**5. Conclusions**

role of primary caregiver among mothers in most families may be more parsimonious. The role of primary caregiver can generate more everyday strain but may also provide more opportunities to experience personal growth and strength as positive contributions of their disabled child. The significant difference on the outside employment situation of fathers and mothers in our sample (89% and 54%, respectively) is a relevant fact that demonstrates the high probability that mothers were exercising the role of primary caregiver. In addition, this difference in employment status of parents of children with ASD is not unique to our sample and the social environment in which this study is carried out but instead seems to be a fairly

The results of the correlation analysis showed a positive relationship between the perception of positive contributions and psychological well-being among both fathers and mothers. That is, parents who perceived more positive contributions of their child's disability had higher levels of psychological well-being. In mothers, it also appeared that a positive relationship existed between perceived positive contributions and the perception of family quality of life. These results support the hypothesis that the positive relationship between perceived positive contributions and the perception of family quality of life exists, but it appeared only in the case of mothers. The positive relationship between positive contributions and psychological wellbeing found in this study is consistent with the results of other studies that found a negative relationship between perceived positive contributions and both paternal stress [54] and

It is pertinent to note the relationship between coping strategies and perceived positive contributions. More frequent use of active avoidance coping strategies had a negative rela‐ tionship with the perception that the condition of their child contributed to their happiness and fulfilment among both fathers and mothers. Meanwhile, positive and problem-focused coping strategies were associated with the perception of positive contributions, particularly in the case of mothers. For fathers, only a positive relationship between positive and problem focused coping strategies and the subscale of strength and family closeness appeared, while in the case of mothers, this relationship was broader. Mothers who reported greater use of positive and problem-focused coping strategies reported also higher levels of perceived contributions not only in relation to the strength and closeness of the family but also in relation to more personal aspects such as happiness and fulfilment and personal growth and maturity.

The bidirectionality of these relationships makes it difficult to know whether the ability to perceive positive contributions has a positive effect on promoting the use of positive and problem-focused coping strategies or whether parents who resort to this type of coping strategy better perceive the positive contributions of their child to their life and the life of their family. It is also possible that a third variable, such as a psychological trait, could explain the covariation of these two factors. In any case, despite the difficulty of clarifying the direction of effects, this finding on the relationship between coping strategies and positive perceptions is important, to the extent that both factors were also expressed as predictors of psychological well-being and the family quality of life reported by parents. Both aspects could become the subject of future work in psychological intervention to support parents with potential mutual

widespread reality [83].

68 Autism Spectrum Disorder - Recent Advances

maternal anxiety [55] in parents of children with ASD.

benefits and positive effects on parents' well-being.

Despite its limitations, this study contributes to a better understanding of the factors related to the psychological well-being of parents raising a child with ASD. A better understanding of these factors may guide the design of intervention strategies to promote parents' well-being. The empirical evidence supporting the importance of coping strategies and the perception of the positive contributions of disability for parental psychological well-being and their family

quality of life suggest the importance of awareness among professionals working with families. Parents of children with ASD are faced with many potential stressful situations. The challenges may change over the course of their children's lifespan. There is not only one pattern of coping that fits well for all of these stressful situations. The results of the current investigation show that active avoidance coping strategies may be maladaptative and may not contribute to parents' well-being. Professional interventions to help parents of children with ASD could include objectives oriented to provide them with a wide repertoire of emotional, cognitive and instrumental positive coping strategies and to develop the flexibility to implement the most appropriate strategy to address the situation at a given time. Moreover, helping parents in their processes of positive transformation, guiding them to pay attention to and learn to appreciate the achievements of their children and helping them discover their own personal and family strengths will contribute to their well-being.

We agree with Patterson [87] in her conclusion that clinicians who believe in the ability of the family to discover their strengths are in a much better position to enhance family resilience and facilitate the adaptive processes needed by the family to restore its functioning after a crisis situation. Believing in the ability of the family to discover their strengths and recognising their success in coping with stressful situations, whether large or small, empowers the family to cope effectively. The importance of paying attention to the positive aspects of the development of children and families it is not solely the responsibility of clinicians. Many professionals in very different roles (psychologists, medical, nurses, social workers and teachers) are involved in accompanying parents in caring for their child with ASD. In each moment of evaluation, monitoring or guidance to parents, professionals' ability to adopt, within their speciality, a perspective not only focused on the problem and the difficulties but also oriented toward the child's achievements and other positive aspects of his or her development and family's functioning can be critical to help parents develop strength and positive experiences.

Over the past few decades, we have been able to incorporate major changes related to the perception of people with disabilities. An increase in sensitivity has led to important legislative changes that recognise and promote rights aimed at improving the quality of life of people with intellectual disabilities and their families. There have been changes that affect aspects as simple as our language, such as changing the disorder-focused expression (e.g., disabled child or autistic child) to a person-focused expression (e.g., child with intellectual disabilities or child with autism or ASD) or changing patient consideration to the active participants, and some decisive other as inclusive education. Considering not only the problem and special needs of the child but also the positive contributions of people with disabilities to their environment, particularly to their family, is a necessary change in both research and practice. This change is just beginning to take hold, and much more work in practice and research is needed.
