Effects of Autistic Spectrum Disorder on Parental Work Outcomes Michael Watt B.A., Simon Fraser University, 2000 Thesis Submitted in Partial Fulfillment of The Requirements for the Degree of Master of Arts in Disability Management The University of Northern British Columbia August 2008 © Michael Watt, 2008 1*1 Library and Archives Canada Bibliotheque et Archives Canada Published Heritage Branch Direction du Patrimoine de I'edition 395 Wellington Street Ottawa ON K1A0N4 Canada 395, rue Wellington Ottawa ON K1A0N4 Canada Your file Votre reference ISBN: 978-0-494-48772-3 Our file Notre reference ISBN: 978-0-494-48772-3 NOTICE: The author has granted a nonexclusive license allowing Library and Archives Canada to reproduce, publish, archive, preserve, conserve, communicate to the public by telecommunication or on the Internet, loan, distribute and sell theses worldwide, for commercial or noncommercial purposes, in microform, paper, electronic and/or any other formats. AVIS: L'auteur a accorde une licence non exclusive permettant a la Bibliotheque et Archives Canada de reproduire, publier, archiver, sauvegarder, conserver, transmettre au public par telecommunication ou par Plntemet, prefer, distribuer et vendre des theses partout dans le monde, a des fins commerciales ou autres, sur support microforme, papier, electronique et/ou autres formats. The author retains copyright ownership and moral rights in this thesis. Neither the thesis nor substantial extracts from it may be printed or otherwise reproduced without the author's permission. L'auteur conserve la propriete du droit d'auteur et des droits moraux qui protege cette these. Ni la these ni des extraits substantiels de celle-ci ne doivent etre imprimes ou autrement reproduits sans son autorisation. In compliance with the Canadian Privacy Act some supporting forms may have been removed from this thesis. Conformement a la loi canadienne sur la protection de la vie privee, quelques formulaires secondaires ont ete enleves de cette these. While these forms may be included in the document page count, their removal does not represent any loss of content from the thesis. Bien que ces formulaires aient inclus dans la pagination, il n'y aura aucun contenu manquant. Canada Abstract This study, through nine hypotheses, examined the differences in parental coping ability; mental health and stress; satisfaction with marriage, life, and job; and work interest and quality between parents of children with an Autism Spectrum Disorder (ASD) and parents raising a typical child. Repeated measures analysis of variance and repeated measures multivariate analysis of variance was used to analyse 28 families comprised of two parents and at least one child. The results indicated that parents of ASD children did not differ from parents of typical children on coping ability, world assumptions, marital satisfaction, satisfaction with life, interest and quality of work, or hours of work missed. The results did however show that parents of ASD children experienced significantly more parental stress and more mental health issues than did parents of typical children. Several conclusions were drawn on the relationship between coping ability, mental health, and work outcomes. 11 Table of Contents Abstract ii Table of Contents iii List of Tables v List of Appendices vi Chapter 1: Introduction Mental Health Disabilities and Mental Health The Family as a System Disabilities and Parental Stress Mixed Results in Studies on Parental Stress Differences in Parental Stress Persistence of Parental Stress Factors Influencing Parental Stress Interaction of Factors Influencing Parental Stress ASD and Parental Mental Health ASD and Parental Stress Factors Influencing Parental Stress Interaction of Factors Influencing Parental Stress Parent's Mental health and Work Outcomes Parents of Typical Children and Their Employment Parents of Disabled Children and Their Employment Hypothesis Coping Mental Health and Stress Satisfaction Work Quality and Performance 1 1 2 2 3 3 6 8 10 13 18 19 21 22 23 23 25 31 32 33 34 35 Chapter 2: Methods Participants Procedure Measures Demographic Measures Coping Measures Mental Health and Stress Measures Satisfaction Measures Work Quality and Performance Measures 37 37 38 38 38 38 39 39 40 in Chapter 3: Results Demographic Characteristics of the Respondents Results Coping Coping Ability World Assumptions Mental Health Overall Mental Health Parental Stress Satisfaction Marital Satisfaction Job Satisfaction Satisfaction with Life Work Quality and Performance Interest and Quality of Work Time Missed 41 42 44 44 44 48 48 48 49 51 51 52 53 53 53 54 Chapter 4: Discussion Overall Limitations Coping Coping Ability World Assumptions Mental Health and Stress Mental Health Parental Stress Satisfaction Marital Satisfaction Job Satisfaction Life Satisfaction Work Quality and Performance Interest and Quality of Work Time Missed Summary Contributions to the Literature Areas of Future Research 55 55 57 57 58 59 59 61 65 65 67 69 70 70 71 72 72 74 Chapter 5: Conclusions 76 References 78 Appendix 82 IV List of Tables Table 1: Demographic T Scores 43 Table 2: Means and Standard Deviations for Demographics 43 Table 3: Frequency of Parent's Jobs 45 Table 4: ANOVA and MANOVA F Scores for Group Differences 46 Table 5: ANOVA and MANOVA F Scores for Gender Differences 47 Table 6: Means and Standard Errors for Coping Analyses 48 Table 7: Means and Standard Errors for Mental Health and Stress Analyses 51 Table 8: Means and Standard Errors for Satisfaction Analyses 52 Table 9: Means and Standard Errors for Work Quality and Performance Analyses 54 v List of Appendices Appendix A: Information Letter and Consent Form Appendix B: Parental Demographic Survey Appendix C: Emotional Intelligence Scale Appendix D: Satisfaction with Life Scale Appendix E: Rosenberg Self-Esteem Scale Appendix F: Proactive Coping Scale Appendix G: World Assumptions Scale Appendix H: Locke-Wallace Marital Adjustment Test Appendix I: Job Satisfaction Survey Appendix J: Employee Interest and Quality of Work Scale VI Chapter 1: Introduction Mental Health Research has demonstrated that raising a child with a disability can increase a parent's level of stress (Beck, Hastings, Daley, & Stevenson, 2004; Glidden & Schoolcraft, 2003; Quine & Pahl, 1991). Moreover, this increased level of parental stress has been linked with part-time work status as well as increased levels of absenteeism. Parents of children with disabilities are reported to miss work more often or alternately, to give up full-time work, in order to provide adequate care for their disabled child. In contrast, work performance does not appear to be compromised for this population. That is, once at the workplace employees parenting a disabled child perform at the same level of quality as employees that are either non-parenting or are parenting typical children (Cuskelly, Pulman, & Hayes, 1998; Freedman, Litchfield, & Warfield, 1995; Landis, 1992; Warfield, 2001). Although previous literature has considered the link between parental well-being, workplace outcome, and raising a child with a disability, much of this research is qualitative in nature and as such, has not considered this special population in comparison to a similar sample of control parents who are employed and parenting typical children. In addition, little research has been completed that addresses the workplace effects of parenting a child with Autistic Spectrum Disorder (ASD), a pervasive developmental disorder that can impact an individual in almost all areas of functioning (American Psychiatric Association, 2000). Consequently, the present research considered the parental well-being and workplace effects related to parenting a child with ASD. Furthermore, this study contributes to the literature by providing a novel examination of this area that employed a quasi-experimental design in which parents raising a child with ASD were compared to parents raising a typical child. 1 Disabilities and Mental Health The family as a system. The family can be considered a system in which the family as a whole is more than the sum of each of its parts; what affects one person in a family can, in turn, affect each other member of the family (Jaffe-Ruiz, 1984; Swick and Williams, 2006). Parenting a child with a disability can have various effects on the entire family system. For example, Gray (2002) found that parents of children with disabilities can often experience felt stigma (believing that others view them critically or as different) as well as enacted stigma (such as avoidance, hostile staring, or rude comments). This stigma can then affect how the family functions outside home (such as whether the disabled child is taken on outings). Several studies have been conducted that illustrate the potential impact on the family system that may result as a function of raising a child with a disability. For example, Mastroyannopoulou, Stallard, Lewis, and Lenton (1997) found, while examining the effects of raising a child with a life threatening illness, that the majority of fathers and mothers reported that they experienced changes in their relationships with each other, their children, and other family members. Specifically, the authors found that family members can experience low cohesion (commitment, help, and support in the home) and low openness to expression. Moreover, mothers felt that their relationship with their spouse had become more negative (Mastroyannopoulou, et al., 1997). Siblings of disabled children are often affected within the family system as well. For example, Giallo and Gavidia-Payne (2006) found that siblings of a disabled child experienced more adjustment difficulties and emotional symptoms than normal. Additionally, the siblings' adjustment was directly related to their parent's level of stress, family routines, and communication problems. 2 In addition to the potential impacts on the family system with respect to mental health, raising a child with a disability has similar impacts on the social experience of the family (Floyd & Gallagher, 1997; Rodrigue, Morgan, & Geffken, 1990). For example, Rodrigue et al. found that families that included a developmentally disabled child demonstrated more disruption in the planning of family activities, had more financial difficulties, and placed greater demands on the mother than did families with normally developing children. Overall, parents of children with a disability required extra assistance or help supervising their child in many different areas of their life (Roberts & Lawton, 2000), and experienced a restriction in social activity as others tended to either not invite them to social occasions, or not invite them back (Gray, 2002). Similarly, families with children diagnosed as having ASD and Down Syndrome had fewer people in their social networks; moreover, the people in their social networks tended to serve multiple functions within that social network (e.g,. giving practical assistance, financial aid, and participating in social activities with the mother). This contrasts with families with typically developing children who had many individuals within their social networks, each serving specialized roles (Rodrigue et al.). In summary, the literature reviewed thus far appears to suggest that overall the effects of having a child with a disability can ripple throughout the entire family system, having effects on the parents and siblings, as well as the relationships between each of the parents and the parents and their children. Disabilities and parental stress. Mixed results in studies on parental stress. Research on the stress related to parenting a child with a disability has revealed mixed results. Some studies have shown that there is no difference between the parental stress of parents with a disabled child and the stress of the 3 parents with a non-disabled child (e.g., Frey, Greenberg, & Fewell, 1989). In contrast, other studies have shown that there is a difference in the level of stress experienced by parents of a child with a disability and the parents of a child without a disability (e.g., Quine & Pahl, 1991). Stress is the result of interactions between a person and their environment where it is recognised that one cannot cope with the demands of the situation. Stress requires a continuous cognitive process of appraising and adjusting the interactions between the person and his or her environment whereby cognitive appraisal involves assessing whether a demand threatens the person's well-being, as well as appraising his or her resources for meeting present demands (Lazarus, 1966 in Quine & Pahl, 1991). When an individual is under stress, he or she can actively choose to cope with or influence the impact of that stressor by attempting to manage the perceived discrepancy between the demands placed upon them and their ability to cope with said demands - in this case, raising a child with a disability. People manage this discrepancy by developing coping strategies that serve to enhance their feelings of self-efficacy, a person's belief about his or her own skills in a particular area. Thus, stress-related self-efficacy is specific - it varies as a function of behaviour and context (Lazarus, 1966 in Quine & Pahl, 1991; Taylor, 1983 in Hastings & Brown, 2002). Frey et al. (1989) found that parents of children with a handicap were not viewed as having more psychological distress than were parents of typical children. The authors examined child characteristics, family social networks, parent belief systems, and coping styles in relation to the outcomes for parents of handicapped children. Mothers and fathers of young children with a handicap completed questionnaires and participated in home interviews. The questionnaires included the Daily Parenting Hassles, the Questionnaire on Resources and Stress - Fredrich Edition, the Family Relationship Inventory, the Brief Symptom Inventory, the Revised Ways of 4 Coping Checklist, the Belief in Personal Control Scale, and the Comparative Appraisals Scale. The home interview included the Vineland Adaptive Behaviour Scale, the Home Quality Rating Scale, and a structured question format. The results indicated that the mean levels of psychological distress reported by the parents on the Brief Symptom Inventory were within one standard deviation of normative data. Thus, no significant differences in parental psychological distress were indicated by the findings of this research group, suggesting no difference in the psychological distress of parents raising a child with a handicap and parents raising a child without a handicap (Frey et al.). Beck et al. (2004) found mixed results for the differences between parents of children with an intellectual or developmental disability who had behavioural problems and parents of children with an intellectual or developmental disability who did not have behavioural problems. This work examined whether a child's problem behaviours are a more powerful predictor of maternal stress than adaptive and pro-social behaviour, including behaviours such as empathy, helping, and altruism. The results indicated that the mothers of children with behavioural problems did experience high levels of health problems and parenting stress; however, their level of depression was not atypical as compared to a normative group (Beck et al.). In contrast to the findings of the above-described studies, Quine and Pahl (1991) found that mothers of children with severe learning disabilities experienced more stress than did mothers of typical children. These authors examined child characteristics that were associated with maternal stress, as well as social characteristics that may buffer or mediate the effects of that stress by examining mothers of children with severe learning difficulties. A longitudinal study comprised of a comprehensive register of children with severe learning difficulties was developed within two health districts. These researchers chose for the register a stratified 5 random sample of children who had been assessed using the Disability Assessment Schedule. The children's mothers were interviewed using structured questionnaires, including the Malaise Inventory to measure stress, and the Measure of Daily Coping to measure coping strategies. Three years later, the children were re-assessed and the mothers were re-interviewed. The results indicated that sixty one percent of the mothers had stress scores outside the normal range, thus indicating a significant difference in parental stress (Quine & Pahl, 1991). The research reviewed above demonstrates the mixed results in the research looking at the parental stress impacts of raising a child with a disability. Specifically, some research has indicated that there is no significant difference in levels of parental stress between parents of a disabled child and parents of a non-disabled child (Beck et al., 2004; Frey et al., 1989); alternately, other research has demonstrated increased levels of parental stress in families raising a child with a disability (Quine & Pahl, 1991). This apparent contradiction in the literature is likely the result of differences in design; that is, the above three studies differed in the assessment tools used, the disabilities being measured, and the normative groups to which comparisons were made. Most importantly, all of the reviewed studies were primarily descriptive in nature - none of these studies directly compared the parents of children with a disability to a control group of parents of children without a disability. Differences in parental stress. In addition to research demonstrating parental stress in general, other research, in the area of parental stress and well-being, shows differences between the stress of mothers and fathers. In particular, Baker, Blacher, and Olsson (2005) found that fathers of disabled children with behavioural problems did not experience long term effects on their well-being, whereas the behavioural problems associated with the disabled child affected the mothers' well-being over time. 6 Similarly, Mastroyannopoulou et al. (1997) found a connection between raising a child with a life threatening illness and parents' mental health. This study was intended to identify differences between mothers and fathers of a child with a life threatening illness, and to identify the predictive factors affecting parental adjustment. Ninety-three families were recruited through a local health district and each parent was subsequently assessed at home through a structured interview, standardized questionnaire, and nursing assessment questionnaire. The results indicated that approximately half of the mothers and fathers felt that they had not coped well with their child's diagnosis. Specifically, mothers of children with a life threatening illness, when compared to the risk experienced by their spouses and other mothers parenting a child without a life threatening illness, had an increased risk of developing mental health problems (Mastroyannopoulou et al.). In other research, Sloper, Knussen, Turner, and Cunningham (1991) examined the effects of life events, child characteristics, marital relationship, social psychological, physical, and coping characteristics on parental distress and perceptions of quality of life in families of children with Down Syndrome. The results indicated that there was a significant difference between mothers' and fathers' levels of stress. Specifically, fathers showed lower overall levels of stress than did mothers (Sloper et al., 1991). Sloper et al.'s findings regarding overall levels of parental stress were later expanded by Sloper and Turner's (1993) examination of the factors related to adaptation in parents of children with a severe motor disability at times of increased stress as defined at the time of diagnosis and time at which the child started school. In this research, a severe motor difficulty was operationalized as a prognosis that the child would not be able to walk more than a few steps independently. These authors found that sixty seven percent of the mothers and thirty nine percent of the fathers scored above the required cut off indicative 7 of distress, suggesting that they suffered from a high level of emotional disturbance. There were no significant differences between the mother and father on satisfaction with life or adaptation to their child. However, mothers showed significantly higher levels of distress than did fathers (Sloper & Turner, 1993). Findings on the parental differences in the effects of raising a child with a disability were further examined by Mastroyannopoulou et al.'s (1997) previously described work examining the differences between the parents of children with a life threatening illness. The authors found that mothers and fathers used different coping strategies to deal with their child's diagnosis. Specifically, at