COPING WITH STRESS: IMPACT OF 7-11 YEARS OLD CHILDREN WITH AUTISM SPECTRUM ON THEIR PARENTS Introduction It has

been said that no parent is ever prepared to become the parent of an exceptional child. When a child is diagnosed with special need, there is a changed in the way society deals with that child,both formally through special institutions and informally in the way members of the society reacts to children with special needs.By association too, the diagnosis of the disability in a child has implications for the parent the way which they construct their particular tasks because of the images of parenthood available to her based on the healthy able-bodied children. As new parents, they are subjected to different stresses that might be a crisis. Worrying about the well- being of children and dealing with many everyday challenges that raising a child brings with it can build into significant level of overall stress. Giving birth to exceptional child adds additional stress to the parents since they have to perform additional role as parent of an exceptional child and they must adjust their self-image to cope with new responsibilities and function.Toquero (2004) stated that a child with a disability in the family will affect the members in different ways, either strengthening family bonds of breaking up relationships perhaps because of too much stress. The reaction and attitude of the members of the family especially parents towards the disability paves the path for success parents in dealing with their child This stress could have negative impact on parents,some parents experience helplessness, feeling of inadequacy, anger, shock and guilt, period of sadness and depression. For parents of child autism, these emotions are heightened by the fact that the baby was born normal. Many individuals with ASD have behavior repertoires (e.g. limited verbal communication, social behavior deficits and aggressive behavior) is expected to have an impact on immediate and extended family members and becomes stresses. Autism Spectrum Disorder refers to the wide variety of complete pervasive developmental disorder that typically appears during the first 3 years of life. Autism spectrum disorders (ASDs) are lifelong developmental disabilities. People with ASDs have impairments in social skills and verbal and nonverbal communication. They often have repetitive behaviors or unusual interests. Range from a severe form, called autistic disorder, to a milder form, Asperger syndrome. The key to optimal childhood development lies in the influences of the immediate environment. The family system, as part of the environment, plays a central role in the childs developmental outcome (Sameroff, 1990). In studies of families with autism, researchers have traditionally examined this interaction by focusing on the parents effect on the child, not the childs effect on the parents (e.g., Kanner, 1943). More

recently, studies have focused on the difficulties that both parents face because of the effects of caring for a child with autism and the strategies that are employed to cope with the stress (e.g., Gray, 2002; Schall, 2000). OBJECTIVE: This public lecture aims to: a. Define Autism Spectrum Disorder, Stress and Coping b. Provide Theoretical Background c. Give supporting researches on how parents cope with stress in parenting children with autism stress disorder d. Implication on Guidance and Counseling Autism Spectrum Disorder History of Autism The first description of what may have been an autistic child was done in 1801 by the French physician Jean Marc Gaspard Itard (1774-1838) in 1891. Itard's account is of a twelve year old boy who had lived for some time in a forest and had been captured naked the previous year. The boy, known as the Sauvage de lAveyron, was named Victor by Itard. Victor had probably grown up without any form of human contact and never spoke. Leo Kanner first wrote in 1949 that autism classification should not focus on the origin or cause but on practical educational and clinical possibilities. But he later changed his mind, claiming that the therapeutic cart should not be placed before the diagnostic horse. Leo Kanner focused on symptoms of stereotypy and aloofness (such as lack of eye contact, spinning, hand-flapping and non-responsiveness) as essential criteria for making the diagnosis. Kanner considered autism a rare disorder typically affecting children of highly intelligent parents who were emotionally cold. He considered motor skills as a possible strength, although he was concerned with repetitive motor actions.

Definition The word autism is from a Greek word autos meaning self. It was first used to describe the condition we now know as ASD, autism was thought to manifest as sever withdrawal. Autism is the most severe developmental disability. Appearing within the first three years of life, autism involves impairments in social interaction such as being aware of other peoples feelings and verbal and nonverbal communication. Some people with autism have limited interests, strange eating or sleeping behaviors or a tendency to do things to hurt themselves, such as banging their heads or biting their hands. Adapted from the Encyclopedia of Psychology The term spectrum implies a range from a child who experiences more mild impairments in the areas of language, social understanding and behavior to sever impairment, which can include comorbid conditions such as mental retardation. There is no medical test for ASDs. Typically, a diagnosis is made after a thorough evaluation. Such an evaluation might include clinical observations, parent interviews, developmental histories, psychological testing, speech and language assessments, and possibly the use of one or more autism diagnostic tests. Children with an ASD may have other developmental disabilities, such as mental retardation, seizure disorder, fragile X syndrome, or tuberous sclerosis. Also, some children may have mental health problems such as depression or anxiety. Some children with ASDs may also have attention deficits, sleeping disorders, sensory issues, sleep problems, and gastrointestinal disorders. For the last five decades the term stress has enjoyed increasing popularity in the behavioral and health sciences. It first was used in physics in order to analyze the problem of how manmade structures must be designed to carry heavy loadsand resist deformation by external focus. In this analysis, stress referred to external pressure or force applied to a structure, while strain denoted the resulting internal distortion of the object (for the term's history, cf. Hinkle 1974, Mason 1975a, 1975c). In the transition from physics to the behavioral sciences, the usage of the term stress changed. In most approaches it now designates bodily processes created by circumstances that place physical or psychological demands on an individual (Selye1976). The external forces that impinge on the body are called stressors (McGrath 1982).

