Physical Activity and Mental Health of Parents of Children With Autism Spectrum Disorder

in Adapted Physical Activity Quarterly

Click name to view affiliation

Xiaoxia Zhang Department of Kinesiology, Centenary College of Louisiana, Shreveport, LA, USA

Search for other papers by Xiaoxia Zhang in
Current site
Google Scholar
PubMed Close
https://orcid.org/0000-0001-5076-9035 *
,
Zackary G. Kern Department of Kinesiology, East Carolina University, Greenville, NC, USA

Search for other papers by Zackary G. Kern in
Current site
Google Scholar
PubMed Close
, and
Joonkoo Yun Department of Kinesiology, East Carolina University, Greenville, NC, USA

Search for other papers by Joonkoo Yun in
Current site
Google Scholar
PubMed Close
https://orcid.org/0000-0002-5144-7318
DOI:
https://doi.org/10.1123/apaq.2022-0175
Keywords:
anxiety; depression; strengthening physical activity; vigorous physical activity
First Published Online:
13 Mar 2023
In Print:
Ahead of Print
Page Range:
1–15
Restricted access

This study aimed to examine physical activity (PA) levels and mental health status (i.e., anxiety and depression) among parents of children with autism spectrum disorder (ASD). Secondary data analysis was conducted using the 2018 National Health Interview Survey. We identified 139 parents of children with ASD and 4,470 parents of children with no disability. Their PA levels, anxiety, and depression were analyzed. Compared with parents of children with no disability, parents of children with ASD were significantly less likely to meet the PA guideline for Americans and had lower odds of vigorous PA (aOR = 0.702), strengthening PA (aOR = 0.885), and light to moderate PA (aOR = 0.994). Parents of children with ASD reported significantly higher odds of anxiety (aOR = 1.559) and depression (aOR = 1.885). This study revealed lower PA levels and higher risks of anxiety and depression in parents of children with ASD.

  • Collapse
  • Expand

Adapted Physical Activity Quarterly

Cover Adapted Physical Activity Quarterly

  • Adamo, K.B., Langlois, K.A., Brett, K.E., & Colley, R.C. (2012). Young children and parental physical activity levels. American Journal of Preventive Medicine, 43(2), 168–175. https://doi.org/10.1016/j.amepre.2012.02.032

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Ainsworth, B.E. (2011). 2011 compendium of physical activities: A second update of codes and met values. Medicine & Science in Sports & Exercise, 43(8), 1575–1781. https://doi.org/10.1249/MSS.0b013e31821ece12

    • Search Google Scholar
    • Export Citation

  • Alhuzimi, T. (2021). Stress and emotional wellbeing of parents due to change in routine for children with autism spectrum disorder (ASD) at home during COVID-19 pandemic in Saudi Arabia. Research in Developmental Disabilities, 108, Article 103822. https://doi.org/10.1016/j.ridd.2020.103822

    • PubMed
    • Search Google Scholar
    • Export Citation

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.

    • Search Google Scholar
    • Export Citation

  • Armstrong, S., Wong, C.A., Perrin, E., Page, S., Sibley, L., & Skinner, A. (2018). Association of physical activity with income, race/ethnicity, and sex among adolescents and young adults in the United States. JAMA Pediatrics, 172(8), 732–740. https://doi.org/10.1001/jamapediatrics.2018.1273

    • Search Google Scholar
    • Export Citation

  • Ayvazoglu, N.R., Kozub, F.M., Butera, G., & Murray, M.J. (2015). Determinants and challenges in physical activity participation in families with children with high functioning autism spectrum disorders from a family systems perspective. Research in Developmental Disabilities, 47, 93–105. https://doi.org/10.1016/j.ridd.2015.08.015

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Benson, P.R., & Karlof, K.L. (2009). Anger, stress proliferation, and depressed mood among parents of children with ASD: A longitudinal replication. Journal of Autism and Developmental Disorders, 39(2), 350–362. https://doi.org/10.1007/s10803-008-0632-0

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Brody, D.J. (2018). Prevalence of depression among adults aged 20 and over: United States, 2013–2016. NCHS Data Brief, 303, 1–8.

