Study of Marital Satisfaction in Autistic Families

The aim of this study was to investigate the quality of marital relations and family performance in parents of children with autism in 110 different questions. In this test, the coefficient was examined on 10 scales in 8 items. 51 families with at least one child with autism in Iran was tested. To assess the quality of marital relationships, marital adjustment, and family functioning, all parents completed the AMSS (Afrooz Marital Satisfaction Scale) questionnaire. The study, which looked at families' satisfaction with autism, found that there was a significant relationship between the quality of marital relationships and mental health in families with children with autism, based on all our hypotheses. This study and other similar studies show that families need ongoing programs. These programs include identifying, finding solutions, and providing direct advice to families. In this program, we will see a reduction in stress and conflict among families with autism, a correct and thoughtful approach to family members, and people with autism. This program should be done in groups and separately in autism centers and other psychological and counseling offices.

Introduction

One on the most natural groups to meet the human needs is the family. We hear many definitions about the family every year, although they cannot still define all the points about a family for us. It is a word with different meanings. The first definition of “family” can be stated as “two or more people sharing their goals, who have long-term commitments and usually live in one place”.

Researchers have been conducting studies of psychological well-being in parents of children with Autism Spectrum Disorders (ASD) for decades, and have sought to identify ‘stressors’ associated with poor outcomes. Reports indicate more negative outcomes in parents of children with ASD compared to parents of typically developing children or those with intellectual disabilities without ASD [10]. Autism is one of the childhood disorders, which every year allocates many studies to itself in the field of psychology [5].

Autism spectrum disorders (ASD) are common lifelong neurodevelopmental conditions, characterized by qualitative impairments in social relation and interaction, engagement in rituals and routines, and hypo- or hyper-sensory sensitivities [7]. In the DSM-5, due to the difficulties of distinguishing between autism, Asperger's syndrome, rat syndrome, and disability in children, and introduced them all as "autism spectrum disorder" [9].

The previous ADDM Network ASD prevalence estimate was 16.8 per 1,000 (1 in 59) children aged 8 years in 2014 [1]. The most recent data from the disease control centers indicate that although autism spectrum disorder (ASD) can be diagnosed as early as two years of age [16] and the first concerns by parents are commonly reported between 18 and 24 months [20]. Perhaps most important because interventions to improve the functioning of children with ASD may be more effective with younger children [4]. The American Academy of Pediatrics continues to stand behind its recommendation to screen for ASD at 18 and 24 months [18].

There is an increasing psychological pressure on the parents during the diagnosis of autism spectrum disorders, which can lead to reactions such as mental disturbances [11]. It should be noted that this aggressive and nervous behavior of parents is a reaction to the inability of the child to show the functional aspects. These disabilities of the child are considered a kind of stress and the reaction of the parents to the child is an attempt to deal with this stress [19].

Family resilience is defined as ‘‘the positive behavioral patterns and functional competence that the individuals and the family unit demonstrate under stressful or adverse circumstances, which determine the family’s ability to recover by maintaining its integrity as a unit while insuring, and where necessary restoring, the well-being of family members and the family unit as a whole [14].

In this regard have shown that marital satisfaction is low in the parents with autistic children [12]. Also has shown that the parents of autistic children have a different and less marital satisfaction as compared to those with healthy children [13]. Parents of these children do not have enough time for their spouses, which further affects their relationships [3].

Hence, new studies should be carried out on the impact of this wide spectrum on the families. This requires that we look for different aspects and dimensions of marital relationships. In this respect, we can have more precise priorities for the autistic children. Therefore, this study was conducted to measure marital satisfaction in the families with children having autism disorder.

Population, sample, and method of sampling

This study considers random investigations. The present statistical population includes the families with autistic children in Isfahan/Iran during 2018-2019. The study was done involving 51 people in the available basis.

38 women and 13 men participated in this study. The age of the participants in this study is from 25 to 65 years old. All the information of the participants is confidentially available to the author of this study.

Tools

The present study was conducted to evaluate the marital satisfaction of parents using Afrooz Marital Satisfaction Questionnaire. This scale is a tool for measuring marital satisfaction, which was developed and normalized by Dr. Gholamali Afrooz in 2010.

Moreover, the reliability coefficient using the Cronbach's alpha for a short form was 0.947, which indicates the satisfactory reliability coefficient of Afrooz Marital Satisfaction Questionnaire. This questionnaire has 110 questions, which is prepared with the five-point Likert scale, from “entirely disagreed” to “entirely agreed” criteria.