THEORETICAL BACKGROUND: AUTISM Three domains: 1. Stereotyped or ritualistic behavior and patterns of interest y Stereotypy or Stimming(Campbell and Shay 2003) Defined as repetitive and apparently purposeless body movements (e.g., body rocking), body part movements (e.g., hand flapping, head rolling), or use of the body to generate object movements (e.g., platespinning, string twirling). 2. Social Interaction Deficit Theory of the Mind(Symon, D. ) The ability to understand or speculate about the ways others think and believe, including the ability to anticipate others behavior. Children with autism have difficulty understanding that others have thoughts and emotions different from their own. Some researchers suggest that the theory of mind is necessary both for understanding ones social environment and for the ability to engage in socially appropriate behavior. o Theory of Internalization (Vgotsky) The process by which a childs reasoning about mental states becomes internalized through participation in interpersonal dialogue about self and others thoughts and emotions. This interpersonal dialogue can be witnessed through social and pretend play. The childs social self emerges when he discovers that others also think of themselves as me and they have different experiences than the childs own. A child with ASD seem to have tremendous difficulty learning to engage in give-and-take everyday human interaction. They show slower in learning to interpret what others are thinking ad feeling. Subtle social cues like smiling may have little meaning. Without the ability A child with ASD may;

o Attachment Theory (Bowlby)

Early caregiver relationship with the child can shape the childs expectation of others behavior, as the construction of mental representations of the surrounding social world is a natural consequence of the early caregiver relationship.

3. Communication deficit Speech and Language Development (Bruner) It greatly influences the childs internal speech potential source of information about the social world, which the child can then internalize into his or her own thoughts and feelings about the world. y Sensory Sensitivity Each of us has various sensory systems which process information and assist us in making sense of the world. People with autism spectrum disorders have difficulty processing and using sensory input in a meaningful and relevant way.Some individuals are over sensitive and others are under sensitive to sensory input Child with ASD may: y y y y y y y y y y y y y y y Prefer to be alone; appear unaware of peoples existence Not respond to name and may on occasion appear to be deaf Appear to avoid gaze or show unusual eye contact Not reach out anticipation of being picked up Not seek comforting even when hurt or ill Not smile in response to parents face or smile Have difficulty in mixing and playing with other children Not point to share or indicate interest, or not share in others interest Not point to ask for something Not try to attract attention to his/ her own activity Not look at a toy across room when adult points at it Not look at things adult looking at Have difficulty taking turns in turn-taking games or activities Not imitate adults actions Have unusual or repetitive play, lack or have limited pretend play

y Have extreme unusual fears or have poor awareness of danger or not show fear y Show delay or lack language development or loss of early acquired language y Rarely or not use gestures to communicate y Lead adults by the arm to have needs met, or use adult hand as an object y Reverse pronouns y Echo words or phrases y Have difficulty in initiating and sustaining conversation y Enjoy rotating or spinning object, or lining up objects, twirl twigs, flap paper y Be occupied with parts of objects like knobs, switches, wheels y Like sameness in everyday routines; may show resistance to change in routines or surroundings y Display repetitive actions and ask repetitive actions y Not cuddle or stiffen when hugged or cuddled y Show extreme distress from no apparent reason y Appear unaware of distress of others

Psychological Stress ( Lazaruz 1991) Cognitions (thoughts) and behavior that a person used to reduce stress and to moderate its emotional impact.It is usually from some form of threat to security, selfesteem, way of life, or safety. The threat produces fear especially fear of loss, uncertainty and the grates cause of uncertainty is change. Sometimes changes are also losses. There are two types of appraisal: 1. Primary During the primary appraisal stage a person will be seeking answers as to the meaning of the situation with regard to their well being. One of three types of appraisals could be made:

1. It is irrelevant 2. It is good (benign-positive) 3. It is stressful.

Further appraisal is made with regard to 3 implications: y Harm-loss refers to the amount of damage that has already occurred. There may have been an injury. The seriousness of this injury could be exaggerated producing a lot of stress. Threat is the expectation of future harm, for example the fear of losing one's job and income. Much stress depends on appraisals that involve harm-loss and threat. Challenge is a way of viewing the stress in a positive way. The stress of a higher-level job could be seen as an opportunity to expand skills, demonstrate ability, and make more money.