  • Carlson, S.A., Densmore, D., Fulton, J.E., Yore, M.M., & Kohl, H.W. (2009). Differences in physical activity prevalence and trends from 3 United States Surveillance Systems: NHIS, NHANES, and BRFSS. Journal of Physical Activity and Health, 6(Suppl. 1), S18–S27. https://doi.org/10.1123/jpah.6.s1.s18

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Case, L., Ross, S., & Yun, J. (2020). Physical activity guideline compliance among a national sample of children with various developmental disabilities. Disability and Health Journal, 13(2), Article 100881. https://doi.org/10.1016/j.dhjo.2019.100881

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Centers for Disease Control and Prevention and U.S. Departmetn of Health and Human Services. (2018). 2018 National health interview survey description.

    • Search Google Scholar
    • Export Citation

  • Collins, P.Y., Pringle, B., Alexander, C., Darmstadt, G.L., Heymann, J., Huebner, G., Kutlesic, V., Polk, C., Sherr, L., Shih, A., Sretenov, D., & Zindel, M. (2017). Global services and support for children with developmental delays and disabilities: Bridging research and policy gaps. PLoS Medicine, 14(9), Article 1002393. https://doi.org/10.1371/journal.pmed.1002393

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Costa, A.P., Steffgen, G., & Ferring, D. (2017). Contributors to well-being and stress in parents of children with autism spectrum disorder. Research in Autism Spectrum Disorders, 37, 61–72. https://doi.org/10.1016/j.rasd.2017.01.007

    • Search Google Scholar
    • Export Citation

  • Daly, M., & Robinson, E. (2021). Anxiety reported by U.S. adults in 2019 and during the 2020 COVID-19 pandemic: Population-based evidence from two nationally representative samples. Journal of Affective Disorders, 286, 296–300. https://doi.org/10.1016/j.jad.2021.02.054

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Erickson, K.I., Hillman, C., Stillman, C.M., Ballard, R.M., Bloodgood, B., Conroy, D.E., Macko, R., Marquez, D.X., Petruzzello, S.J., & Powell, K.E. (2019). Physical activity, cognition, and brain outcomes: A review of the 2018 physical activity guidelines. Medicine & Science in Sports & Exercise, 51(6), 1242–1251. https://doi.org/10.1249/MSS.0000000000001936

    • Search Google Scholar
    • Export Citation

  • Galper, D.I., Trivedi, M.H., Barlow, C.E., Dunn, A.L., & Kampert, J.B. (2006). Inverse association between physical inactivity and mental health in men and women. Medicine & Science in Sports & Exercise, 38(1), 173–178. https://doi.org/10.1249/01.mss.0000180883.32116.28

    • Search Google Scholar
    • Export Citation

  • Haegele, J.A., Lee, J., & Chang, S.H. (2017). Physical activity of parents of children with autism spectrum disorder. International Journal of Disability, Development and Education, 64(4), 368–377. https://doi.org/10.1080/1034912X.2016.1232375

    • Search Google Scholar
    • Export Citation

  • Hamilton, K., & White, K.M. (2010). Understanding parental physical activity: Meanings, habits, and social role influence. Psychology of Sport and Exercise, 11(4), 275–285. https://doi.org/10.1016/j.psychsport.2010.02.006

    • Search Google Scholar
    • Export Citation

  • Healy, S., Marchand, G., & Williams, E. (2018). “I’m not in this alone” the perspective of parents mediating a physical activity intervention for their children with autism spectrum disorder. Research in Developmental Disabilities, 83, 160–167. https://doi.org/10.1016/j.ridd.2018.08.014

    • Search Google Scholar
    • Export Citation

  • Hickey, E.J., Nix, R.L., & Hartley, S.L. (2019). Family emotional climate and children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 49(8), 3244–3256. https://doi.org/10.1007/s10803-019-04037-6

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Jin, J., Agiovlasitis, S., & Yun, J. (2020). Predictors of perceived health in adults with an intellectual disability. Research in Developmental Disabilities, 101, Article 1036462. https://doi.org/10.1016/j.ridd.2020.103642

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Johnson, N.L., Bekhet, A.K., Sawdy, R., Zint, E., Wang, J., Pena, S., Zurcher, H., & Enea, N. (2022). Parent physical activity: A systematic review of the literature and recommendations for parents of children with autism spectrum disorder. Journal of Physical Activity and Health, 19(2), 132–147. https://doi.org/10.1123/jpah.2021-0438