This scale evaluates 10 factors in 8 items, which include: the desirability of the spouses, marital satisfaction, personal behaviors, social and relational behave, seniors, a problem-solving method, financial affairs, and economic issues, religious feelings and behaviors, parenting method, leisure time, interaction (verbal, visual, motor, behavioral). These indicators include:

1. Desire of spouses
2. Marital satisfaction
3. Personal behaviors
4. Communication and social behaviors
5. Problem-solving method
6. Financial affairs and economic activities
7. Sense and religious behavior
8. The method of parenting
9. Free time
10. Emotional interaction (verbal and visual).

The method of scoring the questionnaire is such that the articles of it have five options in the Likert scale considering “entirely agreed, = 4”, “agreed=3”, “agreed in some cases=2”, “disagreed=1”, and “entirely disagreed=0”. The total score of 110 questions is a general score and is interpreted as follows: The score above 55 is very good, 44 to 45 is moderate, 34 to 43 indicates tolerable, while 24 to 33 is unpleasant, and less than 24 is unbearable.

The questionnaire is primarily prepared and given quite randomly to the referring people through the advertisement in two autism centers, all of whom attended in a definite time in a definite day in a counselling center to answer the questions in 45 minutes, as was previously notified. Finally, the answers were analyzed by the Pearson correlation test.

Statistical population

The questionnaire was compiled to be given to the parents of children with autism. 51 people answered the questionnaire. The following table and graph depict the breakdown of participants in this research in terms of gender (Table 1). It can be observed that 75.5% of the respondents were mothers of autistic children and 24.5% of them were fathers of these children. Most of the people in this study were women.

Table 1

Abundant distribution of people's gender status

In Figure 1, you can see the age of the clients. 41.176 is the highest age in this chart.

The following table (Table 2) shows the breakdown of respondents in terms of age. It can be seen the participants are divided into four age groups and the frequency table is concluded. The highest percentage is in the age group of 45-35 years, indicating 44% of the respondents.

Frequency distribution of children's parent age

The following table (Table 3) is the distribution of respondents based on their education. 41.2% (the highest percentage) of the respondents had high school certificates and 25.5% had bachelor’s degrees.

Table 3

Abundant distribution of people's education

The relation between different variables of this research are defined and analysed in this section. The main variables of this study are the results of the mean of scaled variables obtained from questions are described in such a way that some issues are raised and the respondents have to answer the questions by choosing the appropriate option. The maximum score for each question is 4. Thus, the average value of each variable is obtained by Excel software and the tests were performed using SPSS software.

The variable "desirable evidence of the spouse" is derived from the 1 till 11 points.

1        My spouse and I understand each other in different situations of life

2        My spouse and I have tried to psychologically satisfy each other

3        My spouse is hopeful about our better future

4        My spouse knows about the present situation and decides accordingly

5        My spouse believes that prosperity is the sense of relief

6        My spouse does not feel superior to me

7        My spouse believes that couples are destined for each other

8        My spouse believes that the couple can pave the way for peace and happiness to each other

9        My spouse shows a positive feeling towards what I am interested in

10     My spouse helps me in my benevolent efforts

11     My spouse is interested in my personal and social progress

The second variable is “the satisfaction of spouse”, is derived from the 1 till 10 points:

1        I have good relationship with my spouse

2        I have a good and pleasant relationship with my spouse

3        I am wholeheartedly satisfied about marrying with my spouse

4        I have never felt lonely and strange after marrying with my spouse

5        The most pleasant moments of my life are the moments that I have with my spouse

6        I am satisfied with the sexual relations with my spouse

7        Similar to the relation of dress and body, the relationship between my spouse and me is warm, cosy, and comfortable

8        Apart from special cases, my spouse and I sleep together at the same time

9        My wife's behavior and characteristics are pleasant to me

10     My spouse believes that after God, the closest person to him/her is me

The third variable "Personal Behaviors" is derived from the 1 till 19 points:

1        My spouse knows my personality traits and respects them

2        I am satisfied with the personality traits of my spouse

3        My spouse believes that our goal of marriage is to achieve peace

4        My spouse and I never reveal each other’s secrets

5        My relationship with my spouse is based on honesty

6        In my opinion, my spouse is an optimistic person

7        My spouse is hopeful about our better future

8        I consider my spouse as a committed and faithful person

9        My spouse is amiable at home and always smiles

10     My spouse is a hard working person

11     My spouse has accepted the continuation of my studies and my working

12     My spouse tries to operate according to his/her desirable thought instead of advising

13     I am pleased with the way my spouse is dressed and adorned at home

14     My spouse does not get angry at home

15     My spouse is not a vagrant or a revenger

16     My spouse does not oblige me despite the many having efforts in life

17     My spouse is interested in helping me with the things he/she can do

18     When traveling, my spouse tries for me to enjoy myself

19     My spouse tries to maintain his/her adornment at home.

The fourth variable is “social relations as behaviors”, is derived from the 1 till 11 points:

1        My spouse tries to be the provide peaceful life for me

2        My spouse associates me with my relatives

3        My spouse treats with my family and relatives respectfully and kindly

4        My spouse is not sad and angry.

5        My spouse considers the family as the source of peace

6        Either in the presence of others or when we are only together, my spouse treats with me with respect

7        My spouse respects me and calls me “Mr./Mrs.”

8        My spouse has empathy with me in visiting the relatives

9        My spouse believes that we should have proper emotional relations with our children

10     Apart from necessary periods, my spouse never tells about the deficiencies of our life to others

11     My spouse talks well about me to his/her relatives

The fifth variable, i.e. “methods of solving the problems” is derived from the 1 till 8 points:

1        My spouse and I decide about the important issues of our married life

2        When we encounter the uninvited guests at home, we welcome them with pleasure and receive them with the available facilities

3        My spouse believes that we should try to provide peace and reconciliation between our relatives

4        In case of disagreements or different opinions, my spouse patiently wishes to solve the issue

5        In confronting with disasters, my spouse patiently thinks and acts about the appropriate approach

6        My spouse tries to attend local neighborhood contemplating meetings or parent and teachers’ association meetings

7        When we are simultaneously invited to two ceremonies or parties of the relatives or friends, my spouse tries to provide me with good advice to prevent future complaints

8        If others are bothering us, my spouse will resolve the issue before making a complaint and legal pursuance.

The sixth variable includes “financial and economic affairs”, is derived from the 1 till 9 points:

1        My spouse respects my opinion in selecting the residential place

2        My spouse thinks about being able to afford our living opportunities and not buying loans.

3        My spouse tries to save money for unforeseen expenses

4        My spouse saves and pays attention on life costs.

5        My spouse informs me about all his/her bank earnings and accounts.

6        My spouse is not concerned about luxurious life in the family

7        My spouse does not ask too much about my everyday spending

8        My spouse consults with me about my finances and the high costs of living

9        My spouse thinks about the benefits and expedience of our life when buying our home appliances

The seventh variable “religious feelings and behaviors” is derived from the 1 till 8 points:

1        My spouse and I have common sense and empathy in religious practices and sticking to our divine values

2        I am happy that my spouse is bound in doing the religious practices

3        My spouse relies on God at hard conditions

4        My spouse does not allow anyone to talk behind others’ backs

5        My spouse is satisfied in life and is not demand excessively

6        I do not see envy in my spouse

7        My spouse does not intend to have objections and complaints

8        My spouse maintains the valued limits in having contacts with stranger people

The last variable is “methods of educating the child”, is derived from the 1 till 8 points:

1        My spouse is a good example for developing the personality of our children

2        My spouse has empathy with me regarding upbringing and growing of children

3        My spouse believes that couples should first love each other and then think about having children

4        My spouse believes that the family is like a garden; the mother is the gardener and the father is the guard

5        My spouse believes that the best way of parenting is spousal education

6        My spouse has strong belief that the husband and wife are the main part of the family and the child is a gift of God

7        My spouse believes that the family is the best school for the spousal education

8        My spouse believes that we must have a good emotional relationship with our children

Results

In this section, it is dealt with the considered hypotheses.

Hypothesis 1: There is a significant relation between the proper spousal desirability evidences and satisfaction of the spouse.

Table 4

Correlation is significant between Evidences 2 & Spouse satisfaction 4

For this hypothesis, the Pearson correlation coefficient was used according to the type of variable. Since the p-value obtained is zero (less than 0.05), this relationship is significant. Also, the obtained correlation coefficient (0.882) indicates a strong correlation between these two variables.

Hypothesis 2: There is a significant relation between the proper spousal desirability evidences and personal behaviors.

