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- Title
- DOES FAMILY QUALITY OF LIFE MEDIATE THE RELATION BETWEEN AUTISM WAIVER SERVICES AND CHILD PROGRESS?
- Creator
- Desai, Shivani S.
- Date
- 2022
- Description
-
Autism Spectrum Disorder (ASD) is a pervasive neurodevelopmental disorder that affects a child’s language, social, and behavioral development,...
Show moreAutism Spectrum Disorder (ASD) is a pervasive neurodevelopmental disorder that affects a child’s language, social, and behavioral development, and also is associated with difficulty with academics, independent completion of daily living skills, and emotion regulation. Diagnosed individuals often require comprehensive, long-term, and family-based intervention that is costly. Several states, including Maryland, have adopted Medicaid Home and Community Based Services (HCBS) waiver services that specifically serve children and young adults with ASD at no out-of-pocket cost to families. The Maryland autism waiver (AW) also includes services to support diagnosed individuals’ family members, including family consultation and respite services. Family factors, such as specific parenting behaviors and parental mental health, contribute significantly to symptom improvement in children with ASD and child development more broadly, highlighting the importance of studying family systems and targeting them in treatment. Prior research has found that AW services have a positive impact on family quality of life (FQoL), which is a multidimensional concept of family functioning. The aim of the present study was to examine if the several domains of FQoL are mediators in the relation between receipt of Maryland HCBS AW services and caregivers’ perception of their child’s improvement in several domains of functioning. The participants in this study consisted of 460 families who were enrolled in a larger study examining effects of Maryland AW services. Half of these families (n = 230) received the Maryland Medicaid AW services (n = 230) and the other half were on a registry to receive services (n = 230). Deidentified survey data were collected between 2013-2016 from caregiver informants who had a child under the age of 21 who exhibited symptoms of ASD. The survey included questions about demographics, FQoL, and their child’s progress in the areas of academics, independent living skills, social communication skills, stereotypic and repetitive behaviors, and aggressive behaviors over the past 6 months. Results of the mediation analyses revealed that FQoL in the domains of parenting, emotional well-being, and disability support services (but not in the domains of family interaction and physical/material well-being) each mediated the relations between AW services and caregiver report of improvement in all measured domains of child functioning (academics, independent living skills, social communication skills, stereotypic and repetitive behaviors, and aggressive behaviors). These findings highlight the significant role of FQoL as a mediator in the relation between waiver serves and child outcome. They also reveal the importance of increasing family quality of life when providing treatment services to children with symptoms of autism and their families.
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