**Abstract**

Coping with challenges associated with caregiving for a child with autism spectrum disorders (ASD) could be a parental stressful task. The present study is aimed at exploring the coping styles adopted by parents to handle the demands of this diagnosis for their children. To understand the parental coping style of Iranian parents who are caregiving for their offspring with ASD, a mixed-method approach is considered in which deep interview and self-report questionnaires were used. In all, 43 parents were recruited from different services for individuals with ASD across Tehran. The finding showed that ASD had multiple impacts on Iranian parents' general well-being. They also used less effective coping styles to meet the associated demands of caregiving for a child with ASD. These impacts were similar to reported findings for parents in other countries, but there were some special features of parenting that might be rooted in the Iranian culture or special contexts such as limitation of the formal and informal supports and services.

**Keywords:** coping style, autism spectrum disorders (ASD), parental general well-being, autism parenting, Iran

#### **1. Introduction**

As it is defined by the American Psychiatric Association, individuals with autism spectrum disorders (ASD) exhibit qualitative impairments in communication and social interaction along with restricted and repetitive behavioural patterns [1]. These features mostly negatively impact the parents, resulting in poor general health as a consequence, impacts such as lower levels of family functioning [2] and a lower level of satisfaction with caregiving [3]. In a study on Middle Eastern mothers' reaction after the diagnosis of developmental disabilities for their children in the United Arab Emirates (UAE) [4], it was reported that giving birth to a child with disabilities was a real threat to their marital stability and their general wellbeing and it was a source of stress and challenge for them. It is also found that when mothers managed to adjust with the imposed position within the family and to fulfill their maternal duties, the results will be strengthening and centralizing the position of both mother and the child with a developmental disability in the family context. Similar findings reported among parents of children with a developmental disability (DD) such as cerebral palsy (CP) in Iran [5].

From the available data on comparison of parents of children with different conditions of development, it was reported that parents of children with ASD experience higher levels of challenges such as stress and general well-being problems compared to parents of typically developing children and parents of children with other developmental disabilities (i.e. intellectual disability, ADHD and cerebral palsy) [2, 6, 7].

parents about children with different severe forms of disabilities such as ASD could help parents to cope with high levels of stress and serve as an adaptive functioning. This aspect might be worth exploring further with parental caregiving to a child

*Parental Coping Styles of Individuals with Autism Spectrum Disorders: A Report from Iran*

**1.1 The situation of the children with developmental disabilities in Iran**

To assess suitability for registration in the first grade of primary school, all Iranian 6-year-old children are required to go through a national screening system administered annually. The evaluation procedure is done under the supervision of the Iranian Special Education Organization (ISEO). The program is extensive and consists of a physical check-up and mental screening undertaken by a general physician and other health professionals. The mental evaluation of the children is done by checking their communication level and readiness for education by an educational counsellor using a nationally devised scale. Every child is individually assessed by different evaluators. Those children who do not pass the screening are referred for a professional evaluation. The outcomes are documented in the children's 'Health Identification Booklet'separately for girls and boys, which are given to their parents and are necessary for registration in the first elementary grade. Based on the results of this evaluation, children are referred to public or special schools for children with special needs such as schools for visual impairment, hard of hearing or intellectually disabled. For children with physical and motor disabilities and high-functioning autism or mild level of disabilities, there are inclusive schools in which children are admitted in public school classes with an appointed assistant (called a shadow trainer) to help the child to adjust to the situation through meeting their individual needs. Children with special needs in some areas due to the absence of special schools might refer to the mainstream schools which are educational centres that have special classes inside a public school. The situation for preschoolers with special needs is different. Kindergartens, preschool, and daycare centres are under the supervision of the Iranian State Welfare Organization

(ISWO), and the registration of children with special needs depends on the admin-

The rationale for utilizing this study was a dearth of information on the impact of caregiving for a child with ASD on parents' coping style to adjust themselves with associated challenges and demands in less affluent countries with limited support

i. to understand the different impacts of ASD on parental coping styles based on their explanation obtained from the parents' answers to the interview

ii. to understand the relationship between parental coping style and children

iii. to understand the relationship between parental coping style and other parental qualifications related to their general well-being, particularly

with ASD features, that is, the severity of ASD symptoms; and

family functioning and parental satisfaction with caregiving.

istrator's decision based on the services available in each centre.

and service. The survey study had the following research objectives:

with ASD globally.

*DOI: http://dx.doi.org/10.5772/intechopen.92700*

**2. The present study**

questions;

**107**

**2.1 The rationale for the present study**

The wealth of data has examined factors associated with adverse impacts on the general well-being of parents bringing up a child with ASD. Hastings and colleagues [8] have found that a positive linear relationship exists between the severity of the child's ASD symptoms and boosting mothers'stress level. From a literature review, it is concluded that a lack of social support as an important factor predicts maternal general well-being problems. These impacts can be in different ways; on the one hand, there are reports [9] on existing negative correlations between the level of parental stress and the degrees of available social support for mothers, and on the other hand, it is reported that some types of formal support might be considered as a stressor which forces parents to adopt negative coping styles.

As an example, professionals might place extra demands on parents to accomplish prescribed tasks with their children. These groups of parents are in contact with many different professionals and they can often be confused as to what each person's role and demand is in the care and rehabilitation and training their child [10, 11]. Consequently, interactions with professionals might prove to be stressful as well as supportive experiences [10]. The importance of developing and employing a well-functioning coping style for the parents of children with ASD has been stressed by Sivberg [12] and has been replicated more recently by other professionals in the field of mental health and resilience [13]. Coping style is an action, a series of actions, or a thought process used in meeting a stressful or unpleasant situation or in modifying one's reaction to such a situation. Based on the American Psychological Association (APA) [14] online dictionary, coping style typically involves a conscious and direct approach to problems, in contrast to defence mechanisms. As an example of coping strategy, the parent might decide to be careful not to expect extra assistance in caregiving for his/her child with ASD and starting to adopt a consistent and mutually beneficial approach with the child with ASD, which is classified as a 'problem-focused' or positive coping strategy. While the wealth of findings supports the applicability of positive coping style and its correlation with better adjustment to different challenging situations such as caregiving for an offspring with chronic illnesses or disabilities [15], findings by Higgins and colleagues [16] revealed that such positive adopted coping style did not necessarily appear to be related to other family qualifications such as family functioning, marital quality, marital happiness and parental self-esteem. Their justification regarding this unexpected finding was that the particular stresses and coping style associated with caregiving for a child with ASD, or that the reality of living with a child with ASD was not facilitated by the adopted coping style employed by parents. Altiere and Kluge [17] found that parents who use positive coping styles tended to consider their family as a highly integrated and joined unit. This may mean that as the levels of cohesion increases among the family members, they tend to use more positive coping strategies such as rational style.

Conversely, Dunn and colleagues [18] found that avoidant coping styles, such as distancing and escape, significantly correlated with depression in parents of children with ASD. Further research suggests that elevated stress levels, lack of social support, and ineffective coping styles are among the most dominant predicting factors of psychologically problematic outcomes among parents of children with ASD [19, 20]. Hence, there are reports on the positive side of caregiving for a child with ASD, and Hastings and Taunt [21] found that the positive perception of

#### *Parental Coping Styles of Individuals with Autism Spectrum Disorders: A Report from Iran DOI: http://dx.doi.org/10.5772/intechopen.92700*

parents about children with different severe forms of disabilities such as ASD could help parents to cope with high levels of stress and serve as an adaptive functioning. This aspect might be worth exploring further with parental caregiving to a child with ASD globally.