Table 5

Correlation is significant between Evidences 2 & Personal behavior 5

Since P-value <0.05, then the second hypothesis is confirmed. This means that there is a meaningful relationship between the desirable evidence of the spouse and personal behaviors. The obtained correlation coefficient is 0.906 that shows the strength of this relationship.

Hypothesis 3: There is a significant relation between the social relations and the desirable evidence of the spouse.

Table 6

Correlation is significant between Evidences 2 & Social relations 6

Since the P-value obtained is zero and less than 0.05, the relationship between these two variables is also significant. The correlation coefficient between these two variables is 0.886.

Hypothesis 4: There is a significant relation between the desirable evidence of the spouse and problem-solving methods.

Table 7

Correlation is significant between Evidences 2 & Problem solving 7

Since P-value = 0 <0.05, the fourth hypothesis is confirmed. This indicates that there is a significant relationship between the desirable evidence of the wife and the problem-solving methods. The obtained correlation coefficient is 0.872, which shows the strength of this relationship, i.e. the stronger the methods of problem solving, the stronger will be the desirable evidences of the spouse.

Hypothesis 5: There is a significant relation between the desirable evidence of the spouse and financial and economic issues.

Table 8

Correlation is significant between Evidences 2 & Financial issues 8

Using the Pearson correlation test and considering that the P-value is zero (less than 0.05), this relationship is significant. Also, the obtained correlation coefficient (0.822) indicates a strong correlation between these two variables.

Hypothesis 6: There is a significant relation between the desirable evidence of the spouse and religious emotions and behavior.

Table 9

Correlation is significant between Evidences 2 & Religious issues 9

According to the following table, the obtained P-value is equal to zero (less than 0.05). Hence, this relationship is significant. Meanwhile, the correlation coefficient was found “0.663”.

Hypothesis 7: There is a significant relation between the desirable evidence of the spouse and methods of educating the children.

Table 10

Correlation is significant between Evidences 2 & Child education 10

According to the above hypotheses and the correlation coefficients obtained, the strongest relationship between the variable of the spouse's desirable evidence and the spouse's personal behaviors. The correlation coefficient "0.906" shows a strong relationship between these two variables.

Limitations

The problems such as finding a suitable population, the presence of fathers in this research, coordinating with the autism centers, and the required coordination for better implementation of this study can be considered as the limitations of this research.

Discussion

The present study was done in order to determine the marital satisfaction of parents in autistic children families. The results of this study show significant results on every 10 scales available in the test, which is consistent with the results of previous research. [15]. However, is not consistent with the findings with studies that have revealed gender differences in marital satisfaction, including the results [2].

Mothers usually apply more energy in dealing with the autistic child. They have emotionally less interaction with their husbands, and it seems to be the cause of their marital dissatisfaction. Mothers have a lot of self-sacrifice in relation to their autistic children, which may lead the parents to become further apart.

The results of [6] indicate that parents who concentrate on empathy and compassion regarding their autistic children have greater personal satisfaction in their lives, which suggests that changing parenting motivation may successfully confront with the stress of a child with autism.

Assessing the family strength indicates how a person believes the families can resist their lives and control the challenging events. Following a positive psychological approach, emphasizing the positive aspects of mental health [17] and identifying the positive elements that contribute to family flexibility, to a broader understanding of the effects of stressors [8].

Conclusion

Finally, we need to plan for families with children with autism to change their lifestyles and resolve marital conflicts. This study and other similar studies show that families need ongoing programs to grow their mental health and communicate effectively with each other. By examining the ten indicators considered, family issues can be addressed in the discussion of marital affairs and the treatment of children with autism.

First, by identifying problems in families and holding regular meetings and programs in autism centers and counseling with a direct approach to resolving marital conflicts and improving mental health in families with children with autism, to reduce some of the psychological damage. Action. Note that this is a cross-sectional study, but it is not generalizable.