diagnosis, mothers were more likely to cope through emotional release, while fathers were more likely to cope through withdrawal (Mastroyannopoulou et al.). The above studies have illustrated not only that there are differences in how raising a child with a disability affects mothers and fathers, but specifically that, when raising a child with a disability, mothers appear to experience more overall stress than do fathers (Sloper & Turner, 1993; Sloper etal., 1991). Persistence of parental stress. The research on parenting a child with a disability and parental stress has also included an investigation into the persistence of parental stress. For example, Bruce, Schultz, and Smyrnios (1996) examined change over time for parents of children with intellectual disabilities in their level of intrusive thoughts in relation to their child's disability, their level of distress when recalling the time of diagnosis, and the presence and intensity of their wish for "what might have been." This work found that parents maintained their grief over time. Specifically, both parents continued to grieve over having a child with a disability despite the finding that both mothers and fathers experienced an eventual decrease in the intensity of wishing for "what might have been." Bruce et al. (1996) also examined the 8 differences between parents in their reported frequency of intrusive thoughts, their level of distress, and the presence and intensity of their wish for "what might have been." The results indicated that there were significant differences between the grieving of mothers and fathers over time. Specifically, mothers more than fathers experienced intrusive thoughts and emotional distress related to their recall of the time of diagnosis. Mothers as compared to fathers also made more active efforts to avoid the distress of thinking about the child. These authors also demonstrated that mothers had a decrease in distress between two and three years after diagnosis whereas fathers' distress at recalling the time of diagnosis did not decrease (Bruce et al.). Glidden and Schoolcraft (2003) helped to expand on the previous research by demonstrating that maternal stress declines after the time of diagnosis. These researchers examined birth and adoptive mothers of children with intellectual disabilities. Mothers completed questionnaires by mail, telephone, and interview at three time periods spanning approximately eleven years; the time of first measure was at the birth or placement of the child. This study found a significant difference between the well-being of birth and adoptive mothers. Specifically, birth mothers experienced significantly more depression than did adoptive mothers at time one. In contrast, adoptive mothers showed low levels of depression at all three points of measure. Birth mothers were also more depressed at time one and less depressed at times two and three, as at times two and three neither the adoptive mothers' reported levels of depression or the birth mothers' reported levels of depression met clinical criteria. Hence, it appears that raising a child with a disability does not cause significant depression in adoptive mothers. However, birth mothers raising a child with a disability may experience an initial depression at diagnosis, which subsequently decreases over time. Glidden and Schoolcraft's (2003) examination of birth and adoptive mothers is important because it is one of the first studies to 9 utilize comparative groups - other studies discussed above only compare parents to normative data or provide qualitative descriptions of apparent differences. The above studies demonstrate that although some aspects of parental stress may dissipate over time, the stress of raising a child with a disability can be persistent, especially when recalling the time of diagnosis (Bruce et al., 1996; Glidden & Schoolcraft, 2003). However, the picture at this point is not entirely clear because there appear to be many interconnected factors affecting parental stress. Factors influencing parental stress. When receiving the news that their child has a disability, parents can experience many different emotions. Some of these emotions are likely the result of the realization that their dreams and expectations for their child have been shattered, as well as not knowing what the future will now hold. Most parents spend the time from conception to birth planning their lives with their new child. Finding out that all of those plans and expectations may not be possible can be very difficult for a family to accept (Graungaard & Skov, 2006). There are many factors that can lead parents to feel shock, conflict, and stress, the most important of which appears to be the specific characteristics of the child. For example, Freidrich, Wilturner, and Cohen (1985) conducted two studies examining the factors involved in parental stress and coping for parents with mentally handicapped children. The results of the first study indicated that both medical problems and behaviour problems predicted parental wellbeing. Specifically, this study indicated that as medical and behaviour problems increased, parental well-being decreased (Freidrich et al., 1985). A later study conducted by Quine and Pahl (1991) expanded on these results by showing that child variables such as behaviour problems, sleep problems, poor academic skills, being difficult to manage, being difficult to keep 10 occupied, high dependency, and greater care-taking demands were significantly related to higher maternal stress. Floyd and Gallagher (1997) examined the effects of type of disability, behavioural problems, family status, and child age on parental stress, care-giving demands, and the use of support services by families with school aged children with behavioural problems, intellectual disabilities, and chronic illnesses. The results indicated that although the type of disability of the child was an important determinant of parental stress and care demands, behaviour problems were the more important factor in determining parental stress. Specifically, the authors found that mothers of children with intellectual disabilities and behavioural problems report significantly increased demands as compared to mothers of intellectually disabled children without behavioural problems. Similarly, mothers of children with behavioural problems reported more stress as well as significantly higher depression than did mothers of children without behavioural problems. Thus, it appears that raising a child with behavioural problems is associated with more demands, stress, and depression than raising a child without behavioural problems (Floyd & Gallagher, 1997). Further support comes from Hastings and Brown (2002). They found that parents of children with behavioural problems, especially mothers, showed high levels of potential mental health problems, as shown on the Hospital Anxiety and Depression Scale. In addition, the extent of the child's behavioural problems significantly predicted the parent's level of anxiety and depression. Thus, not only are behaviour problems in a child with a disability one of the major predictors of parental well-being, it appears as though the extent of behavioural problems can be used to predict the extent of parental stress (Hastings & Brown, 2002). 11 The association between problem behaviour and parental well-being has also been investigated by Beck et al. (2004) in their investigation of behaviour problems and pro-social behaviour. This study found that, as expected, a lack of adaptive behavioural skills did not significantly predict maternal stress. Alternately, the children's behaviour problems and prosocial behaviour significantly predicted maternal stress. Both increased behavioural problems and decreased pro-social behaviours were associated with increases in maternal stress. Consequently, the authors concluded that both behavioural problems and decreased pro-social behaviours independently affect a mother's level of stress (Beck et al.). Child communication problems have also been found to predict parental stress. For example, Frey et al. (1989) found that parents experienced greater stress when parenting a child with low communication skills. Specifically, mothers reported greater overall stress, while fathers reported greater psychological distress when parenting a child with serious communication difficulties (Frey et al.). Similarly, Sloper and Turner (1993) found that mothers showed better adaptation to their child in relation to an absence of communication problems. Finally, previous research has indicated that a child's level of self sufficiency is related to parental well-being. Specifically, Sloper et al. (1991) found that mothers reported more satisfaction with life when their children had higher self-sufficiency skills. Self-sufficiency, however, did not significantly affect fathers' satisfaction with life (Sloper et al.). Sloper and Turner (1993) expanded on these results in that they found that fathers indicated better adaptation to their child when the child experienced fewer feeding problems. Thus, although mothers' well-being appears to be primarily affected by the child's overall level of selfsufficiency, fathers' well-being appears to be affected by only the child's lack of specific selfsufficiency skills (Sloper & Turner, 1993). Overall, research appears to demonstrate that 12 parental stress is related to the child's type of disability (Floyd & Gallagher, 1997), including child factors such as medical problems, behavioural problems, communication abilities, the child's self-sufficiency skills, sleep, poor academic skills, and care taking demands (Beck et al., 2004; Freidrich et al., 1985; Frey et al., 1989; Hastings & Brown, 2002; Quine & Pahl, 1991; Sloper et al.; Sloper & Turner, 1993). Interaction of factors influencing parental stress. There are many factors affecting the well-being of parents raising a child with a disability. Some of these factors may have a direct influence on parental well-being, while some may simply mediate the parental well-being effects of raising a child with a disability. Specifically, the gender of the child has been shown to mediate the parental effects of raising a child with a disability. For example, research has shown that fathers experienced greater stress and lower satisfaction with life, when their disabled child was a boy (Frey et al., 1989; Sloper et al., 1991). Furthermore, Sloper et al. found that the presence or absence of other stressors (such as marital relationship, life events or financial difficulties) moderated the effect of child gender on fathers' satisfaction with life. That is, when other stressors were present, fathers of a son with a disability would show lower satisfaction with life; alternately, if few other stressors were present, having a son with a disability would not have as strong an influence on fathers' satisfaction with life (Sloper et al.). Moreover, Sloper and Turner (1993) found that fathers showed better adaptation to their male child when the child experienced a physical disability. Thus, the influence of the child's gender on fathers' wellbeing may also be mediated by the child's type of disability (Sloper & Turner, 1993). These authors also (1993) found differences in the well being of mothers and fathers based on the child having a physical disability. Specifically, mothers reported more satisfaction with life in relation to their child having less severe physical disabilities. Fathers' satisfaction with life however, was 13 not significantly related to the severity of the child's physical disability. Therefore, it appears that the severity of the child's physical disability affects mothers more than fathers (Sloper & Turner, 1993). Parental roll appears to be a factor mediating parents' level of stress. For example, Sloper et al. (1991) found that the influence of behavioural problems on parental well being differs between mothers and fathers. Specifically, mothers showed more stress when their children demonstrated behavioural problems. However, behavioural problems did not significantly affect fathers' levels of stress (Sloper et al.). Thus, the roll that a parent plays in the family can affect how behavioural problems affect that parent's level of stress. In addition to the child-specific factors, parental factors also appear to be influencing parental stress. For example, Sloper et al. (1991) found significant differences in the factors that affected mothers' and fathers' level of stress and satisfaction with life. Specifically, mothers' satisfaction with life was related to child, marital, family, and support characteristics, whereas fathers' satisfaction with life was similarly related to life, child, and marital characteristics, but also to coping and financial situation (Sloper et al.). These results were expanded by Sloper and Turner (1993) who found that mothers and fathers of children with a physical disability did not differ in their overall adaptation towards their child. However, this study did find that parents differed on which factors were related to greater parental stress. For mothers, greater parental stress was associated with a lack of employment, unmet service needs, and higher levels of neuroticism. For fathers, greater parental stress was associated with a lack of car ownership and higher neuroticism. As a result, it appears as though when compared with mothers, fathers' reported life satisfaction and parental stress are affected more by financial and material factors (Sloper & Turner, 1993). 14 Further parental characteristics were identified in Glidden and Schoolcraft's (2003) previously discussed longitudinal study where they identified an interaction in the effects on mothers' well being that was based on her age and having been a birth or adoptive mother. Mothers were divided into typical (non-depressed) and atypical (depressed) groups. These researchers investigated what factors mediated the differences between these two groups of mothers. The results indicated that non-depressed and depressed groups significantly differed on the age of the mother and the age of the child at initial interview. Specifically, both the adoptive mothers and adopted children in the non-depressed group were significantly older than the mothers and children in the depressed group. As well, the children of the non-depressed birth mothers were significantly younger than the children of the depressed birth mothers. Overall, it appears as though being a younger adoptive mother with a younger child or being a birth mother with an older child is related to higher levels of depression in the mothers. Thus, both age (of the child and the mother) and the birth/adoptive status may mediate the well-being of mothers of children with disabilities (Glidden & Schoolcraft, 2003). Freidrich et al.'s (1985) second study examined the influence of marital satisfaction on parental well-being. Parents, of children with medical and behavioural problems, were reexamined eight months after their first study. The results of the second study indicated that, over eight months, there were significant increases in parental depression and overall parental and family problems. This increase is accounted for by a decrease in marital satisfaction. That is, as family problems increased and marital satisfaction decreased, the depression of the parents increased in turn (Freidrich et al.). Quine and Pahl (1991), in their previously discussed study, found that maternal stress was mediated through variables such as coping skills, social class, and recent ill health. These 15 variables were found to mediate the stress that resulted from the child's behaviour problems. That is, being middle class with fewer financial worries acted as a buffer to maternal stress resulting from severe behaviour problems. Having positive adjustment towards and acceptance of the child's disability, having less maternal illness, and having feelings of being able to control their lives and achieve positive outcomes also resulted in less maternal stress (Quine & Pahl, 1991). In addition, parental personality has been found to mediate the parental well-being effects of having a child with a disability. For example, in their longitudinal study Glidden and Schoolcraft (2003) found that for both birth and adoptive mothers, neuroticism was the personality trait that was most significantly influential in predicting depression. They concluded that parental adjustment at different time periods may be mediated through the filter of personality (Glidden & Schoolcraft, 2003). Further, Hastings and Brown (2002) investigated the role of self-efficacy (perceptions of one's skills in a given domain) as an intervening variable between a child's behaviour problems and parental well-being. The results indicated that selfefficacy was a mediator of the relationship between the child's behaviour and the mother's anxiety and depression. Specifically, self-efficacy is compensatory in mothers, having a positive effect on maternal mental health. The authors also found that self-efficacy was a moderator of the relationship between a child's behaviour and paternal anxiety and depression. Thus, selfefficacy was found to be protective for fathers according to the risk and severity of the child's behaviour. That is, when the child was demonstrating low levels of problem behaviour, selfefficacy had no effect on fathers' mental health, but when the child was demonstrating high levels of problem behaviour, self-efficacy reduced the impact (Hastings & Brown, 2002). 16 Coping strategies can also have an influence on mothers' and fathers' level of well being. Specifically, when their child was first diagnosed, most parents questioned why their child was disabled. Three to five years later, less than half of the parents continued to ask themselves this same question. Moreover, mothers that continued to ask why their child was disabled experienced lower levels of well-being. The factors experienced by fathers differed in that fathers who did not externalize blame (such as blaming fate or someone else) experienced higher levels of well-being. Thus, parental coping strategies appear to affect parental well-being (Shapp, Thurman, & DuCette, 1992). Further support for the influence of coping strategies on mothers' and fathers' level of well being can be found in Shapp et al.'s (1992) study examining the relationship between what mothers and fathers attribute their child's disability to (internal or external factors), the relationship between each parent's attribution and their personal well-being, and the relationship between mothers' and fathers' well-being. The results indicated that some of the attributions reported by mothers and fathers were not correlated. Specifically, spouses were likely to disagree that a particular factor was the cause of their child's disability. This work also found that the level of well-being for one of the spouses did not predict the well-being of the other spouse. Therefore, it appears as though each parent's different coping strategy and attributions accounted for his or her personal level of well-being (Shapp et al.). Interestingly, Frey et al. (1989) found that social networks were not related to parenting stress or to the psychological distress of mothers. That is, having a child with a disability is related to having decreased social networks (Rodrigue et al., 1990); however, surprisingly, having fewer social networks does not appear to affect parents' reported feelings of well-being (Frey et al.). 