Autistic parental responsibility, providing highest level of care

Autistic Spectrum  Disorders is considered one of the most serious complex childhood disabilities  (APA, 2000), ASD has become recently one of the major childhood health problems and concern across worldwide  (Simonoff, Pickles, Charman, Chandler, Loucas, & Baird, 2008). Unlikely, studies of mental disorders among children show that there is pervasive comorbidity between purportedly different diagnostic entities. As described by Achenbach (2005), few children who had mental disorders, had only one single disorder; Munir (2016) have found that around 40% of the children and teens who had ASD had at least one co morbid mental disorder.

            The plight of children and families coping with ASD is significant. In fact, ASD is complex conditions, which involves impairments in social interaction; communication; and behavioral functioning (APA, 2013). BakerEriczen, Brookman-Frazee, and Stahmer (2005) found that parents of children with ASD experience higher level of parenting stress and psychological distress than other neurodevelopmental disorders. 

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            Parents can play an important role in child’s psychological, social, and academic development. Children with Autistic Spectrum Disorders (ASD) create special challenges for parents; parents have to deal with challenging behavior; judgements from others; and  lack of support (Ludlow, Skelly, & Rohleder, 2012). Furthermore, owing to being in need with more intensive educational, behavioral and health services, which can be challenging for parents to contact and when handy can require parental time and resources to assist (Rapin, 2001).

            As caregiving is a regular parental responsibility, providing highest level of care that required by a child who has long-term functional impairment can become difficult and oppressive; which can have an influence on parents’ physical and mental health vehemently (Benjak, Vuletic, Mavrinac, & S?imetin, 2009). Indeed, it has been found that parenting a child with ASD can disturb the whole family’s life, furthermore having several economic, social, physical and psychological problems (Parish, Seltzer, Greenberg, & Floyd, 2004). These problems can results in more parental distress, male adjustment, and finally, it can affect the QOL of those parents (Dardas, 2014).

Quality of life (QOL) is a a multidimensional phenomenon encompassing physical, mental, and social functioning and well-being (Hays, Anderson, & Revicki, 1993). According to World Health Organization Quality of life is defined as “an individual’s perception of his/her position in life, in the context of the culture and value systems in which s/he lives, and in relation to goals, expectations, standards and concerns” (Fitzgerald, et al., 2001).

 In spite of the increasing awareness of the need to “shaping, directing, delivering, and evaluating support services”, limited data are available on the impact of raising children with ASD on parents’ QoL when it is compared to other chronic disorders (Dardas & Ahmad, 2014).

            Our role as health care professionals working with children having ASD and them parents is to ensure that care plans are set to target the family system. Parents and children may need special help to ensure higher and healthier interaction. Examining parents’ QoL can help us to measure and to overcome the impact of ASD on parents.The
aim of the present study was to assess the Quality of Life among Omani parents
of Children with Autistic Spectrum Disorders (ASD), and to explore the
correlation between socio-demographic, perceived social support and other
clinical variables and QOL.             First of all, QOL domains among
Omani parents of children with ASD were relatively similar to previous researches,  for example, in the current study, QOL
domains’ score were 56.44, 66.87, 71.71, 
and 62.96 for physical, psychological, social, and environmental,
respectively. Vasilopoulou and Nisbet (2016) stated that mothers
and fathers of children with ASD experience poorer QoL at least in one domain
when compared to mothers and fathers of typically developing children.
According to Skevington, Lotfy, & O’Connell (2004), the WHOQOL mean
scores for the general population on the four domains ranged between 51 and 75
(SD: 11.2-17.6).  By using the score 60
out of 100  as the midpoint where QoL is
judged by WHOQOL (Skevington et al. 2004), the
results of our study showed that QoL is acceptable for the psychological and
social health domains, on the borderline for environmental health domain, and
is comparatively poor for the physical health domain. Furthermore, many studies
found a negative association between having child with ASD and parental QoL (Eapen V, Guan 2016)            Secondly,
it is proved that social support is one of the most important factors that
influence Quality of life (Mendoza
and Dickson 2010). Furthermore, the
perceived social support is significantly associated with better quality of
life (Pozo, Sarriá & Brioso 2014). The findings of
our study revealed that the vast majority of parents perceived a high level of
social support. This finding is consistent with previous research done in
Kuwait and Turkey (Bilgin
and Kucuk 2010 , Al-Kandari, Alsalem, Abohaimed,
et al. 2017). Our study finding support the notion that  having a child with Autism was not
associated with lower social support for parenting. (Montes and Halterman 2007)            Socioeconomic status acts as a
moderator for parents QoL (Hatton & Emerson, 2009). In this study socioeconomic
status was assessed by using two variables; level of education and income. The
result of this study didn’t reveal a significant correlation between parents’
income and the parents’ of education and their QoL.  Although the result of our study agreed
partially with one study conducted in Jordan by Dardas and Ahmad (2014) in term
of parents education, further investigation were required regarding how parents
were perceived their child disabilities.             In term of income, there is no doubt
that parents’ income can play a significant role in helping parents providing
care to their children. Healthcare, family support, and service referral needs
are more likely less among families of children with ASD than without ASD
(Kogan, Strickland, Blumberg, Singh, Perrin, & vanDyck 2008). In our study,
around 52% of the participants had low to moderate income. We can justify the
result that care and support for Omani children and adults with Autistic
Disorder are typically based on the Omani government and all caregivers from
low SES are likely to have continuity of care with psychiatric services (Al-Farsi,
Waly, Al-Sharbati, Al-Shafaee, Al-Farsi etal. 2013)            Greenhaus  Allen and 
Spector (2006) reported that work domain can intensely affect parents
Qol. It appears that having a child with ASD prevent or inhibit career planning
and development (Brown, MacAdam-Crisp,
Wang, & Iarocci, 2006). Depict the
negative impact of these parents caring responsibilities on their work life, some
of them view their outside work as a chance to get out their home-related
stressors (George, Vickers, Wilkes, & Barton, 2008).  In our study all fathers were
employed while around 11% of mothers were unemployed, working fathers tend to
have significant higher levels of QoL compared to working and nonworking
mothers. The result of our study is consistent with logic and revealed that
employment status was correlated with QoL level.  This may be explained by mothers who were
working might have been able to improve their socioeconomic status or they can perceive
more support from the community. On another hand, among national and
international mothers in Kuwait, the majority of mothers reported that they spend  around 6–10 hours  with the
ASD child daily, as a result, they reported decrease  the ability to perform their social duties
and taking care of themselves then decreased the ability to  enjoy their life (Al-Kandari, Alsalem, Abohaimed,
et al. 2017).