1. Baio J. et al. Prevalence of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveillance Summaries, 2018, vol. 67, no. 6, pp. 1–23. DOI:10.15585/mmwr.ss6706a1
2. Brezsnyak M., Whisman M.A. Sexual desire and relationship functioning: The effects of marital satisfaction and power. Journal of Sex & Marital Therapy, 2004, vol. 30, no. 3, pp. 199–217. DOI:10.1080/00926230490262393
3. Brobst J.B., Clopton J.R., Hendrick S.S. Parenting children with autism spectrum disorders: The couple's relationship. Focus on Autism and Other Developmental Disabilities, 2009, vol. 24, no. 1, pp. 38–49. DOI:10.1177/1088357608323699
4. Christensen D.L. et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network, 11 sites, United States, 2012. MMWR Surveillance Summaries, 2018, vol. 65, no. 13, pp. 1–23. DOI:10.15585/mmwr.ss6513a1
5. Chugani D.C. et al. Efficacy of low-dose buspirone for restricted and repetitive behavior in young children with autism spectrum disorder: a randomized trial. The Journal of pediatrics, 2016, vol. 170, pp. 45–53.e4. DOI:10.1016/j.jpeds.2015.11.033
6. Conti R. Compassionate parenting as a key to satisfaction, efficacy and meaning among mothers of children with autism. Journal of autism and developmental disorders, 2015, vol. 45, no. 7, pp. 2008–2018. DOI:10.1007/s10803-015-2360-6
7. Diagnostic and statistical manual of mental disorders: DSM-5. 5th edition. Washington; London: Publ. American Psychiatric Publishing, 2013. ISBN 978-0-89042-554-1.
8. Dykens E.M. Toward a positive psychology of mental retardation. American journal of orthopsychiatry, 2006, vol. 76, no. 2, pp. 185–193. DOI:10.1037/0002-9432.76.2.185
9. Fung L.K., Hardan A.Y. Developing medications targeting glutamatergic dysfunction in autism: progress to date. CNS drugs, 2015, vol. 29, no. 6, pp. 453–463. DOI:10.1007/s40263-015-0252-0
10. Hartley S L. et al. Psychological well‐being in fathers of adolescents and young adults with Down Syndrome, Fragile X syndrome, and autism. Family relations, 2012, vol. 61, no. 2, pp. 327–342. DOI:10.1111/j.1741-3729.2011.00693.x
11. Kotsis K. et al. Psychological distress among parents having offspring with autism spectrum disorder: Authors' reply. Disability and health journal, 2014, vol. 7, no. 4, pp. 370–372. DOI:10.1016/j.dhjo.2014.05.008
12. Lawrence E. et al. Marital satisfaction across the transition to parenthood. Journal of family psychology, 2008, vol. 22, no. 1, pp. 41–50. DOI:10.1037/0893-3200.22.1.41
13. Lee G.K. Parents of children with high functioning autism: How well do they cope and adjust? Journal of developmental and physical disabilities, 2009, vol. 21, no. 2, pp. 93–114. DOI:10.1007/s10882-008-9128-2
14. McCubbin M.A., McCubbin H.I. Resiliency in families: A conceptual model of family adjustment and adaptation in response to stress and crises. In McCubbin H.I., Thompson A.I., McCubbin M.A. (eds.) Family assessment: Resiliency, coping and adaptation: Inventories for research and practice. Madison: Publ. University of Wisconsin, 1996. Pp. 1–64. ISBN 978-0-96393345-4.
15. Newsom, C. Autistic Disorder. In Mash E J., Barkley R.A. (eds.) Treatment of childhood disorders. 2nd edition. New York: Guilford Press, 1998. Pp. 416–467.
16. Ozonoff S., Heung K., Byrd R., Hansen R., Hertz‐Picciotto I. The onset of autism: patterns of symptom emergence in the first years of life. Autism research, 2008, vol. 1, no. 6, pp. 320–328.‏ DOI:10.1002/aur.53
17. Seligman M.E.P. et al. Positive psychology: An introduction. In Csikszentmihalyi M. Flow and the foundations of positive psychology. Dordrecht; Heidelberg; New York; London: Springer, 2014. Pp. 279–298. ISBN 978-94-017-9088-8.
18. The pediatrician's role in the diagnosis and management of autistic spectrum disorder in children / Committee on Children with Disabilities. Pediatrics, 2001, vol. 107, no. 5, pp. 1221–1226. DOI:10.1542/peds.107.5.1221
19. Tripathi N. Parenting style and parents level of stress having children with autistic spectrum disorder (CWASD): A study based on northern India. Neuropsychiatry (London), 2015, vol. 5, no. 1, pp. 42–49. DOI:10.4172/Neuropsychiatry.1000107
20. Zwaigenbaum L. et al. Early identification of autism spectrum disorder: recommendations for practice and research. Pediatrics, 2015, vol. 136, no. Supplement 1, pp. S10–S40. DOI:10.1542/peds.2014-3667C
21.