17 Research has shown that parental well being is an interplay of many factors. The factors reviewed above included child factors such as a child's gender (Frey et al., 1989; Sloper et al., 1991), as well as mediating factors including parental gender, satisfaction with life, the adoptive/birth status, marital satisfaction, social class, poor health, personality, self efficacy, coping strategies, and social networks (Freidrich et al., 1985; Frey et al.; Glidden & Schoolcraft, 2003; Hastings & Brown, 2002; Quine & Pahl, 1991; Shapp et al., 1992; Sloper et al.; Sloper & Turner, 1993). ASD and Parental Mental Health Thus far, the research into the effects of parenting a child with a disability has examined several physical and intellectual disabilities. However, there is a gap in the literature with respect to specific investigation regarding the family system effects related to raising a child with ASD. ASD is a Pervasive Developmental Disorder affecting young children, with onset usually before the age of three. ASD is characterized by impairments in social interaction, impairments in communication as well as restricted, repetitive and stereotyped patterns of behaviour, interests, and activities. Furthermore, ASD is known to be four to five times more common in males than in females (APA, 2000), and it is usually associated with some degree of functional mental handicap and uneven cognitive development. As well, children with ASD may experience abnormal reactions to sensory stimuli, abnormal eating and sleeping patterns, as well as a range of difficult behaviours, including hyperactivity, short attention span, impulsivity, aggression, anger, and self-injury (APA, 2000). That said, the manifestations of ASD can vary greatly between different children. Research on the factors associated with parental well-being has demonstrated that parents' well-being is negatively affected by behavioural problems, communication skill deficits, lack of 18 self sufficiency skills as well as the child being male (Beck et a!., 2004; Floyd & Gallagher, 1997; Freidrich et al., 1985; Frey et al., 1989; Hastings & Brown, 2002; Quine & Pahl, 1991; Sloper & Turner, 1993; Sloper et al., 1991). As outlined above, ASD is a disability characterized by unusual and aggressive behaviour, poor to no communication skills, poor self sufficiency skills, and prevalence in males (APA, 2000). Apparently, ASD is a disability that is characterized by the major factors known to negatively affect parental well-being. Therefore, it could be expected that parents of children with ASD may be experiencing low levels of parental well-being. ASD and parental stress. Although limited, some research has been conducted to investigate the relationship between ASD and parental stress. For example, Bromley et al. (2004) examined the association between the psychological distress of mothers parenting children with ASD and socio-economic situation, her available formal and informal sources of social support, as well as the child's characteristics. The results indicated that 59 percent of the included mothers met the criteria for psychological distress. Thus, it appears mothers of children with ASD, like mothers of children with other disabilities, experience decreased well-being (Bromley et al.). Research has also been conducted to investigate the differences in the level of parental well-being between parents of children with ASD and other parents. For example, Rodrigue et al. (1990) examined the impact of parenting a child with ASD on the psychosocial functioning of the child's mother. The psychosocial functioning of the mother was examined from an individual, spousal, child, familial, extra-familial, and community perspective. Mothers of children with ASD were compared to mothers of children with Down Syndrome and mothers of developmentally normal children. The researchers found that mothers of children with ASD 19 differed from mothers of children with Down Syndrome and mothers of typically developing children on several individual characteristics. Specifically, mothers of children with ASD reported having lower perceived parenting competence, more frustration, as well as more anxiety and tenseness. In addition, mothers of children with ASD felt that parenting was less rewarding. Thus, it appears that parenting a child with ASD may lead to lower maternal well-being than parenting a typical child or a child with Down Syndrome (Rodrigue et al.). Research regarding effects of raising a child with ASD on parental well-being has also indicated that raising a child with ASD can have an impact on the relationship between family members. For example, Rodrigue et al. (1990) found that families including a child with ASD demonstrated higher family cohesion and lower family adaptability as compared to families with a child with Down Syndrome or families with a typical child. It should be noted that in all cases the families mean cohesion and adaptability, although different, remained within the range of healthy family functioning (Rodrigue et al.). Research has also found differences in the effects of raising a child with ASD on the wellbeing of mothers and fathers. For example, Hastings (2003) examined the relationship between a child's behaviour problems and each parent's mental health, while at the same time attempting to address the methodological problems identified in other research. These methodological problems included source variance and measurement overlap of stress experienced by mothers and fathers. In this study, the children's classroom teacher completed an assessment on the child's behaviour while the parents completed questionnaires identifying their personal level of stress. The author found that there was a strong overall association between the reported stress of mothers and fathers. However, mothers did report having significantly more symptoms of anxiety than did fathers. Therefore, it appears as though raising a child with ASD, as with 20 raising a child with another type of disability, has a more negative affect on mothers' well-being as compared to that of fathers' (Hastings, 2003). The research reviewed clearly indicates that parenting a child with ASD, as with parenting a child with another type of disability, can affect parental well-being. As with other disabilities, there also appears to be a difference in how parenting a child with ASD is related to parenting role (Bromley et al., 2004; Hastings, 2003). Finally, the research also suggests that mothers of children with ASD experience lower parenting competence, higher frustration, anxiety, and tension than do mothers of children with Down Syndrome or mothers of typical children (Rodrigue et al., 1990). Factors influencing parental stress. As with parents of children with other disabilities, there appears to be several factors influencing the parental well-being effects of parenting a child with ASD. For example, Rodrigue et al. (1990) found a difference in the coping strategies used by mothers of children with ASD as compared to mothers of children without ASD. Specifically, mothers of children with ASD more often used coping strategies such as information seeking, wish-fulfilling fantasy, and self-blame than did other mothers (Rodrigue et al.). Similarly, as with other disabilities, Hastings (2003) found that not only is parental stress associated with the level of their child's behaviour problems, but also that there are differences between the factors affecting mothers and fathers of children with ASD. For example, despite the finding that the father's stress did not appear to be significantly associated with their child's behaviour or their wife's mental health symptoms, this author found that mothers of children with ASD experience stress that is associated with both her child's behaviour and her husband's mental health symptoms (Hastings, 2003). Similarly, Bromley et al. (2004) found that high levels of challenging behaviour demonstrated by a child with ASD was associated with high levels of 21 psychological distress in the parents. Therefore, behaviour problems do appear to be a factor influencing the well-being of parents raising a child with ASD. As with other disabilities (Sloper et al., 1991), mothers appear to be influenced more by their child's behaviour problems than do fathers (Bromley et al.). Social networks may also play an important role in the well-being of parents raising a child with ASD. For example, unlike research with other disabilities (e.g., Frey et al., 1989), Bromley et al. found that parents' high levels of psychological distress was associated with low levels of support from within their family. In summary, similar to parents of children with other disabilities, the mental health of parents of children with ASD appears to be affected by the child's behavioural difficulties (Hastings, 2003). Furthermore, parental mental health may also be affected by other factors such as fathers' mental health and the amount of support that the family receives (Bromley et al., 2004; Hastings, 2003). Interaction of factors influencing parental stress. As with parents of children with other disabilities, it appears as though the many factors affecting parental well-being are interrelated. For example, Dunn, Burbine, Bowers, and Tantleff-Dunn (2001) examined the relationship between stressors, social support, locus of control, coping style, and negative outcomes in parents of children with ASD. The results indicated that social support can interact with other factors to affect parental well-being. Specifically, higher levels of social support corresponded to fewer spousal problems. Also, decreased social support increased the likelihood that stress will correspond to isolation. Thus, it appears as though parents raising a child with ASD who have more social support will experience fewer spousal problems and fewer stressors that lead to isolation than will parents without adequate social support (Dunn et al., 2001). 22 Previous research has also suggested that parents' types of coping strategies can be mediating factors in their well-being. For example, Dunn et al. (2001) found that an internal locus of control corresponds with lower levels of depression and isolation. Similarly, the coping style of escape-avoidance was found to correspond to increased depression, isolation, and spousal relationship problems whereas, the distancing coping style corresponded only to increased depression. However, less use of distancing increased the likelihood that stressors would correspond with isolation. Furthermore, non-use of positive reappraisal corresponded only with isolation and spousal relationship difficulties while non-use of confrontative coping corresponded to depression. Therefore, the parental well-being effect of raising a child with ASD can be significantly mediated by the coping style that a parent adopts (Dunn et al.). In conclusion, similar to parents of children with other disabilities, the effect of the factors relating to the well-being of a parent of a child with ASD appear to be interrelated. Specifically, previous research appears to indicate that the well-being of parents raising a child with ASD can be moderated by parental locus of control, coping style, and social support (Dunn et al., 2001). Parent's Mental Health and Work Outcomes Parents of Typical Children and Their Employment Work/family conflict can be viewed as conflict where the role pressures of work and family life are partially incompatible; that is, by participating in one role, the person's participation in the other role is compromised (Goff, Mount, & Jamison, 1990). Parents have been found to experience conflict between work and family roles more often than have other workers (Pleck, Staines, & Lang, 1980 in Goff, Mount, & Jamison, 1990). Similarly, research has indicated that having more children at home is a source of more work/family conflict (Keith & Schafer, 1980 23 in Goff, Mount, & Jamison, 1990), and that parents of younger children experience more conflict than do parents of older children (Fernandez, 1986 in Goff, Mount, & Jamison, 1990). There have been several factors identified that affect the influence of being a parent on work outcomes. For example, Goff et al. (1990) examined the relationship among employer supported childcare, work/family conflict, and absenteeism. These researchers found that there was no significant difference in work/family conflict between parents whose children were cared for by their spouse and parents whose children were cared for outside the home. Similarly, there was no significant relationship between the availability of child-care for sick children and work/family conflict. However, this work did demonstrate that there was less work/family conflict when parents were satisfied with the childcare arrangements. Thus, parental satisfaction with, not type of child-care arrangement seems to be the primary factor associated with work/life outcomes. Other outcomes discussed by these authors included the finding that the level of supervisor support influenced parental work outcomes - less supervisor support was associated with more work/family conflict. Further, this work found that the more work/family conflict experienced by the parent the greater their absenteeism (Goff et al.). The literature also suggests that parents' overall well-being is related to work/family conflict. For example, Hughes and Galinsky (1994) examined the relationship between gender, job and family role, work and family interference, and psychological symptomology. These results indicated that conflict between home and work role was related to one's level of psychological distress. Specifically, the authors found that employed women had more demanding family roles than did men, which contributed to their increased psychological symptoms. Accordingly, women's increased work/family role conflict can have a significant impact on overall well-being (Hughes & Galinsky, 1994). 24 In summary, previous research suggests that parents of typical children will experience more work/family conflict than will non-parenting workers, especially when the parents have more, or younger, children (Fernandez, 1986 in Goff, Mount, & Jamison, 1990; Keith & Schafer, 1980 in Goff, Mount, & Jamison, 1990; Pleck, Staines, & Lang, 1980 in Goff, Mount, & Jamison, 1990). Similarly, research also indicates that there is more work/family conflict when the parent is less satisfied with the child-care arrangements and that the greater the work/family role conflict, the greater the potential for absenteeism (Goff et al., 1990). Work/family conflicts have been shown to be greater for women, likely due to their greater demands at home (Hughes &Galinsky, 1994). Parents of Disabled Children and Their Employment Given that a parent of a disabled child may experience greater child behavioural difficulties (Floyd & Gallagher, 1997), more parenting hassles (Cuskelly et al., 1998) and decreased wellbeing (Mastroyannopoulou et al., 1997; Quine & Pahl, 1991), it is suggested that parents of a child with a disability, as compared to those parenting a child without a disability, are likely to experience increased work/home role conflict, which, in turn, could impact their employment status and productivity. Several studies have been conducted in order to look at the employment status of parents of children with disabilities. For example, Landis (1992) examined the marital status, employment status and child care practices of mothers parenting young children with a handicap. The results indicated that parenting a child with a disability has some impact on mothers' employment status. Specifically, this author found that the biological mothers of handicapped children under age three entered the labour force at approximately the same rate as others in the general population. However, the majority of the employed mothers with handicapped children worked 25 part time and irregular shifts. This is the reverse of the full/part time employment of the general population in that the majority of mothers raising children without a handicap had a higher intensity of work (for example, working full time and regular shifts). Thus, parenting a child with a disability may not affect the rate of entrance into the workforce, but it does appear to affect the type of shifts worked by mothers (Landis, 1992). Other studies have found similar results to those of Landis (1992). For example, Cuskelly et al. (1998) examined the relationship between parents and their children, as well as maternal employment of parents raising a child with or without a disability. These results indicated that having a child with a disability did not affect the rate at which parents entered the workforce. That is, these authors found that there was little impact on fathers' employment, as seventy nine percent of fathers parenting a child with a disability and eighty nine percent of fathers parenting a child without a disability were employed. Similarly, there was no significant employment difference in the number of mothers parenting a child with a disability (forty percent) and mothers parenting a child without a disability (fifty percent). Therefore, raising a child with a disability was found to have no significant impact on parents' entrance into the workforce (Cuskelly et al.). In contrast to the above findings, Freedman et al. (1995) found that parents' care taking responsibilities influenced their decisions about their work. Most mothers quit their jobs when their child was born and planned to return to work once the child was older; however, their return to work was delayed by their child's disability. Moreover, parents reported changing their work schedules to accommodate the needs of their children (Freedman et al.). Specifically, mothers of young children with a disability were less likely to be employed full time than were mothers of young children without a disability (Cuskelly et al., 1998; Freedman et al.). Mothers of young 26 children with a disability were also less likely to be employed outside of the home (Cuskelly et al.). In summary, although mothers were as likely to enter the workforce as fathers, the mothers were more likely to be working part time or working within the home. The previously discussed findings are further supported by research indicating that non-working mothers of children with disabilities indicated that the medical needs of their children were important in their decision to stay home. Thus, research indicates that although mothers and fathers of children with a disability enter the workforce at the same rate, mothers' work hours, as well as their places of work are impacted by their children's disability needs, especially if those needs are compounded by medical or life threatening conditions (Cuskelly et al.). Further support for the finding that raising a child with a disability affects work status, but not work entry, comes from Robert's (1999) examination of the impact of mental illness on the labour market performance of family members of the mentally ill. Interestingly, these results indicated that males with a mentally ill person in the family had an increased probability of participating in the labour force when the mental illness was accompanied by a chronic physical illness. On the other hand, having a family member with a mental illness did not significantly impact the probability of a woman being a member of the labour market. This work also found that hours of work are significantly reduced for both males and females when the mentally ill family member is affected by another illness. It appears as though the employment effects of taking care of a person with a disability are perpetuated when the disabled person suffers from multiple conditions (Roberts, 1999). Research has also been conducted in order to identify the impact of raising a child with a disability on parental work needs and performance. For example, Freedman et al. (1995) found via focus groups regarding the impact of caring for a developmentally delayed child on work and 27 family roles, that the overall needs of working parents with children with a developmental disability appeared to be similar to the needs of working parents who had children with no disability (for example, affordable child care, health care, and a supportive work environment). However, the working parents with a developmentally delayed child required more intense and complex arrangements (for child care, health care, sick days, etc.) in order to balance their work and home responsibilities. Interestingly, this focus group research also found that parenting a child with a developmental delay did not affect parental work performance. Parents reported that having a child with a disability had a positive influence on their attitude toward work and their work performance. Many of the parents described their work as a respite from their intense care giving responsibilities. Parents also reported working harder in order to make up for the flexibility in time, or time taken off to attend to their disabled child. Parents of children with disabilities may require more intense and complex arrangements, but these arrangements may help them to maintain a normal level of work performance (Freedman et al.). In contrast, Mastroyannopoulou et al. (1997) found, in their examination of the effects of raising a child with a life threatening illness, that mothers' careers were more affected by their child's illness than were fathers' careers. In addition, the mothers felt that their child's illness had affected their ability to perform their job. Thus, it appears that the impact of raising a child with a disability on job performance may be affected by a child's specific needs as well as the type of parenting role assumed by the worker (Mastroyannopoulou et al.). Although several studies have drawn a connection between parenting a child with a disability and work outcomes, few studies have been conducted in order to draw a direct link between parenting a child with a disability, parental well-being and work outcomes. Warfield (2001) however, examined the relationship between