothers** (*n =* 127)

**Effect size (Cohen' d)**

**Variables Mean** *SD* **Mean** *SD t (1, 215)*

**Positive contributions** 126.76 20.47 134.94 19.53 -2.97\*\* .41

Strength and family closeness 20.20 4.13 21.84 3.43 -3.18\*\* .44

**Active avoidance coping** 2.87 2.76 3.67 3.07 -1.97\* .27

15.14 4.96 17.76 5.71 -3.50\*\* .49

**Behaviour problems** 18.79 15.16 18.65 13.89 .68 **Social support** 49.03 15.22 49.80 14.81 -.37 Informal support 20.48 6.32 19.07 6.80 1.54 Formal support 17.80 6.73 18.35 6.73 -.60 Informational support 10.76 5.97 12.37 6.51 -1.86

Happiness and fulfilment 17.53 3.69 18.35 3.60 -1.64 Personal growth and maturity 17.69 4.60 18.54 4.56 -1.36

**Psychological well-being** 124.34 22.52 122.63 18.91 .61 **Family quality of life** 85.97 18.12 87.60 15.75 -.71

**Table 4.** Results of the comparisons of fathers and mothers' mean values on study variables

The table data show that psychological well-being has a significant positive relationship with family quality of life in both parents (*r=*.49 for fathers; *r*=.54 for mothers). For both parents, psychological well-being was negatively associated with behaviour problems (*r=*-.38 for fathers; *r*=-.20 for mothers) and with active avoidance coping (*r=*-.51 for fathers; *r*=-.33 for mothers), and positively correlated with positive contributions (*r=*.27 for fathers; *r*=.37 for mothers). For fathers, we also found a positive relationship with family income (*r=*.21). In the case of mothers, psychological well-being was positively correlated with social support (*r=*.24)

For fathers and mothers, the family quality of life was negatively associated with behaviour problems (*r=*-.29, *r*=-.21, respectively) and active avoidance coping (*r=*-.23, *r*=-.33, respectively). Additionally, for both parents, family quality of life was positively associated with social support (*r=*.23, *r*=.23, respectively). Only in the case of mothers was family quality of life

5b, respectively*)*. The correlations results are described below.

and positive and problem-focused coping strategies (*r=*.19).

positively associated with positive contributions (*r*=.31) and positive and problem-focused coping (*r*=.21).

Next, we describe the relationship between predictor variables. Educational level was positively associated with family income (*r*=.29 for fathers; *r=*.26 for mothers), and social support was positively correlated with positive contributions (*r*=.25 for fathers; *r=*.24 for mothers). Only in mothers, the perception of severity of child's behaviour problems were negatively associated with family income (*r*=-.22) and positively associated with the two types of coping (*r*=.22 for positive and problem-focused coping; *r*=.23 for active avoidance coping). In the case of fathers, behaviour problems were negatively correlated with positive contribu‐ tions (*r*=-.22), and positive contributions were positively associated with family income (*r*=.24). We performed a more detailed analysis of the relationship between positive contributions (total and subscales) and the other variables included in the study. Correlations were calcu‐ lated separately for fathers and mothers. The results are presented in Tables 6a and 6b, respectively.


(a)


\*\* *P* < 0.01, \* *P* < 0.05

**Table 6.** (a) Pearson correlation coefficients between positive contributions (total and subscales) and other study variables among fathers; (b) Pearson correlation coefficients between positive contributions (total and subscales) and other study variables among mothers

The correlations involving the total score on the positive contributions scale has already been described; here we describe only the findings related to the subscales. For both parents, the happiness and fulfilment subscale was positively correlated with psychological well-being (*r=*. 22 for fathers; *r*=.38 for mothers), and negatively associated with age of the children (*r=*-.31 for fathers; *r*=-.32 for mothers) and active avoidance coping (*r=*-.23 for fathers; *r*=-.18 for mothers).

The strength and family closeness subscale was positively associated with three variables: psychological well-being (*r=*.29 for fathers; *r*=.32 for mothers), family quality of life (*r=*.23 for fathers; *r*=.29 for mothers) and positive and problem-focused coping (*r=*.24 for fathers; *r*=.25 for mothers).

In the case of fathers, family income was positively correlated with the three subscales (*r=.*23 for happiness and fulfilment; *r=*.25 personal growth and maturity; *r*=.23 for strength and family closeness). In the case of mothers, two subscales were positively associated with positive and problem-focused coping (*r*=.18 for happiness and fulfilment; *r*=.22 for personal growth and maturity), psychological well-being (*r*=.38 for happiness and fulfilment; *r*=.18 for personal growth and maturity), and family quality of life (*r*=.35 for happiness and fulfilment; *r*=.29 for strength and family closeness).

Having explored the correlation matrix of the variables, we next examined which variables predict psychological well-being and family quality of life. We performed a multiple regression analysis, as described below.