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Jung, J., Leung, W., Schram, B.M., & Yun, J. (2018). Meta-analysis of physical activity levels in youth with and without disabilities. Adapted Physical Activity Quarterly, 35(4), 381–402. https://doi.org/10.1123/apaq.2017-0123

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Krakovich, T.M., McGrew, J.H., Yu, Y., & Ruble, L.A. (2016). Stress in parents of children with autism spectrum disorder: An exploration of demands and resources. Journal of Autism and Developmental Disorders, 46(6), 2042–2053. https://doi.org/10.1007/s10803-016-2728-2

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Ku, B., & Rhodes, R.E. (2020). Physical activity behaviors in parents of children with disabilities: A systematic review. Research in Developmental Disabilities, 107, Article 103787. https://doi.org/10.1016/j.ridd.2020.103787

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Ku, B., & Sung, M.-C. (2021). Physical activity among parents of children with disabilities: A systematic review. Journal of Family Issues, 43(8), 2134–2158. https://doi.org/10.1177/0192513X211030034

    • Search Google Scholar
    • Export Citation

  • Lai, W.W., Goh, T.J., Oei, T.P.S., & Sung, M. (2015). Coping and well-being in parents of children with autism spectrum disorders (ASD). Journal of Autism and Developmental Disorders, 45(8), 2582–2593. https://doi.org/10.1007/s10803-015-2430-9

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Lee, M.H., Park, C., Matthews, A.K., & Hsieh, K. (2017). Differences in physical health, and health behaviors between family caregivers of children with and without disabilities. Disability and Health Journal, 10(4), 565–570. https://doi.org/10.1016/j.dhjo.2017.03.007

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Ludlow, A., Skelly, C., & Rohleder, P. (2012). Challenges faced by parents of children diagnosed with autism spectrum disorder. Journal of Health Psychology, 17(5), 702–711. https://doi.org/10.1177/1359105311422955

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Maenner, M.J., Shaw, K.A., Bakian, A.V., Bilder, D.A., Durkin, M.S., Esler, A., . . . Cogswell, M.E. (2021). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2018. MMWR Surveillance Summaries, 70(11), 1–16. https://doi.org/10.15585/mmwr.ss7011a1

    • Search Google Scholar
    • Export Citation

  • Martland, R., Mondelli, V., Gaughran, F., & Stubbs, B. (2020). Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan. Journal of Sports Sciences, 38(4), 430–469. https://doi.org/10.1080/02640414.2019.1706829

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Matheson, B.E., Drahota, A., & Boutelle, K.N. (2019). A pilot study investigating the feasibility and acceptability of a parent-only behavioral weight-loss treatment for children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 49(11), 4488–4497. https://doi.org/10.1007/s10803-019-04178-8

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Meadan, H., Halle, J.W., & Ebata, A.T. (2010). Families with children who have autism spectrum disorders: Stress and support. Exceptional Children, 77(1), 7–36. https://doi.org/10.1177/001440291007700101

    • Search Google Scholar
    • Export Citation

  • Millstein, R.A., Lindly, O.J., Luberto, C.M., Perez, G.K., Schwartz, G.N., Kuhlthau, K., & Park, E.R. (2020). An exploration of health behaviors in a mind-body resilience intervention for parents of children with developmental disabilities. Journal of Developmental & Behavioral Pediatrics, 41(6), 480–485. https://doi.org/10.1097/DBP.0000000000000813

    • Search Google Scholar
    • Export Citation

  • Must, A., Phillips, S., Curtin, C., & Bandini, L.G. (2015). Barriers to physical activity in children with autism spectrum disorders: Relationship to physical activity and screen time. Journal of Physical Activity & Health, 12(4), 529–534. https://doi.org/10.1123/jpah.2013-0271

    • Search Google Scholar
    • Export Citation

  • Ou, J.-J., Shi, L.-J., Xun, G.-L., Chen, C., Wu, R.-R., Luo, X.-R., Zhang, F.-Y., & Zhao, J.-P. (2015). Employment and financial burden of families with preschool children diagnosed with autism spectrum disorders in urban China: Results from a descriptive study. BMC Psychiatry, 15, Article 3. https://doi.org/10.1186/s12888-015-0382-4

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Padden, C., & James, J.E. (2017). Stress among parents of children with and without autism spectrum disorder: A comparison involving physiological indicators and parent self-reports. Journal of Developmental and Physical Disabilities, 29(4), 567–586. https://doi.org/10.1007/s10882-017-9547-z