employment, parenting, and well-being of 28 mothers parenting children with disabilities. Mothers of children with disabilities were recruited through the Early Intervention Collaborative Study in Massachusetts and New Hampshire. Each mother was involved in a home visit and functional assessment of her disabled child, followed by self-administered questionnaires. The measures included the Parenting Stress Index, the Impact on Family Scale, the Child Behaviour Checklist, the McCarthy Scales of Children's Abilities, as well as several scales to measure work quality, parenting role, work role, family characteristics, and demographic information. This study demonstrated several important results. First, the results drew a connection between parenting demands, parental stress, and work characteristics. Specifically, Warfield (2001) found that greater parenting demands and less family support were significantly related to greater parental stress. On the other hand, greater work interest and less work intensity were significantly related to lower parenting stress. Hence, it seems that both parenting demands and work characteristics can affect parental stress. Second, the results drew a connection between parental demands, family characteristics and work outcomes. Specifically, Warfield (2001) found that employment status was not significantly related to parenting demands, cognitive performance of the child, family support, or parenting stress. Similarly, work quality was not significantly related to parenting stress, parenting demands, or amount of family support. However, greater parenting demands and stress, as well as greater work intensity were significantly related to more absenteeism. Furthermore, greater work intensity was significantly related to lower work quality, even though work intensity was not a significant predictor of parental stress. Thus, as previous research has demonstrated, parental demands and stress are seemingly not related to employment status, however, parenting demands and parenting stress are apparently related to absenteeism. Third, the results indicated that the effects of parenting demands and stress are moderated by work factors. That is, Warfield (2001) found 29 that when parenting role characteristics (ability to meet the child's demands and attain family support) were controlled for, interest in work significantly predicted lower parental stress. Work interest acts to moderate the negative influence of parenting demands on stress when parenting demands were low or average. On the other hand, when parenting demands were high, work interest no longer moderated the effects on stress. Similarly, when work role characteristics were controlled for, greater parenting demands significantly predicted more absenteeism (Warfield, 2001). Previous research further suggests that parents with disabled children experience more parenting hassles than do parents of non-disabled children (Warfield, 2001). This research further suggests that increased stress does not appear to affect the rate that mothers or fathers enter the workforce, as these mothers and fathers enter at the same rate as parents with nondisabled children (Cuskelly et al., 1998; Landis, 1992). However, the increased stress does appear to affect the employment status of mothers because the majority of surveyed employed mothers worked part time, or delayed their return to work because of their disabled child. Parents of children with disabilities also required more accommodation in order to meet the demands of their work/home role conflict (Cuskelly et al.; Freedman et al., 1995; Landis, 1992). Parents report that their work is a break from the demands of their home roles and that they work harder in order to make up for the time needed for accommodation of work/life roles. That said, it remains true that the greater the parenting demands, the more parental absenteeism from work. As a consequence, it appears that having a child with a disability does impact some aspects of parental employment (Freedman et al.; Warfield, 2001). It is clear that the research on parenting children with disabilities discusses the impacts on parental stress and well-being, as well as the relationship between parenting a child with a disability, parental well-being, and the workforce 30 (Beck et al, 2004; Glidden and Schoolcraft, 2003; Warfield, 2001; Quine & Pahl, 1991). However, there is a gap in the literature with respect to direct comparisons between parents of children with ASD and parents of children without disabilities regarding the effects of parenting a child with a disability. The research reviewed has shown different results for the parents of children with different disabilities. As different disabilities appear to have different effects on parental well-being and work outcomes, future research should narrow the view to identify the effects of parenting a child with one specific disability on parental well-being and work outcomes (Frey et al., 1989; Mastroyannopoulou et al., 1997; Rodrigue et al., 1990; Quine & Pahl, 1991). ASD would be a fitting disability to employ when undertaking this examination. Children with ASD have been found to demonstrate higher levels of challenging behaviour (Bromley et al., 2004) and elicit more parental stress (Rodrigue et al.) as compared to children with other disabilities. Examining a substantial disability may help to identify the parental stress effects of parenting a child with a challenging disability and the effect of that stress on parental work outcomes. Thus, this research project undertook the task of comparing parents of children with ASD to parents of children without ASD in order to identify the influence of an extreme disability on parental wellbeing as well as the impact of their well-being on their work outcomes. In addition, this research program will help to identify the impact of the parental stress created by such an extreme disability on parental work status, work quality, and absenteeism. Hypotheses Thus far, research has shown little influence of parental stress on work performance, except for parents of children with life threatening illnesses (Freedman et al., 1995; Mastroyannopoulou et al., 1997). However, the available research in this specific area is scant and primarily of a 31 descriptive nature - as well, the parental stress created by the extreme nature of ASD may have a more drastic effect on parental work outcomes than that created by other types of disabilities. Consequently, this research used a quasi-experimental design whereby parents raising a child with ASD were compared to parents raising a typical child on a number of important constructs including coping, mental health and stress, satisfaction, and job performance. Given these constructs, the following hypotheses were proposed. Coping The first hypothesis holds that parents raising a child with ASD will display higher levels of coping ability than will parents raising a typical child. This expectation is drawn from the belief that in order to cope and survive with the substantial emotional and functional needs related to parenting a child with ASD, these parents will require optimal coping mechanisms. Support for this hypothesis comes from Rodrigue et al.'s (1990) study showing that mothers of children with ASD used different coping strategies than do mothers of children who do not have ASD. This study aims to identify if this difference in coping strategy use translates into a difference in overall coping ability. The second hypothesis suggests that parents raising a child with Autism will display more positive world views than will parents raising a typical child. A positive world assumption may be the underlying construct that allows parents to develop the coping strategies that they require to cope with raising a child with ASD. This belief is developed from previous research that has shown that parents of children with autism were less depressed and isolated depending on the coping strategy they used, such as having an internal locus of control, using more positive reappraisal, and confrontative coping (Dunn et al., 2001). For example, the parents of ASD children may have to believe that the world is just and fair, that they are doing good, and that 32 they are working towards a good outcome in order to cope with the difficulty and stress they experience raising their child. Similarly, a perception of the world as a good place, as just and that they themselves are good, despite having a developmentally disabled child, may help the parents of children with Autism to cope with the emotional and functional needs of their child. Mental Health and Stress Hypothesis three proposes that the parents raising a child with ASD will report lower overall mental health than will parents raising a typical child. This hypothesis is formulated from the idea that raising a child with poor communication and self care skills, as well as inappropriate or aggressive behaviours will put strain on the parents, which will result in a decrease in parental mental health. This theory is supported by previous research that has shown that with increased communication and behavioural problems, parents experience more mental health problems (Brown, 2002; Frey et al., 1989) and psychological distress (Bromley et al., 2004). The fourth hypothesis suggests that parents raising a child with Autism will report more parental stress than will parents raising a typical child. As with the third hypothesis, it is believed that as the difficulty in raising the child increases (for example, more communication, self care and behavioural problems), there is more strain on the parents, which results in increased levels of parental stress. Thus, as children with Autism can show poor communication skills, self care skills, and behavioural problems (APA, 2000), as compared to typical children, parents of children with Autism should experience more stress. This hypothesis is suggested by previous research showing that parents raising a child with a disability have reported increased levels of stress (e.g., Quine & Pahl, 1991). Similarly, research has found that as communication 33 difficulties and behavioural problems increase, so does a parent's level of stress (Brown, 2002; Freyetal, 1989). Satisfaction The fifth hypothesis holds that the marital satisfaction of parents raising a child with ASD will be lower than that of parents raising a typical child. This hypothesis is based upon the belief that the increased difficulty in raising a child with ASD, as well as the increased parental stress, will cause strain between the parents, resulting in lower levels of marital satisfaction. This theory is supported by research where mothers of children with life threatening illnesses have indicated that their relationship with their spouse had become more negative (Mastroyannopoulou, et al., 1997). Similarly, parents who were raising children with behavioural problems showed a decrease in marital satisfaction over time (Freidrich et al., (1985). Hypothesis sixth holds that parents raising a child with ASD will report a higher level of job satisfaction than will parents raising a typical child. Specifically, the parents of children with ASD will have a higher level of job satisfaction in relation to actually performing the job, but not specifically with the satisfaction with others that they work with. This hypothesis is based on previous research that suggests that parents with a disabled child may view their work outside of the home as a respite from their disabled child (Freedman et al., 1995). Thus, the parents of children with ASD should have an overall level of satisfaction and contentment with being at work because this provides them with time away from the stressful home life with their ASD child. Hypothesis seven proposes that parents raising a child with autism will report a lower level of life satisfaction than will parents raising a typical child. This hypothesis is developed from 34 the idea that the increased difficulty of raising a child with ASD will result in the parents not achieving the goals that they dreamed of, thus resulting in a lower level of satisfaction with their lives. This theory has been supported by previous research that has found that raising a child with a disability can affect a father's satisfaction with life (Frey et al., 1989; Sloper et al., 1991), as well as research that has shown that the parents experience decreased social support and increased social isolation (Dunn et al., 2001). Work Quality and Performance The eighth hypothesis suggests that the interest and quality of work for parents raising a child with ASD will be higher than that of parents raising a typical child. Although previous research has indicated that job performance does not differ between parents raising a child with a disability and parents raising a typical child (Cuskelly, Pulman, & Hayes, 1998; Freedman, Litchfield, & Warfield, 1995), it is believed that further refinement of this construct to look directly at work interest and quality will show different results. This theory is drawn from the belief that if parents view their work as a respite from their disabled child, (Freedman et al., 1995), they may value the time that they have away from that child, thus, fostering an increased interest in their work as well as an increased motivation to succeed at work. Similarly, if the parents are working harder to make up for the accommodations they require to care for their disabled child (Freedman et al.), their work quality should be higher than that of parents raising a typical child. The ninth hypothesis proposes that parents raising a child with ASD will miss more work due to illness and or family matters than will parents raising a typical child. This hypothesis is based on the idea that if a parent raising a child with ASD experiences more stress and mental health issues, they will require more time off work. This theory is supported by Warfield's 35 (2001) research showing that greater parental stress was related to more absenteeism from work. Similarly, parents raising a child with ASD would require more days off work to deal with issues related to their ASD child (such as suspensions from school, injuries due to aggressive behaviour, etc.). 36 Chapter 2: Method Participants The participants for this study included twenty eight families (consisting of two parents and at least one child) (N = 28) with at least one parent working; fifteen families were self-identified parents of a child with Autistic Spectrum Disorder (n = 15; Group 1), the remaining thirteen families were self-identified parents of a child without Autistic Spectrum Disorder (ASD) and, as such, served as a comparison group (n = 13; Group 2). The two groups were similar on important demographic characteristics, such as parent's age, number of children in the household, target child's age, and hours worked per week (Rodrique et al., 1990). Demographic information was also collected on each family comparing them on variables such as ethnicity, parent's education and employment status. Group 1 was recruited through a local ASD service society. This recruitment was facilitated by a pre-existing situation whereby the primary researcher has employment access to families at Gateway Society, the local ASD service organization. Following UNBC research ethics board approval, additional permission was attained from Gateway Society's Executive Director regarding the researcher contacting Society clients for participation. Previous literature suggests that participant recruitment through similar service providers is a common practice in comparable types of research (Bromley et al., 2004; Cuskelly et al., 1998; Dunn et al., 2001; Floyd, & Gallagher, 1997; Glidden & Schoolcraft, 2003; Rodrique et al., 1990; Shapp et al., 1992). Group 2 was recruited through traditional convenience sampling methods (e.g., word-of-mouth, flyers, advertisements, etc.) and written informed consent was attained prior to the initiation of data collection in any context (Appendix A). 37 Procedure Participants were initially contacted via telephone or informational flyers to obtain indications of interest and to arrange a follow-up in-home, or community location, meeting time convenient for the parents. The researcher then met with the parents either at their home or another location convenient for the parents (such as at the researcher's office or a lab at the University). During the meeting, each participant was asked to independently complete a demographic questionnaire as well as several counter-balanced psychological and employment measures (see below). The parent participants were provided with the information letter and informed consent sheet. Measures Demographic measure. 1. The demographic questionnaire (Appendix B) contained items measuring the parent's relationship with the child, marital status, date of birth, ethnicity, education, employment status, occupation, and length of employment. The demographic survey also requested information regarding child characteristics such as the identified child's gender, family status, and ethnicity, as well as the number of additional children in the family, their birth dates/age, and their disability (if any). Coping measures. 1. The Proactive Coping Scale (Appendix F; Greenglass, Schwarzer, & Taubert, 1999) was used in this study because it is positively correlated with perceived self-efficacy and negatively with job burnout in different professions. This scale is composed of 14 items to which the participants rate their agreement on a 4 point scale from 1 ("not at all true") to 4 ("completely true") (Greenglass et al., 1999). 38 2. The World Assumptions Scale (Appendix G; Janoff-Bulman, 1989; a = .67-.78) was used to investigate the manner in which the participant views the world. This 32 item scale uses a 6-point Likert scale ranging from "disagree completely" to "agree completely" and evaluates eight independent sub-scales entitled benevolence of the world, benevolence of people, justice, controllability, randomness, self-worth, self-controllability, and luck. Mental health and stress measures. 1. The 36-item Parenting Stress Index/Short Form (PSI-SF; Abidin (1995) assesses the parent-child system and parenting stress through the parent, the child, and their interactions (Abidin, 1995). The PSI-SF has three subscales: Parental Distress (PD), Parent-Child Dysfunctional Interaction (P-CDI), and Difficult Child (DC), as well as provides a measure of defensive responding (DR). Respondents answer each question on a 5-point scale, and responses are summed to calculate the subscale scores. A measure of total stress is also calculated as the sum of the three sub-scales. The PSI has shown evidence of construct validity, as well as internal reliability (see Abidin, 1995). 2. The Symptom Checklist-90-Revised © (Derogatis, 1996) was used to evaluate levels of reported symptoms on nine different symptom scales (somatization, obsessivecompulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism). This scale is a 90 item scale that can be completed in approximately 15 minutes. Satisfaction measures. 1. The Locke- Wallace Marital Adjustment Test (Appendix H; Locke & Wallace, 1959; a = .90) was used to assess marital adjustment and satisfaction. The test consists of 15 items 39 measuring overall marital satisfaction, amount of disagreement, and level of compatibility. 2. The Job Satisfaction Survey (Appendix I; Traut, Larsen, & Feimer, 2000; a = .69-.88) is a twenty-five item measure that asks respondents to rate on a scale from one (strongly disagree) to four (strongly agree) how much they support statements of satisfaction with various aspects of their employment experience. The scale evaluates five dimensions of job satisfaction each investigated using five items, including overall job satisfaction, satisfaction with supervisor, satisfaction with job content, satisfaction with departmental relationships, and satisfaction with job training. Although this survey was originally created for use within the fire services, simple adaptations were made in order to create a generalized survey for this purpose (e.g., the item "Time in-station is effectively planned and constructive" was altered to read "Time on-site is effectively planned and constructive"). Work quality and performance measures. 1. The Employee Interest and Quality of Work Scale (Appendix J; a = .751) is a researchercreated measure that includes items addressing the employees' interest in their current jobs, as well as their average hours of work missed, self-rated quality of work, level of productivity (if applicable), probability of advancement, ability to interact effectively with supervisors, ability to interact effectively with co-workers, and organizational commitment. 