#### **3.3. Regression**

We performed a more detailed analysis of the relationship between positive contributions (total and subscales) and the other variables included in the study. Correlations were calcu‐ lated separately for fathers and mothers. The results are presented in Tables 6a and 6b,

> **Happiness and fulfilment**

Age of individuals with ASD -.04 -.31\*\* -.06 -.03 Educational level .01 -.06 -.12 -.02 Family income .24\* .23\* .25\* .23\* Behaviour problems -.22\* -.20 -.07 -.12 Social support .25\* .13 .06 .19

Active avoidance coping -.01 -.23\* -.07 -.06 Psychological well-being .27\* .22\* .12 .29\*\* Family quality of life .20 .11 -.04 .23\*

Age of individuals with ASD -.12 -.32\*\* -.02 -.01 Educational level -.13 -.04 -.26\*\* -.05 Family income -.01 -.03 -.98 .05 Behaviour problems -.01 -.14 .07 .04 Social support .24\*\* .11 .13 .09

Active avoidance coping -.06 -.18\* -0.12 -.16 Psychological well-being .37\*\* .38\*\* .18\* .32\*\* Family quality of life .31\*\* .35\*\* .16 .29\*\*

(b)

**Table 6.** (a) Pearson correlation coefficients between positive contributions (total and subscales) and other study variables among fathers; (b) Pearson correlation coefficients between positive contributions (total and subscales) and

The correlations involving the total score on the positive contributions scale has already been described; here we describe only the findings related to the subscales. For both parents, the happiness and fulfilment subscale was positively correlated with psychological well-being (*r=*.

(a)

**Happiness and fulfilment**

**Personal growth and maturity**

**Personal growth and maturity**

.19 .20 .17 .24\*

.25\*\* .18\* .22\* .25\*\*

**Strength and family closeness**

**Strength and family closeness**

**Total positive contributions**

**Total positive contributions**

respectively.

64 Autism Spectrum Disorder - Recent Advances

Positive and problem-focused

Positive and problem-focused

\*\* *P* < 0.01, \* *P* < 0.05

other study variables among mothers

coping

coping

A stepwise forward selection multiple regression analysis was run to examine the predictor variables of psychological well-being and family quality of life. The analysis was carried out separately for fathers and mothers. We considered the age of children with ASD, behaviour problems, family income, social support, positive contributions and coping strategies (active avoidance coping and positive and problem-focused coping) as potential predictor variables. The null hypotheses tested were that multiple *R2* was equal to 0 and that the regression coefficients were equal to 0. The data were screened for violation of assumptions prior to analysis.

The results of the multiple regression analysis for psychological well-being are presented in Table 7. We used the adjusted *R*<sup>2</sup> index, which indicates the percentage of variation in the dependent variable explained after adjusting for sample size and the number of predictors.

The active avoidance coping strategies measure was the main explicative variable in the models for both mothers and fathers, accounting for a significant amount of the variance in psychological well-being (Δ adjusted *R*<sup>2</sup> =.24 for fathers and.14 for mothers). Specifically, higher levels of active avoidance coping strategies predicted lower levels of psychological well-being (β=-.50, *p* <.001 for fathers and β=-.38, *p* <.001 for mothers). Positive contributions also account‐ ed for a significant amount of the variance in psychological well-being (Δ adjusted *R*<sup>2</sup> =.07 for fathers and.11 for mothers). In this case, higher levels of positive contributions predicted higher levels of psychological well-being (β=.26, *p*=.004 for fathers and β=.35, *p* <.001 for mothers). The regression model included a third predictive variable in the case of fathers, indicating that higher behaviour problems predicted lower fathers' psychological well-being (β=-.19, *p*=.049). The total adjusted *R*2=.33 for the fathers' model indicated that these three variables accounted


**Table 7.** (a) Regression analysis predicting psychological well-being in fathers' (b) Regression analysis predicting psychological well-being in mothers

for approximately 33% of the variation in psychological well-being among fathers. Interpreted according to [82], this value suggests a large effect size (2=.49). In the case of mothers, the multiple adjusted *R*2=.25 (2=.33) indicated a medium effect size. Other variables proposed in the analysis such as age of children with ASD, family income, and social support were not included in the models, indicating that these variables do not account for a significant amount of variance in psychological well-being after including active avoidance coping strategies, positive contributions and behaviour problems.

Regression models of family quality of life are presented in Table 8. The fathers' model includes only behaviour problems and social support as predictor variables, and the total adjusted *R*2=. 11 (2=.12) indicates a small effect size. Higher behaviour problems predicted lower perceived family quality of life (β=-.28, *p*=.007), and higher levels of social support predicted higher levels of family quality of life (β=.23, *p*=.027) among fathers.

In mothers, the regression model was more complex, with four predictors that could predict 23% of the variance of family quality of life (adjusted *R*2=.23; 2=.30), which suggests a medium effect size. The active avoidance coping strategies measure was the main variable explaining the variance in family quality of life among mothers (Δ adjusted *R*<sup>2</sup> =.11). Behaviour problems also appeared as a predictor (Δ adjusted *R*<sup>2</sup> =.02). Higher levels of active avoidance coping strategies and behaviour problems predicted lower levels of family quality of life (β=-.33, *p* <. 001 and β=-.18, *p*=.027, respectively). Positive contributions and positive and problem-focused coping strategies accounted for a significant amount of the variance in mothers' reported family quality of life (Δ adjusted *R*<sup>2</sup> =.04, Δ adjusted *R*<sup>2</sup> =.05, respectively). Higher levels of positive contributions and positive and problem-focused coping strategies predicted higher levels of mothers' reported family quality of life (β=.29, *p*=.004 and β=.18, *p*=.011, respectively).


**Table 8.** (a) Regression analysis predicting family quality of life in fathers; (b) Regression analysis predicting family quality of life in mothers

The other variables proposed in the analysis (age of children with ASD and family income) were not included in the models.