2. Secondary Feelings of not being able to deal with the problem such as:
y y y y y y

I can't do it-I know I'll fail I will try, but my chances are slim I can do it if I get help If this method fails, I can try a few others. I can do it if I work hard. No problem-I can do it.

Coping Strategies (Lazarus and Folkman) Problem-Focused Coping A response are aimed at reducing, modifying, or eliminating a source of through taking control and weighing up pros & cons. Importantly individuals who use this strategy also suppress feelings.

Emotion-Focused Coping A response aimed at reducing the emotional impact of the stressor . These strategies attempt to regulate (keep going) emotional distress with stressful or potentially stressful events.

Coping Strategies (McCubbin and Patterson, 1981)

The cognitive and behavioralefforts made to master, tolerate, or reduce external and internal demands and conflicts amongthem. Describe some internal and external coping strategies. Internal coping strategies An individual changes ones view of the situation. Family members can adhere to the belief that the problems will resolve themselves over time. This is not a good coping strategy in families of a child with autism. This includes ones sense of this includes ones sense of purposefulness and ones adherence to a set of philosophical and/or religious values.

The external coping strategies The most often studied external coping strategy is social support. These external coping mechanisms may be the most important for families of a child with autism, but unfortunately it can be difficult to find quality support networks.

Related Researches Mothers and Fathers of Autistic Children: An Exploratory Study of Family Stress and Coping by Emma Conception D. Liwag, Ateneo de Manila University The research sought to study in-depth the families of the Filipino autistic children to explore the following question: 1. What stresses associated with the autistic child are experienced by these families? Mothers      Tantrums Hyperactivity Speech Behave irregularly in public that causes people to stare Will not be able to appreciate some of the things I enjoy like having friends

Fathers  The child will never be normal

   Both   

The fact that in spite of all the care he is autistic He might never get well My childs condition would deteriorate

The prospect that he will grow up not being able to fend for himself Fear itself that we cannot cope with his needs Who will take care of him when I am gone

2. What coping patterns are utilized by these families in living with their autistic child? 1. Family life adjusted such that the autistic child becomes the primary consideration in terms of time, effort, attention, and even expenses. y See to it that that their children gets the best of everything y Give their children first priority in more things 2. Family members have to learn to relate to the child with extra patience and understanding. y Accept the tragedy y Accept their children for who they are 3. How are these stresses and coping patterns differentially experienced by the mothers and fathers of autistic children? Mothers y Giving up things and making sacrifices Fathers y Work harder to attend all of their childrens needs. Stress and Coping in Mothers of Autistic Children by NishaVidyasagar and Susan Koshy, Womens Christian College, Chennai The objectives of the study were to compare mothers of children with autism and normal children with respect to their stress and ways of coping . Seeking social Mothers of children with autism have been found to use this coping strategy more frequently than mothers of normal children. To cope with the stress of having a special child, mothers of these children have more often tried to seek informational

Escape-avoidance Mothers of children with autism have used this coping mechanism more often than mothers of normal children. This could be because of the nature of the childs disability, with its accompanying behavioral difficulties which prove stressful to the mothers and hence they have tried to cope with it by avoiding or shirking their responsibilities. Having a child with autism causes stress in the mothers, with which they have coped by using wishful thinking and by escaping or avoiding the problem. Positive reappraisal Mothers of children with autism have been found to use this coping strategy more frequently than mothers of normal children. While dealing with the stressful situation of having a special child with autism, the mothers have tried to create positive meaning out of the situation, by focusing on personal growth and through religious means. Implication: It is thus inferred that in these mothers as the stress level experienced by them increases, they adopted a more confrontative coping approach often. In other words, with more stress experienced, mothers used more aggressive efforts to alter the situation and are willing to engage in risk taking and hostile behaviors. IMPLICATION ON GUIDANCE AND COUNSELING

We write from a distance, we write from far away We write of the tears, we write of the pain We write of time, we write of what happens all day. The words of enoughs enough is not enough. Autism Autism Autism is much too much; To be cared for by one person, by one couple, by one nation. Knowing what we know, it should never have happened. We hold our breath We hide our shame We must go on, day after day??

REFERENCES 1. McConell SR. Interventions to facilitate social interaction for young children with autism: review of available research and recommendations for educational intervention and future research. Journal of Austism and Developmental Disorders 2002;32(5): 351-372 2. Proprium Journal of Psychology, Vol. 2, 2008 3. J.H. Bryne& H. Roedger, Learning and memory: A comprehensive reference: Cognitive Psychology: New York: Elsevier 4. Journal of Autism and Developmental Disorders 26 (1996) 169-172 5. Journal of Autism and Developmental Disorders 22 (1992) 1-21 6. Journal of Autism and Developmental Disorders 24 (1994) 315-329 7. 6juhgb