40 Chapter 3: Results For all analyses involving more than one dependent variable (DV), repeated measures multivariate analysis of variance (MANOVA) was used, with an alpha level of .05. In order to achieve a medium effect size based on a 2X2 analysis of variance (ANOVA), a cell size of 33 would be required. Although the number of participants included in these analyses were low, the use of a within subjects design increased the available power (Tabachnick & Fidell, 2001). In addition, issues of power are typically not of concern when using MANOVA, as long as the number of participants in each cell is higher than the number of DVs in the analysis. For all MANOVA analyses in this study, there were more participants in each cell than there were DVs. Repeated measures analysis was used for analyses of all hypotheses, as parenting role was considered to be a within subject factor, given that mothers and fathers could not be considered independent samples. Hastings (2003) identified measurement overlap between parents as a potential issue when measuring factors such as parental stress. Treating parenting role as a within participant factor was intended to address the issue of measurement overlap because this process allows this research to investigate each family as a unit, instead of as individual parents. Follow-up analyses were conducted on all significant omnibus tests using repeated measures analysis of variance (ANOVA), with an alpha of .05. Typically, an alpha of .01 would be used in following up significant MANOVA omnibus tests in order to control for the increased type one error that results from running multiple ANOVAs (Tabachnick & Fidell, 2001). However, given the exploratory nature of this study and the relatively low level of power resulting from a small sample size, an alpha level of .05 was allowed for follow-up analysis. This alpha level allowed greater exploration of relationships that could not be identified at more 41 conservative alpha levels. It is however suggested that the low level of power be considered and future research be conducted to confirm the effects discussed in this study. Demographic Characteristics of the Respondents Of the families originally assessed, only families with two parents and at least one parent working were included in the final analysis. One family was dropped from the analysis because neither of the parents were working (Autism group). Ten of the families were dropped from the analysis because they were single parent families (4 Autism; 6 Control). Of the participants included in the analysis, 28 were male and 28 were female, making up a total of 28 family units consisting of two parents and at least one child (See Table 1 for mean (M) and standard deviation (SD) information and Table 2 for all demographic t scores.). There were no significant differences between the two groups for maternal age (Autism group M = 42.330, SD = 5.678; Control group M = 40.154, SD = 5.014); paternal age (Autism group M = 46.333, SD =5.972; Control group M = 42.308, SD = 5.122), number of children in each family (Autism group M = 2.600, SD = 1.183; Control group M = 1.920, SD = 1.115), age of the target child (Autism group M = 13.000, SD = 4.721; Control group M = 10.380, SD = 5.440), maternal hours worked per week (Autism group M = 28.333, SD = 9.526; Control group M = 35.773, SD = 4.069), or paternal hours worked per week (Autism group M = 46.339, SD = 17.387; Control group M = 43.111, SD = 5.215). Both groups were comprised mostly of Caucasians (26 fathers, 24 mothers), with one father self-reporting as Ukrainain (Autism group), one father self-reporting as other (Autism Group), one mother self-reporting as Aboriginal (Autism group), one mother self-reporting as Asian (Control Group), and two mothers self-reporting as other (Control Group). 42 Table 1 Means and Standard Deviations for Demographics Age of Father Age of Mother Age of Target Child Hours of Work per Week Father Hours of Work per Week Mother Number of Children in Household Mean Autism 46.333 42.333 13.000 46.339 SD Autism 5.972 5.678 4.721 17.387 n Autism 15 15 15 14 Mean Control 42.308 40.154 10.380 43.111 SD Control 5.122 5.014 5.440 5.215 n Control 13 13 13 12 28.333 9.526 9 35.773 4.069 11 2.600 1.183 15 1.92 1.115 13 1.899 1.069 1.363 .661 2.185 1.550 .690 .295 .185 .518 .053 .133 Table 2 Demographic T scores Age of Father Age of Mother Age of Target Child Hours of Work per Week Father Hours of Work per Week Mother Number of Children in Household For the Autism group, 6% of the fathers did not complete high school (n = 1), 13% of the father's highest level of education was secondary school (n = 2), 13% completed trade or technical school (n = 3), 20% completed some college (n = 3), 20% completed a college diploma (n = 3), 13% completed some university (n = 2), and 13% completed a university degree (n = 2). The highest level of education for 36% of the mothers in the Autism group was a secondary school diploma (n = 5), 14% completed trade or technical school (n = 2), 29% completed some college (n = 4), and 21% completed a university degree (n = 3). For the control group, 15% of the father's highest level of education was trade or technical school (n = 2), 15% completed 43 some college (n = 2), 8% completed some university (n = 1), and 62% completed a university degree (n = 8). The highest level of education for 8% of the mothers in the control group was some college (n = 1), 15% completed some university (n = 2), and 77% completed a university degree (n= 10). The participants in this study held a variety of different jobs (see Table 3 for the frequencies that participants fell within each job). For the Autism group, 79% of the fathers worked full time permanent (n = 11), 7% worked full time in a temporary or contract position (n = 1), 7% worked part time in a temporary or contract position (n = 1), and 7% worked in a casual position (n = 1). Forty four percent of the mothers in the Autism group worked in a full time permanent position (n = 4), and 56% worked in a part time permanent or contract position (n = 5). For the control group, 100% of the fathers worked in a full time permanent position (n = 12). Fifty five percent of the mothers in the control group worked in a full time permanent position (n = 6), 9% worked in a part time permanent position (n = 1), 18% worked in a full time temporary or contract position (n = 2), 9% worked in a part time temporary or contract position (n = 1), and 9% reported other as their employment status (n = 1). Results Coping Coping ability. A repeated measures analysis was conducted to identify whether there was a difference in proactive coping between the Autism group (n = 15) and the control group (n = 13). The participants' scores on the Proactive Coping Scale were analyzed in a 2 between (group) X 2 within (gender) repeated measures ANOVA, with gender as the within subject variable (Tabachnick & Fidell, 2001). The results of the ANOVA indicated that there was no 44 significant effect for proactive coping, thus, hypothesis one was rejected. (See Table 4 and 5 for the F and p statistics, as well as Table 6 for the means and standard error scores.) Table 3 Frequency of Parent's Jobs Autism Fathers Adjudicator Aviation Safety Inspector Behavioural Consultant Book Keeper Case Manager Cashier Clerical Clerk Correctional Officer Customer Service Representative Designer Engineer Executive Director Fire Fighter Fishery Officer Forester Group Instructor House Cleaner Lab Instructor Labourer Machine Operator Manager Mechanic Not Working Nurse Planner Police Officer Professional Sales Representative Superintenint Road Builder Teacher Teacher's Assistant Vice Principal Youth Care Worker Autism Mothers Control Fathers Control Mothers 1 1 1 1 1 1 1 2 1 2 6 1 1 1 1 1 1 1 1 1 1 1 1 45 1 1 1 Table 4 AN OVA andMANOVA F Scores for Group Differences Coping Coping Ability World Assumptions Benevolence Meaningfulness Self Worth Mental Health and Stress Mental Health Somatisation Obsessive Compulsive Interpersonal Sensitivity Depression Anxiety Hostility Phobic Anxiety Paranoia Psychotasism Parental Stress Defensive Responding Parental Distress Dysfunctional Interaction Difficult Child Total Stress Satisfaction Marital Satisfaction Job Satisfaction Overall Supervisor Contentment Relationships Training Satisfaction with Life Work Quality and Interest and Quality Performance ofWork Performance Interest Time Missed 46 F 1.807 .719 .662 .228 2.123 2.481 P .190 .550 .423 .637 .157 .048 TV2 .065 .083 .025 .009 .075 .554 3.754 8.426 10.404 .064 .007 .003 .126 .245 .286 1.108 3.080 4.684 3.667 5.144 1.552 12.894 15.345 16.656 40.628 .302 .091 .040 .067 .032 .224 .000 .001 .000 .000 .041 .106 .153 .124 .165 .056 .692 .371 .390 .610 53.515 43.179 1.504 3.356 8.266 4.789 15.222 .876 2.636 3.420 .000 .000 .232 .040 .011 .044 .001 .363 .124 .076 .673 .624 .057 .583 .341 .230 .488 .052 .141 .116 2.495 .116 .250 1.538 5.234 .438 .233 .036 .518 .088 .247 .027 Table 5 ANOVA and MANOVA F Scores for Gender Differences Coping Coping Ability World Assumptions Benevolence Meaningfulness Self Worth Mental Health and Stress Mental Health Somatisation Obsessive Compulsive Interpersonal Sensitivity Depression Anxiety Hostility Phobic Anxiety Paranoia Psychotasism Parental Stress Defensive Responding Parental Distress Dysfunctional Interaction Difficult Child Total Stress Satisfaction Marital Satisfaction Job Satisfaction Overall Supervisor Contentment Relationships Training Satisfaction with Life Work Quality and Interest and Quality Performance of Work Performance Interest Time Missed 47 F .896 2.687 3.624 1.103 1.577 .966 P .353 .069 .068 .303 .220 .497 T? .338 1.447 1.690 .566 .240 .205 .013 .053 .061 .942 .347 .340 6.219 .180 .508 .809 .019 .022 .021 .341 .561 .565 .019 .675 .482 .532 .892 .883 .887 .035 .013 .013 .193 .007 .019 .123 .001 .001 .001 .952 .052 1.768 .630 .353 .349 .424 .104 .405 .691 .338 .821 .196 .681 .561 .563 .524 .751 .533 .413 .035 .002 .066 .208 .022 .021 .026 .006 .025 .026 .424 .662 .053 .512 .082 1.884 .485 .779 .189 .031 .005 .105 .033 .251 .122 .041 .057 .326 Table 6 Means and Standard Errors for Coping Analyses Mean Autism Coping Ability World Assumptions Benevolence Meaningfulness Self Worth n Control 31.731 Std. Error Control 1.632 37.577 42.038 57.231 1.059 1.578 2.058 13 13 13 n Autism Mean Control 28.733 Std. Error Autism 1.519 15 36.400 43.067 53.133 .986 1.469 1.916 15 15 15 13 World assumptions. A repeated measures analysis was conducted on parental world assumptions to identify if there was a difference between the Autism group (n = 15) and the control group (n = 13). The participants' scores on the scales of the World Assumptions Scale were analysed in a 2 between (group) X 2 within (gender) X 3 measure (benevolence towards the world, meaningfulness of the world, self worth) repeated measures MANOVA, with gender and measure as the within subject variables (Tabachnick & Fidell, 2001). The results of the MANOVA indicated no significant multivariate effects for world assumptions, thus follow-up analyses were not conducted. Hypothesis two was therefore rejected. (See Table 4 and 5 for the F and/? statistics, as well as 6 for the means and standard error scores.) Mental Health Overall mental health. A repeated measures analysis was conducted to identify if there were differences in mental health between the Autism group (n = 15) and the control group (n = 13). Participants' scores on the scales of the SCL-90 were analysed using a 2 between (group) X 2 within (gender) X 9 measure (somatisation, obsessive compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoia, and psychotisism) repeated measures MANOVA, with gender and measure as the within subject variables (Tabachnick & Fidell, 48 2001). The MANOVA indicated that there was a significant group by measure interaction on the SCL-90 scales, F (9,18) = 2.48\,p = .048, n2 = .554, small effect size, thus hypothesis three was accepted. Follow-up tests were run on the significant group by measure interaction using ANOVA, with a probability level of .05, accounting for Type 1 error and low power. The results of the follow-up ANOVAs showed significant group differences on several of the specific SCL90-R scales. The Obsessive Compulsive scale, F (1,26) = 8.426,/? = .007, n2 = .245, small effect size, indicated higher levels of Obsessive Compulsive behaviours in the Autism group (M = 64.830; SE = 1.983) than in the control group (M = 56.390, SE = 2.130). The Interpersonal Sensitivity scale, F (1,26) = 10.404,p = .003, n = .286, small effect size, indicated higher levels of interpersonal sensitivity in the Autism group (M = 61.900, SE = 1.644) than in the control group (M = 54.120, SE = 1.766). The Hostility scale, F(\, 26) = 4.684,p = .040, n2 = .153, small effect size, showed higher levels of parental hostility in the Autism group (M = 62.033, SE = 2.142) than in the control group (M = 55.231, SE = 2.301). The Paranoia scale, F (1,26) = 5.144,/? = .032, n2 = .165, small effect size, indicated that parents in the Autism group (M = 57.233, SE = 1.619) experience more paranoia than do the parents in the control group (M = 51.846, SE = 1.739). (See Table 4 and 5 for the F and/7 scores, as well as Table 7 for the means and standard error scores of all of the SCL-90-R scales.) Parental stress. A repeated measures analysis was conducted in order to identify whether there were differences between the Autism group (n = 15) and the control group (n = 13) on level of parental stress. Participant's scores on the scales of the Parental Stress Index - Short Form (PSI-SF) were analysed using a 2 between (group) X 2 within (gender) X 5 measure (defensive responding, parental distress, parent child dysfunctional interaction, difficult child, total parental stress) repeated measures MANOVA, with gender and measure as the within subject variables 49 (Tabachnick & Fidell, 2001). The results of the MANOVA indicated that there was a significant group by measure interaction on the scales of the PSI-SF, F (4, 23) = 12.894, p < .000, n2 = .692, medium effect size, thus hypothesis four was accepted. Follow-up tests were run on the significant group by measure interaction using ANOVA, with a probability level of .05 to account for Type 1 error and low power. The follow-up ANOVA analyses showed significant group differences on all of the PSI-SF scales. The ANOVA on the defensive responding scale, F (1, 26) = 15.345,/? = .001, n2 = .371, small effect size, indicated a significant difference between groups, with the Autism group having higher levels of defensive responding (M = 21.630, SE = 1.207) than the control group (M = 14.690, SE - 1.297). The ANOVA on the parental distress scale, F (1, 26) = 16.656, p < .001, r\2 = .390, small effect size, indicated a significant difference between groups, with the Autism group having higher levels of parental distress (M = 35.130, SE = 1.910) than the control group (M = 23.690, SE = 2.052). The ANOVA on the parent child dysfunctional interaction scale, F (1, 26) = 40.628,/? < .001, n = .610, medium effect size, indicated a significant difference between groups, with the Autism group having higher levels of dysfunctional interactions (M = 34.470, SE = 1.604) than the control group (M = 19.460, SE = 1.723). The ANOVA on the difficult child scale, F ( l , 26) = 53.515,/? < .001, n2 = .673, medium effect size, indicated a significant difference between groups, with the Autism group reporting a more difficult child (M = 43.470, SE = 1.785) than the control group (M - 24.310, SE = 1.917). Finally, the ANOVA on the total parental stress scale, F ( l , 26) = 43.179,/? < .001, rj2 = .624, medium effect size, indicated a significant difference between groups, with the Autism group having higher levels of total parental stress (M = 134.700, SE = 5.449) than the control group (M = 82.154, SE = 5.853). (See Table 4 and 5 for the F and/? scores, as well as Table 7 for the means and standard error scores of all of the PSI-SF scales.) 50 Table 7 Means and Standard Errors for Mental Health and Stress Analyses Mental Health Somatisation Obsessive Interpersonal Depression Anxiety Hostility Phobic Anxiety Paranoia Psychoticism Parental Stress Defensive Parental Distress Dysfunctional Difficult Child Total Stress Mean Autism Std. Error Autism n Autism Mean Control Std. Error Control n Control 57.633 64.833 61.900 60.800 58.500 62.033 52.933 57.233 57.933 2.211 1.983 1.644 2.236 1.926 2.142 1.742 1.619 1.983 15 15 15 15 15 15 15 15 15 51.346 56.385 54.115 57.346 53.538 55.231 48.038 51.846 54.308 2.375 2.130 1.766 2.401 2.069 2.301 1.871 1.739 2.130 13 13 13 13 13 13 13 13 13 21.633 35.133 34.467 43.467 134.700 1.207 1.910 1.604 1.785 5.449 15 15 15 15 15 14.692 23.692 19.462 24.308 82.154 1.297 2.052 1.723 1.917 5.853 13 13 13 13 13 Satisfaction Marital satisfaction. A repeated measures analysis was conducted on marital satisfaction to identify whether there was a difference between the Autism group (n = 14) and the Control group (n = 13). Participants' scores on the marital satisfaction survey were analysed in a 2 between (group) X 2 within (gender) repeated measures ANOVA, with gender as the within subject variable (Tabachnick & Fidell, 2001). The results of the ANOVA indicated no significant effects for marital satisfaction, thus hypothesis five was rejected. (See Table 4 and 5 for the F and/? scores, as well as Table 8 for the means and standard error scores for the marital satisfaction analysis.) 51 Table 8 Means and Standard Errors for Satisfaction Analyses Marital Satisfaction Job Satisfaction Overall Supervisor Contentment Relationships Training Satisfaction with Life n Control 43.192 Std. Error Control 1.560 17.250 16.950 14.900 13.800 15.000 28.000 .478 .899 .378 .881 .539 1.372 10 10 10 10 10 13 n Autism Mean Control 40.536 Std. Error Autism 1.503 14 15.188 14.000 12.688 12.563 13.688 24.533 .535 1.005 .423 .986 .603 1.277 8 8 8 8 8 15 Mean Autism 13 Job satisfaction. A repeated measures analysis was conducted to identify if there was a difference between the Autism group (n = 8) and the Control group (n = 10) on job satisfaction. Participants' scores on the scales of the Job Satisfaction Survey were analysed in a 2 between (group) X 2 within (gender) X 5 measure (Overall satisfaction, satisfaction with supervisor, job contentment, departmental relations, and satisfaction with training) repeated measures MANOVA, with group and measure as the within subject variables (Tabachnick & Fidell, 2001). The results of the MANOVA indicated a significant group by measure interaction in job satisfaction, F (5,12) = 3.356,p = .040, n2 = .583, small effect size. Follow-up tests were run on the significant group by measure interaction using ANOVA, with a probability level of .05, to account for Type 1 error and low power. The ANOVA analysis showed significant group differences on three of the job satisfaction sub scales. The Overall Satisfaction scale, F ( l , 16) = 8.266,p = .011, n 2 = .341, small effect size, showed a significant effect with the Autism group (M = 15.188, SE = .535) having lower overall satisfaction than the control group (M = 17.250, SE = .478). The Satisfaction with Supervisor scale, F (1, 16) = 4.789,/? = .044, n2 = .230, small effect size, showed a significant effect with the Autism group (M = 14.000, SE = 1.005) having 52 lower overall satisfaction than the control group (M = 16.950, SE = .899). The Job Contentment scale, F ( l , 16) = 15.220, p = .001, n2 = .488, small effect size, indicated a significant difference between groups, with the Autism group having less contentment (M = 12.690, SE = .423) than the control group (M = 14.900, SE = .378). Thus, given the reverse direction of the effect, hypothesis six was rejected. (See Table 4 and 5 for the F and/> statistics, as well as Table 8 for the means and standard error scores for job satisfaction analysis.) Satisfaction with life. A repeated measures analysis was conducted to identify if there was any difference between the Autism group (n = 15) and the Control group (n = 13) on their satisfaction with life. Participants' life satisfaction was analysed in a 2 between (group) X 2 within (gender) repeated measures ANOVA, with gender as the within subject variable (Tabachnick & Fidell, 2001). The results of the ANOVA indicated that there was no significant effect for satisfaction with life, thus hypothesis seven was rejected. This ANOVA did however show an interesting trend towards lower levels of life satisfaction in the Autism group (M = 24.530, SE = 1.277) than in the control group (M = 28.000, SE = 1.372). (See Table 4 and 5 for the F and/? statistics, as well as Table 8 for the means and standard error scores for the life satisfaction analysis.) Work Quality and Performance. Interest and quality of work A repeated measures analysis of interest and quality of work was conducted to see whether there was a difference between the Autism group (n = 8) and the Control group (n = 10). The job preference and interest scales of the Interest and Quality of Work Scale were analyzed in a 2 between (group) X 2 within (gender) X 2 measure (interest and performance) repeated measures MANOVA, with gender and measure as the within subject variables (Tabachnick & Fidell, 2001). The results of the MANOVA indicated that there were 53 no significant effects for interest and quality of work, thus, no follow-up analyses were completed. Hypothesis eight was therefore rejected. (See Table 4 and 5 for the F and/> statistics, as well as Table 9 for the means and standard error scores for the interest and quality analysis.) Table 9 Means and Standard Errors for Work Quality and Preference Analyses Interest and Quality of Work Performance Interest Time Missed Mean Autism Std. Error Autism n Autism Mean Control Std. Error Control n Control 8.375 13.500 3.250 .225 .766 1.268 8 8 8 8.750 15.850 4.375 .202 .685 1.134 10 10 10 Time missed. A repeated measures analysis was conducted to identify the difference between the Autism group (n = 8) and the control group (n = 10) on the number of hours that were missed from work per month. Participants' hours missed were analysed using a 2 between (group) X 2 within (gender) repeated measures ANOVA, with gender as the within subject factor (Tabachnick & Fidell, 2001). The results of the ANOVA indicated that there was not a significant effect for time missed, thus hypothesis nine was rejected. (See Table 4 and 5 for the F andp statistics, as well as Table 9 for the means and standard error scores for the time missed analysis.) 