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Pan, C.-Y. (2014). Motor proficiency and physical fitness in adolescent males with and without autism spectrum disorders. Autism, 18(2), 156–165. https://doi.org/10.1177/1362361312458597

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Pavey, T.G., Peeters, G., Bauman, A.E., & Brown, W.J. (2013). Does vigorous physical activity provide additional benefits beyond those of moderate? Medicine & Science in Sports & Exercise, 45(10), 1948–1955. https://doi.org/10.1249/MSS.0b013e3182940b91

    • Search Google Scholar
    • Export Citation

  • Piercy, K.L., Troiano, R.P., Ballard, R.M., Carlson, S.A., Fulton, J.E., Galuska, D.A., George, S.M., & Olson, R.D. (2018). The physical activity guidelines for Americans. JAMA, 320(19), 2020–2028. https://doi.org/10.1001/jama.2018.14854

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Polfuss, M., Dobson, C., Sawin, K. J., & Klingbeil, C.G. (2019). The Influence of a Developmental Disability on the Child’s Weight-Related Behaviors: A Parent’s Perspective. Journal of Pediatric Nursing, 47, 121–130. https://doi.org/10.1016/j.pedn.2019.05.009

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Reiner, M., Niermann, C., Jekauc, D., & Woll, A. (2013). Long-term health benefits of physical activity – A systematic review of longitudinal studies. BMC Public Health, 13(1), Article 813. https://doi.org/10.1186/1471-2458-13-813

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Resch, J.A., Mireles, G., Benz, M.R., Grenwelge, C., Peterson, R., & Zhang, D. (2010). Giving parents a voice: A qualitative study of the challenges experienced by parents of children with disabilities. Rehabilitation Psychology, 55(2), 139–150. https://doi.org/10.1037/a0019473

    • Search Google Scholar
    • Export Citation

  • Rosenbaum, S., Tiedemann, A., Sherrington, C., Curtis, J., & Ward, P.B. (2014). Physical activity interventions for people with mental illness: A systematic review and meta-analysis. Journal of Science and Medicine in Sport, 18, Article 150. https://doi.org/10.1016/j.jsams.2014.11.161

    • Search Google Scholar
    • Export Citation

  • Ross, S.M., Smit, E., Yun, J., Bogart, K.R., Hatfield, B.E., & Logan, S.W. (2021). Exploring the interaction of disability status and childhood predictors of physical activity and sport participation: An exploratory decision-tree analysis. Adapted Physical Activity Quarterly, 38(2), 248–267. https://doi.org/10.1123/apaq.2020-0027

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Safe, A., Joosten, A., & Molineux, M. (2012). The experiences of mothers of children with autism: Managing multiple roles. Journal of Intellectual & Developmental Disability, 37(4), 294–302. https://doi.org/10.3109/13668250.2012.736614

    • Search Google Scholar
    • Export Citation

  • Siebert, E.A., Hamm, J., & Yun, J. (2017). Parental influence on physical activity of children with disabilities. International Journal of Disability, Development and Education, 64(4), 378–390. https://doi.org/10.1080/1034912X.2016.1245412

    • Search Google Scholar
    • Export Citation

  • Siu, Q.K.Y., Yi, H., Chan, R.C.H., Chio, F.H.N., Chan, D.F.Y., & Mak, W.W.S. (2019). The role of child problem behaviors in autism spectrum symptoms and parenting stress: A primary school-based study. Journal of Autism and Developmental Disorders, 49(3), 857–870. https://doi.org/10.1007/s10803-018-3791-7

    • Search Google Scholar
    • Export Citation

  • Skordilis, E.K. (2015). Quality of life, depression and involvement in physical activity of parents with disabled children in Greece. Retos, 27, 193–196. https://doi.org/10.47197/retos.v0i27.34376

    • Search Google Scholar
    • Export Citation

  • Smith, L.E., Hong, J., Seltzer, M.M., Greenberg, J.S., Almeida, D.M., & Bishop, S.L. (2010). Daily experiences among mothers of adolescents and adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 40(2), 167–178. https://doi.org/10.1007/s10803-009-0844-y

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Song, J., Mailick, M.R., & Greenberg, J.S. (2018). Health of parents of individuals with developmental disorders or mental health problems: Impacts of stigma. Social Science & Medicine, 217, 152–158. https://doi.org/10.1016/j.socscimed.2018.09.044