54 Chapter 4: Discussion Research on ASD and parental outcomes has shown many different and informative results, however, most of this research is of a qualitative nature, with very little quantitative research comparing parents of disabled children to parents of children without disabilities (for example, Warfield, 2001). Similarly, researchers have not yet attempted to draw a connection between ASD, parental stress and work outcomes, using a control group. In order to clarify and expand on the research in these areas, the present study attempted to identify a relationship between raising a child with ASD and parental coping ability, parental mental health, satisfaction and work outcomes; in comparison to a control group of parents with no disabled children. In order to better understand the impacts of raising a child with ASD, it is important to identify how these factors are related for parents of children with ASD, in comparison to parents of typical children. Overall Limitations The overall limitations of this study fall within four categories. First, due to the relatively low frequency of ASD in the population, the overall sample size was fairly low for a multivariate study with the current number of dependant variables being analysed. The result of the low sample size was decreased power during the analysis. In order to compensate for this low power, follow-up analyses were conducted with a significance level of .05, allowing for the exploration of results that would not have otherwise been significant (for example, the mental health followup analyses and the job satisfaction follow-up analyses). In addition, this low power likely resulted in the life satisfaction analyses showing a non-significant group difference, where more power may have shown a significant group difference. 55 Second, this study did not specifically assess the severity or characteristics of the children with ASD. ASD can manifest itself in many different ways, with many different symptoms (APA, 2000), thus it is possible that differing ASD profiles between the children of the participants may have impacted how the ASD affects their life and work outcomes. For example, if some of the ASD children were higher functioning with few behavioural problems, the parent's answers on the assessment questionnaires may have been drastically different from the answers of parents whose ASD child is lower functioning and has many behavioural problems. A questionnaire specifically addressing the severity of ASD may have helped to clarify some of the results (as discussed above). Third, parental coping strategies may play a large role in many of the factors investigated in this study. However, the present study did not specifically measure the coping strategies that parents with ASD use. Measurement of specific coping strategies may have lead to clarification on the reason that many of the analyses showed the results that they did (for example, the relationship between the coping strategies that parents of ASD children use and their level of coping ability). Fourth, this study used self report questionnaires, which may have altered the expression of parents' attitudes and opinions. For example, the participants were limited to the questions and response options provided by the researcher as based upon a set of pre-determined hypotheses. Participants were unable to provide additional information that may have altered the researcher's view of their scores. Although it should be noted that there is a difference between what people say they do and what they actually do (Craig, & Dunn, 2007), self report questionnaires have been found to be one of the most reliable and replicable forms of data collection (Lunsford & Lunsford, 1995). All of the self report questionnaires used in this research were selected because 56 they have demonstrated good reliability scores and have been shown to accurately measure the constructs that this research has set out to examine. Coping Coping Ability Contrary to the hypothesis that parents of children with ASD will have higher levels of coping ability than will parents of children without ASD, this study has found that the parents of children with ASD do not show a significant difference in coping ability. Specifically, it appears as though the coping ability of parents with children with ASD does not differ from that of parents with typical children, which may be indicative of a difference in coping strategies used by parents of children with ASD and other parents. Although this finding does not support the present hypothesis, there is research that supports what the current results suggest. For example, Mastroyannopoulou et al. (1997) found that parents of children with a life threatening illness felt that they did not cope well with their child having a disability. Similarly, for parents with children with ASD, coping may be subjective. For example, the extra stress that parents of children with ASD are experiencing may translate into a lower level of coping ability, given their coping strategies, than these parents would experience at lower levels of stress. Research has shown that parents of children with ASD may be using different coping strategies than those used by other parents (Rodrigue et al., 1990). However, these strategies may not result in a better coping ability than parents of typical children because the coping strategies may be insufficient to overcome the level of stress that these parents experience. This study did not look at the specific coping strategies that the parents used, thus it is not possible to draw a direct connection between coping strategies used and coping ability. Previous research has only investigated what types of coping strategies parents of children with disabilities use (for 57 example, Shapp et al., 1992), but has not compared data to a control group consisting of parents of non-disabled children. It would be interesting for future research to look at this in more detail in a comparative study to identify exactly which coping strategies may play a role in affecting the overall coping ability of parents of children with ASD, as well as how effective parents believe their coping strategies are. This future research may be helpful in teaching parents more effective coping strategies so that they are better able to manage the stress and demands of raising a child with ASD. World Assumptions Contrary to the hypothesis that parents of ASD children will have more positive world assumptions than parents raising typical children, the present study demonstrated that the world assumptions of parents raising a child with ASD do not significantly differ from those of parents raising a typical child. One possible explanation for this finding centers on the parents' experiences both with and without their ASD child. It is possible that the parents of children with ASD are able to see the world as a whole, beyond their disabled child (for example, they are typically also raising non-disabled children and may have many nieces and nephews that are not disabled). Thus, they may believe that most children are healthy and overall the world is a positive place. Research has shown that parent's well-being can be affected by the coping style that the parent uses (Dunn et al., 2001). Positive world assumptions would include beliefs such as the world is a good place, people are basically good, we get what we deserve, and we do good things that control our outcomes. If the parents of children with ASD use coping strategies or defence mechanisms that allow them to rationalise (for example, believing that they were given a disabled child because they can handle it, or my child has a purpose), internalize (for example, raising a child with a disability makes me a better person), or if the parent's defence mechanism 58 biases him or her towards viewing the positive things in life (such as the number of non disabled children in the world, or the positive things their child does), the presence of the disability may not affect world assumptions. Therefore, the world perceptions of parents raising children with ASD would not be any different than those of other parents. As the present research did not look specifically at the coping strategies that parents used, it would be beneficial for future research to compare the specific coping strategies that parents of ASD children use to their world assumptions, in contrast to parents raising children without ASD; in order to see if there is a relationship. Mental Health and Stress Mental Health The third hypothesis proposed that parents of children with ASD would display poorer mental health than would parents raising typical children. The results of this study support this hypothesis; parents of children with ASD were found to have significantly higher levels of mental health issues than were parents of typical children. As children with ASD commonly have a variety of difficult behaviours (APA, 2000), this finding is in support of previous research that has shown that both increased behavioural problems and raising a child with ASD are related to decreased parental mental health (Bromley et al., 2004; Brown, 2002). The present study takes these results one step further to show the impact of raising a child with ASD on mental health by illustrating the difference in mental health between parents raising children with ASD and parents raising typical children. Specifically, parents of children with ASD experienced more paranoia than did parents of typical children. This paranoia may be rooted in a constant sense of worry that parents of children with ASD likely experience. For example, the increased unpredictability and potential for violence involved in raising a child with ASD, likely 59 results in a heightened sense of caution and worry in the parents. These parents likely spend a great deal of time worrying about when or what will trigger the next behavioural outburst. Furthermore, parents of children with ASD reported experiencing more obsessive-compulsive tendencies. Parents raising a child with ASD, especially if that child is demonstrating aggressive behaviours, may develop these obsessive-compulsive tendencies, in part as a coping mechanism to help them deal with the chaotic life that comes with raising a child with ASD. For example, if parents find that they are always worrying about doing something that may trigger aggressive behaviour, they may learn ritualistic behaviour patterns that, when followed reduce the incidence of the aggressive behaviours and stress associated with the behaviours, thus reinforcing the ritualistic behavioural patterns. Parents of children with ASD also experience higher levels of hostility than do parents raising typical children. This increased level of hostility may also be a result of the increased difficulty in raising children with ASD, as well as the increased potential for behavioural problems. For example, Nakaya and Nakaya (2006) found that when mothers were stressed about their childcare arrangements and attributed their child's behaviour to aggression, the mothers were more likely to mistreat their child. Thus, it is possible that with increased stress, parents of children with ASD are attributing their child's behaviour to aggression towards the parents, resulting in an increased level of parental hostility. Parents of children with ASD also experience more interpersonal sensitivity than do parents of typical children. This increased level of interpersonal sensitivity may develop out of dysfunctional interactions with others in the community. For example, it is possible that these parents experience more ridicule or judgments from others (complete strangers and friends/family members), based on their child's inappropriate social behaviour. Parents raising a child with ASD have also been found to experience more social isolation and less social support 60 (Dunn et al., 2001). Increased critical evaluation by others and decreased level of support may then result in the parents becoming overly sensitive or concerned with how others perceive them. This in turn may also result in future misinterpretation of how others are reacting to them and their child, thus resulting in a higher level of interpersonal sensitivity. The current research is limited in that the severity or characteristics of each of the children with ASD was not assessed. The characteristics of children with ASD are important in understanding parental mental health because factors such as communication, self care skills and behavioural problems, which accompany different ASD children to differing degrees (APA, 2000), have been found to affect parental well being (for example, Bromley et al., 2004). Thus, future research should be conducted to further investigate the relationship between raising children with ASD and parental mental health. Specifically, this research should look at the severity and characteristics of children with ASD, as well as parents' mental health, in comparison to parents of typical children. This may help to clarify the impact of raising a child with ASD on a parent's mental health, and illustrate how the specific characteristics of ASD impact different areas of mental health (such as hostility, obsessive compulsive behaviour, interpersonal sensitivity, and paranoia). A better understanding of these dynamics may help to develop counselling strategies aimed at helping parents cope with the stressors they experience while raising a child with ASD. Parental Stress As hypothesized, parents of children with ASD showed significantly more child related stress than didparents of typical children. The mean difference between the groups, demonstrated that parents of children with ASD experienced drastically more stress than did the parents of typical children. This finding supports previous research that has shown that parents 61 raising children with a disability experience increased stress (for example, Quine & Pahl, 1991), as well as Beck et al.'s (2004) research showing that parents of children with ASD experience increased stress. The current research expands on previous research by illustrating the dramatic difference in stress experienced by parents raising an ASD child as compared to parents raising a typical child. This difference between parental groups is not surprising given the increased behavioural problems, communication difficulties, and decreased self care skills that accompany ASD (APA, 2000). Previous research has illustrated that increased behavioural problems as well as poor communication skills can result in increased levels of parental stress (Beck et al., 1989; Freyetal, 1989). One interesting finding about parental stress was that the parents with children with ASD scored higher than did the parents with typical children on the Defensive Responding scale. In general, scores such as this, on the PSI-SF have been believed to suggest one of three things (Abidin, 1990). First, the parents raising typical children were attempting to portray themselves as being stress free, and therefore competent. Second, the parents raising a child with ASD were trying to portray themselves as having more parental stress than they actually experience, and therefore deserving of empathy. Third, parents raising children with ASD actually experience drastically more parental stress than do other parents. Given that the participants were unaware of the hypothesis of this study and they completed the PSI-SF in a confidential manner, as well as considering the mean differences on the remaining PSI-SF scales, the third explanation appears to be the most likely. Thus, participant scores on the PSF-SF scales were taken to be an accurate portrayal of their level of parental stress at the time they took part in the study. The parents' scores on the remaining PSI-SF scales clearly show the impact of raising a child with ASD on a parents' overall level of stress. First, parents of children with ASD were 62 found to have higher levels of parental distress than were parents raising a typical child. This indicates that the parents of an ASD child are experiencing an impaired sense of parenting competence, restriction on their life roles, and a lack of social support (Abidin, 1990). This is likely very common for parents raising children with ASD because inappropriate behaviours and other difficulties would affect the roles in which the parent is able to participate. Similarly, the difficulty that parents have teaching children with ASD appropriate behaviours, social rules, communication and self care skills would likely result in an impaired sense of parenting competence because the parent may believe that a good parent would be able to teach their child such skills. Second, the parents' scores on the Parent-Child Dysfunctional Interaction scale indicated that parents raising a child with ASD experienced more dysfunctional interactions than did parents raising typical children. This may indicate that parents raising an ASD child perceive that their child does not meet their expectations, they feel they are being abused by their child and or their interactions with their child are not reinforcing as a parent (Abidin, 1990). The characteristics of ASD likely help to explain why the parents scored so high on this scale. For example, the difficulties that children with ASD have when learning new skills and behaviours could make it very difficult for that child to successfully complete the tasks and activities that the parents expect of their child (such as, playing sports or doing chores), as well as achieving the goals that the parents have for their child (such as, going to university). The parents may then feel that their child is not meeting their expectations. Similarly, if a child exhibits inappropriate or violent behaviours (especially if those behaviours are acted out towards the parents), paired with the lack of emotional reciprocity that is common in children with ASD (APA, 2000), the 63 parents may feel that their child abuses and rejects them. Thus, the parents will be experiencing higher levels of parent child dysfunctional interactions. Third, the scores of the parents on the Difficult Child Scale indicate that parents raising an ASD child perceive their child as being more difficult to raise than do parents with typical children. This means that the parents view that they have difficulty managing behaviour, setting limits, and getting their child to cooperate with them (Abidin, 1990). Children with ASD have been found to display more inappropriate and aggressive behaviours (APA, 2000; Bromley et al., 2004); they are also more difficult to manage and keep occupied (Quine & Pahl, 1991). Increased behavioural problems, difficulty managing and occupying their child very likely can explain the parents scoring their ASD child as being more difficult because these factors could reasonably be expected to increase the parent's difficulty in setting limits and receiving cooperation. For example, a child that is experiencing a tantrum and displaying inappropriate behaviours would not likely follow directions. In order to fully understand why parents raising ASD children scored higher on assessments measuring parental distress, dysfunctional interactions, and difficult child, further research needs to be conducted. As discussed earlier, the present study did not consider the severity or characteristics of the ASD children. To get a better understanding of the influences of ASD on a parents' level of stress, future research needs to compare the severity and characteristics of ASD to the scores on the PSI-SF in relation to parents raising typical children. This research may help to clarify the roll that characteristics like behavioural problems, communication problems, and difficulty occupying have on factors such as parental distress, parent child interactions, and a parents' perception of their child as a difficult child. 64 Satisfaction Marital Satisfaction This research has shown that contrary to the hypothesis that parents of children with ASD will experience lower marital satisfaction than will parents of typical children; the marital satisfaction of parents of children with ASD was not significantly different from that of parents raising typical children. This finding is contradictory to previous research which has shown that parents of children with disabilities viewed their spousal relationship as more negative (Mastroyannopoulou et al., 1997) and that their marital satisfaction decreased over time (Freidrich et al., 1985). However, the findings of this study do support research conducted by Rodrigue et al., (1990), which found that families with children with ASD, although they have lower family adaptability than fdo amilies with children with other disabilities or no disabilities, they also have higher family cohesion. Rodrigue et al.'s research has also shown that for families raising children with ASD, their level of cohesion and adaptability falls within the normal range of a healthy family. Thus, one explanation for the difference between the results of this research and that of previous research may have to do with the impact of coping ability and stress on spousal cohesion. For example, it may be that because parents of children with ASD experience increased stress over other parents, they may also have increased stress over the parents of children with other disabilities due to increased behaviours and difficulty caring for their child. This increased number of stress in parents of children with ASD, as well as the increased level of demands on the parents, may cause them to rely on each other as a respite or debriefing opportunities in order to cope with the stress and demands. This increased reliance or cohesion, may then build a strengthened bond and marital relationship. 65 Furthermore, it is very likely that the differing results of the present study and that of Freidrich et al. (1985) and Mastroyannopoulou et al.'s (1997) work is based on the design of the research. Specifically, neither of the previous studies involved a direct comparison to a control group of families without children with disabilities. It is possible that although parents of children with disabilities may view their spousal relationship as more negative, this view does not differ from that of how parents of typical children view their spousal relationship. Similarly, it is possible that the marital satisfaction of typical parents decreases over time in a similar manner to that of parents of children with disabilities. Further research is needed in this area in order to directly compare the level of marital satisfaction and rate of marital satisfaction decline, over time, between parents of children with disabilities and parents of typical children. This future research could help to clarify the reasons why the marital satisfaction of parents of children with ASD does not differ from that of parents raising typical children. It would also be beneficial for future research to investigate the relationship between level of stress and demands, marital satisfaction, parental cohesion, and coping strategies, between parents of children with ASD and parents of children with other disabilities. This research would help to clarify whether increased stress and demands associated with ASD result in parents increasing their reliance on each other, as well as how this would affect marital satisfaction. Similarly, future research could also look at the difference between married and divorced or separated parents of children with ASD in relation to their coping strategies, level of stress, characteristics of the child, etc. This research would help to identify what specific factors affect marital satisfaction and parents taking the step to separate from one another. The current study did not specifically measure the length of time that each of the parents had been married, nor did it assess the influence of parental relationship on marital satisfaction. 66 It is possible that the length of marriage may have impacted the marital satisfaction of the parents because marital satisfaction has been shown to decrease over time (Freidrich et al., 1985). In addition, whether the primary caregiver married before or after the child with ASD was born is important information. For example, a stepfather coming into a family where an ASD child is already present may be better able to cope with stress and support his partner. Future research in this area should take into account the length of time the parents in each family have been married and when their relationship began if one of the parents is not the ASD child's biological parent. Job Satisfaction The sixth hypothesis proposed that parents of children with ASD would have a higher level of job satisfaction than would parents raising a typical child. Although this study has shown that there is a significant difference in the level of job satisfaction between parents of children with ASD and parents of typical children, the results indicate that the job satisfaction of parents of children with ASD is significantly lower than that of parents raising typical children. Follow-up analysis on this relationship showed that parents of children with ASD felt less overall satisfaction and were less content at their job. These parents were also less satisfied with their supervisor, however their satisfaction with other workplace relationships was no different than that of parents raising typical children. It is possible that the parents view their relationship with their supervisor as a superior/subordinate relationship and therefore part of the overall job satisfaction, whereas their relationship with co-workers is more of a peer relationship and is therefore considered social. The findings for this hypothesis are contrary to what would be expected based on the findings of previous research, where parents of children with disabilities reported that having a disabled child had a positive influence on their work and that they felt their work was a respite 67 from the demands of raising their disabled child (Freedman et al., 1995). The likely reason for the difference in findings between this study and Freedman et al.'s research is the research design. Specifically, Freedman et al.'s findings are qualitative findings based on focus group statements, whereas this study's results are quantitative findings based on a direct comparison between families with an ASD child and families with typical children. It is possible that parents feel and believe that they work harder and are more satisfied with their jobs, however, when compared to other parents, that level of satisfaction is actually lower. In order to help clarify this connection, future research should do a direct comparison between the perceived job performance and actual job performance and contrast that with control parents who are raising children without any disability. This research would help identify whether the perceived job performance of parents with ASD children is consistent with their actual job performance, as well as showing how that job performance relates to other parents. Further explanation of why parents of children with ASD may experience lower job satisfaction stems from the possible work/family role conflicts that they experience. Specifically, work/family role conflict occurs whenever the role pressures of work and family life are partially incompatible, and by participating in one role, the person's participation in the other role is compromised (Goff, Mount & Jamison, 1990). Thus, any time the stress and demands in the home of the parents with an ASD child increase there should be an increase in the parents work/family role conflict, thus compromising the parents' work satisfaction despite the parents' view that their work is a respite and that they work harder to make up for accommodation they require (Freedman et al, 1995). It would be interesting for future research to investigate the relationship between work/family role conflict and perceived job satisfaction. This research may help to determine whether work/family role conflict affects job satisfaction. 68 This future research could then look at the characteristics associated with raising children with ASD that affect work/home role conflict (such as child care arrangements) to identify the impact of these factors on job satisfaction. This research would hopefully help to identify strategies that can be used to reduce work/home role conflict and improve the overall job satisfaction of people raising children with ASD. Finally, this research has suggested that parents of children with ASD may be less satisfied than other parents with their job overall; however, their satisfaction with the social relationships at their job is no different than that of parents with a typical child. A possible explanation for the reason why parents of children with ASD appear equally satisfied with social relationships at work may come from previous research that has shown that parents of children with ASD are more socially isolated and have less social support (Dunn et al., 2001). Given the lack of support and social interaction in the lives of parents with an ASD child, they may welcome the opportunity to interact with other parents, to debrief, and to fit in with other peers that they share interests with, as well as to have an identity that is separate from being the parent of an ASD child. An interesting area for future research to investigate would include the relationship between the level of social isolation and social support of parents with an ASD child and their level of satisfaction with peer relationships in the workplace. This research would help to clarify whether satisfaction with peer relationships in the workplace is impacted by social isolation and lack of social support. Life Satisfaction Contrary to the seventh hypothesis that proposed that parents of children with ASD would experience lower levels of life satisfaction than would parents raising typical children, the present study did not show any significant difference in life satisfaction between parents of ASD 69 children and parents of typical children. This result is unexpected given previous research that has shown that raising a child with a disability can affect a father's satisfaction with life (Frey et al., 1989; Sloper et al., 1991). It is possible that parents of children with ASD continue to be satisfied with their lives because of the sense of pride they feel for the love and effort they put into raising their child. Instead of viewing their situation as one of dismay, they are able to see the good that they are doing; therefore, having a child with ASD does not affect their satisfaction with life. This idea has been supported in research by East, Weisner, and Reyes (2006) who found that youth raising a sibling's child experienced greater satisfaction with life, despite their increased levels of stress. This effect helps to show the importance of attitude in overcoming negative experiences (Patterson & Watkins, 1996). This study did not specifically look at the coping strategies that parents used, thus further research is needed to identify any relationship that may be present between parents' coping strategies, their life views (for example, religion), and their satisfaction with life. Findings from this future research may help to clarify if parents use coping strategies that minimalize the stressors in order to allow them to take pride in their accomplishments. Work Quality and Performance Interest and Quality of Work Contrary to the eighth hypothesis, which proposed that parents of children with ASD would show higher interest in and quality of work than would parents raising typical children, the results of this study suggested that there is no difference in the interest in and quality of work between parents of children with ASD and parents of typical children. Although this finding is not in support of the hypothesis, it does support previous research that indicated that mothers feel that their disabled child affects their ability to do their job (Mastroyannopoulou et al., 1997). 70 Furthermore, previous research has found that work quality is not related to amount of parental stress (Warfield, 2001), thus parents viewing work as a respite from the increased stress and demands of raising a disabled child should not have any influence on work quality. For example, if parents raising a child with ASD experiences a very high level of stress at home, they may find any escape from home as a respite, despite how interested they are in that activity. In this regard, parents of a child with ASD may find their work to be a respite, but they do not have a high level of interest in that job. The same research that identified work as a respite also indicated that parents feel that they work harder in order to make up for the accommodations they require to care for their disabled child (Freedman et al., 1995). The difference between the results of Freedman et al.'s study and the present research may be due to a difference in the perceived versus actual job performance of parents. As discussed above, the findings described in Freedman et al.'s research were based on qualitative descriptions of the participants' beliefs. The present study used quantitative methods to analyse work interest and self perceived quality of work by comparing parents of children with ASD to parents of typical children. Thus, it is likely that parents of children with ASD do feel that their work is a respite and they work hard, but when these perceptions are compared to parents with typical children, they do not differ. In order to help clarify the relationship between respite and work interest, future research should be conducted to compare parents' perception of an activity as respite (from their disabled child) to their interest in that activity. Time Missed The ninth hypothesis in this study proposed that parents raising an ASD child would miss more time from work than would parents raising a typical child, due to family and health issues. Contrary to this hypothesis, the current study suggested that parents of an ASD child and parents 71 of typical children miss about the same amount of work. This finding is contrary to previous research that shows that increased parental stress results in more absenteeism (Warfield, 2001). Parents of children with ASD experienced significantly more parental stress than did parents raising typical children, so it was expected that this study would also show that the parents of ASD children would have more absenteeism. One potential explanation for this finding comes out of Freedman et al.'s (1995) results showing that parents view work as a respite away from their disabled child. The parents of children with ASD experience high levels of parental stress. It is possible that as this stress increases, the parents want more respite away from their ASD child. If this respite comes in the form of work outside of the home, then as parental stress increases, absenteeism would decrease. Further research is needed in this area in order to clarify the differing results between Freedman et al.'s study and the current research. It is recommended that future research examine the relationship between parental stress, need for respite, perception of work as a respite, and absenteeism. Summary Contributions to the Literature Overall, the present research has added to the literature by making a comparative connection between the coping ability, stress, mental health and work outcomes of parents of children with ASD and parents of typical children. Specifically, this study has found that parents of children with ASD experience a great deal more parental stress; they have no better coping ability; no more positive world assumptions, marital satisfaction, life satisfaction, interest or higher quality of work, or absenteeism; and they have poorer mental health and job satisfaction than do parents of typical children. Taken together, these findings paint an overall picture 72 suggesting that parents raising a child with ASD experience high levels of stress and more mental health problems. Similarly, this research supports the idea that parents of children with ASD may use work as a respite from the high levels of stress that they experience at home, resulting in less absenteeism but no higher quality of work. Research in this area is important for parents of children with ASD because the findings of this research can help to improve services in several areas. First, the research explaining the relationship between raising children with ASD, high levels of parental stress, and mental health problems is continuing to grow. As this relationship becomes clearer, it is possible to justify increasing services such as respite, behavioural support, job and skill training, counselling, and support groups to help reduce the level of stress that parents of ASD children experience. Second, research such as the present study helps to develop the knowledge of how coping ability and strategies impact parents with ASD children. This research will help mental health professionals to develop better supports and counselling methods that can be employed to help parents cope with the level of stress that they are experiencing. Third, as the relationship between a child's behaviour and characteristics as well as parental stress and mental health are better understood, mental health practitioners will be better able to develop strategies to help reduce the mental health impacts of raising a child with ASD. When parents are better able to cope with stress and improve mental health, they will hopefully be better able to work with their ASD child and help that child to learn the skills that ho or she needs to live in the most independent manner possible. Fourth, the research base describing the impact of raising a child with ASD on employment is currently very small. As more research is conducted in this area, the impact of raising a child with ASD on work outcomes will become clearer. It will then be possible for disability management professionals to help organisations to develop programs to 73 help accommodate parents of children with ASD when they require time off, flexible work schedules, or even help coping with the increased stress they experience at home. This study was the first to specifically compare parents of ASD children to parents of typical children in looking at the relationship between ASD, parental stress and its impact on mental health, and work outcomes. Similarly, no previous research with parents of children with ASD has looked at the relationship between world assumptions and parental coping ability. This was also the first study to specifically look at parents of children with ASD and work outcomes without including other disabilities. However, further research is necessary in order to better understand the relationships between these factors. Areas of Future Research As mentioned above, the current research incorporated a significance level of .05 on all follow-up analyses in order to compensate for low power. As a result, all results presented in this study should be considered with caution until future research is conducted that shows support for these findings. Thus, it is highly recommended that future research ensure that sample size is adequate to have the power to identify any significant group differences that do exist. This could be accomplished by using ASD organisations in several similar communities or one larger community where the ASD population is higher. Similarly, a research design that helps to minimize time constraints on the collection of data will allow for the recruitment of more participants. As discussed earlier in this document, this study did not take into account the functional level or characteristics of the ASD children, whose parents were assessed. Future research should incorporate measures to identify the functional level of each child as well as a complete functional skill assessment. These variables could then be incorporated into the research in order 74 to identify their relation to parental mental health, coping satisfaction, and employment outcomes. As discussed above, one important limitation of the current research is that it did not analyse the specific coping strategies that parents of children with ASD use. However the results of this study have suggested that parental coping strategy is an important factor in fully understanding the relationship between raising a child with ASD and parental coping ability, stress, mental health, satisfaction, and work outcomes. Thus, it is important that future research on any of these factors incorporate a measure looking at the specific coping strategies that parents use to cope with the stress of raising a child with ASD. 75 Chapter 5: Conclusion This study was conducted to examine the relationship between raising a child with an Autism Spectrum Disorder and parental coping ability, mental health, satisfaction with life, marital satisfaction, satisfaction with work, and work quality. A quasi experimental design using multivariate analyses of variance was used to compare parents of children with ASD to parents of typically developing children. The results of this study have shown several outcomes. First, the results have shown that parents of children with ASD do not have a significantly higher coping ability than do parents raising typical children. Second, parents of children with ASD were found not to differ significantly in their world assumptions than parents of typical children. Third, parents of children with ASD have been found to experience significantly more mental health problems than have parents of typical children. Fourth, the results showed that parents of children with ASD experience significantly more parental stress than do parents of typical children. Fifth, the results have shown that there is no significant difference in marital satisfaction between parents of ASD children and parents of typical children. Sixth, parents of children with ASD were found to significantly differ from parents of typical children in their level of job satisfaction, however, parents of children with ASD were found to experience lower job satisfaction than other parents. Seventh, parents of children with ASD were found not to differ significantly from parents of typical children in their level of satisfaction with life. Eighth, the results indicated that there was no significant difference in the interest and quality of work of parents between ASD children and parents of typical children. Ninth, the results indicated that parents of children with ASD did not miss significantly more work than did parents of typical children. 