    • Search Google Scholar
    • Export Citation

  • Stanton, R., Happell, B., & Reaburn, P. (2014). The mental health benefits of regular physical activity, and its role in preventing future depressive illness. Nursing: Research and Reviews, 2014, 45–53. https://doi.org/10.2147/NRR.S41956

    • Search Google Scholar
    • Export Citation

  • Stavrinou, P.S., Bogdanis, G.C., Giannaki, C.D., Terzis, G., & Hadjicharalambous, M. (2018). High-intensity interval training frequency: Cardiometabolic effects and quality of life. International Journal of Sports Medicine, 39(3), 210–217. https://doi.org/10.1055/s-0043-125074

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Swain, D.P., & Franklin, B.A. (2006). Comparison of cardioprotective benefits of vigorous versus moderate intensity aerobic exercise. The American Journal of Cardiology, 97(1), 141–147. https://doi.org/10.1016/j.amjcard.2005.07.130

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Teychenne, M., Ball, K., & Salmon, J. (2008). Physical activity and likelihood of depression in adults: A review. Preventive Medicine, 46(5), 397–411. https://doi.org/10.1016/j.ypmed.2008.01.009

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Tonge, B., Brereton, A., Kiomall, M., Mackinnon, A., King, N., & Rinehart, N. (2006). Effects on parental mental health of an education and skills training program for parents of young children with autism: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 45(5), 561–569. https://doi.org/10.1097/01.chi.0000205701.48324.26

    • Search Google Scholar
    • Export Citation

  • van Dongen, E.V., Kersten, I.H.P., Wagner, I.C., Morris, R.G.M., & Fernández, G. (2016). Physical exercise performed four hours after learning improves memory retention and increases hippocampal pattern similarity during retrieval. Current Biology, 26(13), 1722–1727. https://doi.org/10.1016/j.cub.2016.04.071

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Weston, M., Taylor, K.L., Batterham, A.M., & Hopkins, W.G. (2014). Effects of low-volume high-intensity interval training (HIT) on fitness in adults: A meta-analysis of controlled and non-controlled trials. Sports Medicine, 44(7), 1005–1017. https://doi.org/10.1007/s40279-014-0180-z

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Willis, C., Nyquist, A., Jahnsen, R., Elliott, C., & Ullenhag, A. (2018). Enabling physical activity participation for children and youth with disabilities following a goal-directed, family-centred intervention. Research in Developmental Disabilities, 77, 30–39. https://doi.org/10.1016/j.ridd.2018.03.010

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Yao, C.A., & Rhodes, R.E. (2015). Parental correlates in child and adolescent physical activity: A meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 12(1), Article 10. https://doi.org/10.1186/s12966-015-0163-y

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Young, S., Shakespeare-Finch, J., & Obst, P. (2020). Raising a child with a disability: A one-year qualitative investigation of parent distress and personal growth. Disability & Society, 35(4), 629–653. https://doi.org/10.1080/09687599.2019.1649637

    • Search Google Scholar
    • Export Citation

  • Zampella, C.J., Wang, L.A.L., Haley, M., Hutchinson, A.G., & de Marchena, A. (2021). Motor skill differences in autism spectrum disorder: A clinically focused review. Current Psychiatry Reports, 23(10), Article 64. https://doi.org/10.1007/s11920-021-01280-6

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Zhao, G., Ford, E.S., Dhingra, S., Li, C., Strine, T.W., & Mokdad, A.H. (2009). Depression and anxiety among us adults: Associations with body mass index. International Journal of Obesity, 33(2), 257–266. https://doi.org/10.1038/ijo.2008.268

    • PubMed
    • Search Google Scholar
    • Export Citation

  • Zimmerman, M., Ruggero, C.J., Chelminski, I., Young, D., Posternak, M.A., Friedman, M., Boerescu, D., & Attiullah, N. (2006). Developing brief scales for use in clinical practice: The reliability and validity of single-item self-report measures of depression symptom severity, psychosocial impairment due to depression, and quality of life. The Journal of Clinical Psychiatry, 67(10), 1536–1541. https://doi.org/10.4088/JCP.v67n1007

    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 1326 1326 298
Full Text Views 26 26 6
PDF Downloads 28 28 2