76 Although future research is needed to help refine and understand the results of this research, the current results help to show that raising children with ASD can have a dramatic impact on parental stress as well as overall mental health. The results of the present study suggest that because parents of children with ASD do not possess greater coping abilities, yet they experience more parental stress than do parents of typical children, they consequently develop more mental health issues. Future research in this area will help to refine the relationship between coping ability, parental stress, and mental health in parents of children with ASD. 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Mental Retardation, 39(4), 297. 81 Appendix Appendix A. Information Letter and Consent Form Date September 9,2008 Dear Sir or Madam: I am writing to tell you about a research project entitled "Parenting a child with Autistic Spectrum Disorder: Personal and work outcomes" that you may be interested in and to ask if you would consider participating. The intent of this project is to attempt to describe parents raising child with autistic spectrum disorder (ASD) regarding various types of personal and work experience. Consequently, your participation may have been requested as either a parent raising a child with ASD, or alternately as a control parent raising a child with no known disability. There are no known risks to participating in this study and the potential benefits include the opportunity to help provide more information about parents raising a child with a disability. Your participation in this phase of this project will involve one 60 minute time period during which we will ask you to complete several surveys that ask questions about yourself and your reactions to stress, etc. These questionnaires should not be viewed as a "test". I am simply interested in overall perceptions or views. All information that you provide is held in strict confidence. Only the researchers who are involved in this project will ever have access to your completed surveys, which will be kept in a locked and secure place at the University for a period of seven years after which time they will be shredded. Your names will be removed from all questionnaires and replaced with code numbers. Also, please be assured that once you volunteer to participate, you can still withdraw from the study at any time with no consequence, and any information collected from you will be withdrawn and shredded. At another time, I may contact you again to participate in the second phase of the project that will evaluate further aspects of your parenting experience. I will provide you with full details about this phase of the study at a later time. If you would like to participate in this project, please complete and return the attached informed consent sheet and feel free to keep this information letter for further reference. A copy of the final results can be attained, upon completion of the project, by contacting me directly. Thank you very much for your time and consideration. I look forward to hearing from you; if you have any further questions please contact me at watt(S>unbc.ca or 250 613-6955. If at any time, you have concerns about the research project, you may contact my supervisor Dr. Shannon Wagner (250 960-6320; wagners@unbc.ca) or the UNBC Office of Research (250 960-5820). Sincerely, Michael Watt Graduate Student Disability Management Program University of Northern British Columbia 82 Parenting a child with Autistic Spectrum Disorder: Personal and work outcomes Researcher: Michael Watt Research Participant Consent Form Do you understand that you have been asked to be in a research study? Has the attached information sheet been read to you? A copy must be given to you for you to keep. Do you understand the benefits and risks involved in participating in this research study? Do you understand that you are free to refuse to participate or to withdraw from the study at any time? You do not have to give a reason for your choice to withdraw Have you been able to ask questions and to discuss this research study? Have the issues of anonymity and confidentiality been explained to you? Yes Yes No No Yes No Yes No Yes Yes No No This research study was explained to me by: Print Name I agree to participate in this study: Signature of Research Participant Printed Name of Research Participant Date of Participant's Signature Signature of Witness Printed Name of Witness Date of Witness's Signature I believe that the person signing this form understands what is involved in the research study and voluntarily agrees to participate. Signature of Researcher Date of Researcher's Signature 83 Appendix B. Parental Demographic Survey Parental Demographic Survey Please answer the following question for our records. What is your gender? Male Female What is your marital status? Single (never married) Married or Common Law Separated Divorced Widowed What is your date of birth? Day Month Year What is your ethnicity? Aboriginal Asian Caucasian East Indian Other (please specify): What is your highest educational level completed? Elementary school (please specify grade completed): Secondary School (please specify grade completed): High School Diploma Trade/Technical School (please specify): Some College College Deploma (please specify): Some University University Degree (please specify): . Other (please specify): What is your occupation? How many hours per week do you work at your job? 84 Please list for each of your children: Name: Gender: Birth Date: Disability (in any): 85 Ethnicity: Relationship to Child's you (e.g., usual living biological child, situation step-child, (e.g., both adoptive child biological etc.) parents, biological mom and step-dad etc.) Appendix C. Emotional Intelligence Scale Directions: Each of the following items asks you about your emotions or reactions connected to emotions. After deciding whether the statement is generally true for you, use the 5-point scale to respond to the statement. Please circle the 1 if you strongly disagree that this is like you, the 2 if you somewhat disagree that this is like you, the 3 if you neither agree or disagree that this is like you, the 4 if you somewhat agree that this is like you, and the 5 if you strongly agree that this is like you. There are no right or wrong answers. Please give the response thai best describes you. 1. I know when to speak about my personal problems to others. 2. When I am faced with obstacles, I remember times I faced similar obstacles and overcame them. 3. I expect that I will do well at most things I try. 4. Other people find it easy to confide in me. 5. I find it hard to understand the non-verbal messages of other people. 6. Some of the major events of my life have led me to re-evaluate what is important 7. When my mood changes, I see new possibilities. 8. Emotions are one of the things that make my life worth living 9. I am aware of my emotions as I experience them. 2 3 4 5 10.1 expect good things to happen. 2 3 4 5 11.1 like to share my emotions with others. 2 3 4 5 12. When I experience a positive emotion, I know to make it last. 2 3 4 5 13.1 arrange events that others enjoy. 14.1 seek out activities that make me happy. 15.1 am aware of the non-verbal messages that I send to others. 86 16.1 present myself in a way that makes a good impression on others. 2 3 4 5 17. When I am in a positive mood, solving problems is easy for me. 2 3 4 5 18. By looking at their facial expressions, I recognize the emotions people are experiencing. 2 3 4 5 24.1 compliment others when they have done something well. 2 3 4 5 25.1 am aware of the non-verbal messages that other people send. 2 3 4 5 26. When another person tells me about an important event in his or her life, I almost feel as though I have experienced this event myself. 2 3 4 5 19.1 know why my emotions change. 20. When I am in a positive mood, I am able to come up with new ideas. 21.1 have control over my emotions. 22.1 easily recognize my emotions as I experience them. 23.1 motivate myself by imagining a good outcome to tasks I take on. 27. When I feel a change in emotions, I tend to come up with new ideas. 28. When I am faced with a challenge, I give up because I believe that I will fail. 29.1 know what other people are feeling just by looking at them. 30.1 help other people feel better when they are down. 31.1 use good moods to help myself keep trying in the face of obstacles. 87 32.1 can tell how people are feeling by listening to the tone of their voice. 1 33. It is difficult for me to understand why people feel the way they do. 1 2 2 3 4 5 3 4 5 Appendix D. Satisfaction with Life Scale Directions: Below are five statements with which you may agree or disagree. Using the 1-7 point scale, indicate your agreement or disagreement with each item by selecting the appropriate number. Please be open and honest in your responding Strongly disagree Disagree Slightly disagree Neither agree or disagree 1. In most ways my life is close to my ideal. 2. The conditions of my life are excellent. 3.1 am satisfied with my life. 4. So far I have gotten the important things I want in life. 5. If I could live my life over, I would change almost nothing. 89 Slightly agree Agree Strongly agree Appendix E. Rosenberg Self-Esteem Scale Directions: Please indicate the extent to which you agree or disagree with the following statements. There are no right or wrong answers. Please give the response that best describes how you feel. Strongly Agree Agree Disagree Strongly Disagree 0 1. I feel that I am a person of worth, at least on an equal plane with others. 0 ]I 2 3 2. I feel that I have a number of good qualities. 0 1L 2 3 3. All in all, I am inclined to feel that I am a failure. 0 1i 2 3 4. I am able to do things as well as most people. 0 1[ 2 3 5. I feel I do not have much to be proud of. 0 1[ 2 3 6. I take a positive attitude towards myself. 0 1I 2 3 7. On the whole, I am satisfied with myself. 0 1L 2 3 8. I wish I could have more respect for myself. 0 1I 2 3 9. I certainly feel useless at times. 0 1 2 3 10. At times I think that I am no good at all. 0 1 2 3 90 Appendix F. Proactive Coping Scale Directions: The following statements deal with reactions you may have to various situations. Indicate how true each of these statements is depending on how you feel about the situation. Do this by circling the most appropriate number. Not at all true Barely true 0 1 Completely true Somewhat true 1. I am a take-charge person. 2. I try to let things work out on their own. 0 2 3 3. After attaining a goal, I look for another, more challenging one. 0 2 3 4. I like challenges and beating the odds. 0 2 3 5. I visualize my dreams and try to achieve them. 0 2 3 6. Despite numerous setbacks, I usually succeed in getting what I want. 0 7. I try to pinpoint what I need to succeed. 0 2 3 8. I always try to find a way to work around obstacles; nothing really stops me. 0 2 3 9. I often see myself failing so I don't get my hopes up too high. 0 10. When I apply for a position, I imagine myself filling it. 11.1 turn obstacles into positive experiences. 0 2 3 12. If someone tells me I can't do something, you can be sure I will do it. 0 2 3 13. When I experience a problem, I take the initiative in resolving it. 91 14. When I have a problem, I usually see myself in a no-win situation. 0 92 1 2 3 Appendix G. World Assumptions Scale 1 = strongly disagree 2 = moderately disagree 3 = slightly disagree 4 = slightly agree 5 = moderately agiee 6 = strongly agree 1. Misfortune is least likely to strike worthy, decent people. 2 3 4 6 2 3 4 6 2 3 4 6 2 3 4 6 I often think I am no good at all. 2 3 4 6 There is more good than evil in the world. 2 3 4 6 10. I am basically a lucky person. 2 3 4 6 11. People's misfortunes result from mistakes they have made. 2 3 4 6 13. I usually behave in ways that are likely to maximize good results for me. 2 3 4 5 6 14. People will experience good fortune if they themselves are good. 2 3 4 5 6 15. Life is too full of uncertainties that are determined by chance. 2 3 4 5 6 2. People are naturally unfriendly and unkind. 3. Bad events are distributed to people at random. 4. 5. Human nature is basically good. The good things that happen in this world far outnumber the bad. 6. The course of our lives is largely determined by chance. 7. Generally, people get what they deserve in this world. 8. 9. 12. People don't really care what happens to the next person. 93 16. When I think about it, I consider myself to be very lucky. 17. I almost always make an effort to prevent bad things from happening to me. 18. I have a low opinion of myself. 19. By and large, good people get what they deserve in this world. 20. Through our actions we can prevent bad things from happening to us. 2 3 4 5 6 21. Looking at my life, I realize that chance events have worked out well for me. 2 3 4 5 6 22. If people took preventive actions, most misfortune could be avoided. 2 3 4 5 6 24. In general, life is mostly a gamble. 2 3 4 5 6 25. The world is a good place. 2 3 4 5 6 26. People are basically kind and helpful. 2 3 4 5 6 27. I usually behave so as to bring about the greatest good for me. 2 3 4 5 6 29. When bad things happen, it is typically because people have not taken the necessary actions to protect themselves. 2 3 4 5 6 30. If you look closely enough, you will see that the world is full of goodness. 2 3 4 5 6 3 1 . 1 have reason to be ashamed of my personal character. 2 3 4 5 6 23. I take the actions necessary to protect myself against misfortune. 28. I am very satisfied with the kind of person I am. 94 32. I am luckier than most people. 1 95 2 3 4 5 6 Appendix H. Locke-Wallace Marital Adjustment Test Directions: Check the dot on the line below which best describes the degree of happiness, everything considered, of your present marriage (spousal relationship). The middle point "happy" represents the degree of happiness, which most people get from marriage, and the scale gradually ranges on one side to those who are very unhappy in marriage, and on the other, to those who experience extreme joy in marriage. 1. happy very unhappy perfectly happy Directions: State the approximate extent of agreement or disagreement between you and your spouse on the following items. Please be sure to answer each question. Always agree Almost always agree 1 Occasionally disagree Frequently disagree Almost always disagree Always disagree 3 2. Handling family finances. 2 3 4 5 6 3. Matters of recreation. 2 3 4 5 6 4. Demonstrations of affection. 2 3 4 5 6 5. Friends. 2 3 4 5 6 6. Sex relations. 2 3 4 5 6 7. Conventionality (right, good, or proper conduct). 2 3 4 5 6 8. Philosophy of life. 9. Ways of dealing with in-laws. 96 Directions: For each of the following questions, check only one answer for each. 10. When disagreements arise, they usually result in: (a) husband giving in (b) wife giving in 11. Do you and your spouse engage in outside interests together? (a) All of them (b) some of them (c) very few of them (d) none of them 12. In leisure time, do you generally prefer: (a) to be "on the go" (b) to stay home Does your spouse generally prefer: (a) to be "on the go" (b) to stay home 13. Do you ever wish you had not married (a) frequently (b) occasionally (c) rarely (d) never 14. If you had your life to live over, do you think you would: (a) marry the same person (b) marry a different person (c) not marry at all 15. Do you confide in your spouse: (a) almost never (b) rarely (c) in most things (d) in everything 97 Appendix I. Job Satisfaction Survey Directions: Each of the following items asks you about how you feel about several aspects of your job. Please use the above scale to give the response thai best describes you. 1. I feel my job is an important part of the organization. 2. I feel confident that my supervisor will do his/her best to get me an answer if he/she doesn't know. 3. I believe that my workload is just about right. 4. I receive adequate support from other divisions. 5. The training that I receive is adequate for me to perform my job. 6. I feel that training requirements are reasonable. 7. Operations, training, prevention, and headquarters personnel feel like they work as one organization. 8. On duty time is available for self improvement. 2 3 4 9. My supervisor has earned my respect. 2 3 4 10.1 am not bored while on duty. 2 3 4 11.1 believe that I can make a difference. 2 3 4 12.1 am allowed to make the decisions needed to do my job. 13.1 feel that the recruit training program is adequate to produce quality workers. 14.1 feel that my supervisor is interested in my suggestions. 98 15. Communications flow up and down the chain of command. 16.1 feel that members from the other divisions do all they can to help me do my job. 17. Time on-site (in-station) is effectively planned and constructive. 2 3 4 18.1 receive good training for my position. 2 3 4 24.1 receive the support I need from my supervisor. 2 3 4 25.1 look forward to coming to work. 2 3 4 19. My job performance does make a difference in the community. 20.1 feel that my work is productive and not busy work. 21.1 receive adequate support from the Chief Officers. 22. Leaving town for up to two weeks for outside training is not a waste of my time. 23.1 feel that my supervisor adequately explains what is expected of me. 99 Appendix J. Employee Interest and Quality of Work Scale Parental Job Questionnaire Please complete this questionnaire only if you are currently employed outside of the home: What is your occupation: Number of years that you have been employed with your organization: years months Your employment status within your organization: full-time permanent part-time permanent ____ full-time temporary (or contract) part-time temporary (or contract) casual other (please specify) Are you required to work shift-work: yes (please describe)_ no Please provide the average number of hours that you miss monthly due to: illness family related other (please specify) Using the following scale please rate yourself at work on each of the dimensions listed below: 1 Very •': Poor CO / 2 Poor / _, Average , 4 Good , 5 Very Good ,....„., , //.