The Relationship between Sense of Coherence and Parenting Stress in

Mothers of Children with Autism Spectrum Disorder

Priskila Kurniandini

and Nurul Hartini

Clinical and Mental Health Psychology Department, Faculty of Psychology, Universitas Airlangga, Surabaya - Indonesia

Keywords: Autism Spectrum Disorder, Sense of Coherence, Parenting Stress

Abstract: Taking care of children with autism spectrum disorder is different from taking care of children in general.

This phenomenon often leads the mothers to experience parenting stress. This study aims to find out the

relationship between sense of coherence and parenting stress in mothers of children with autism spectrum

disorder. Data collection in this study is using a technique of survey and involving 32 mothers. Mothers of

children with autism spectrum disorder in ages between 5-13 years old, and they come from many different

schools and therapy center in Surabaya, Sidoarjo, Gresik, and Tangerang. The result of data analysis shows

that there is a negative and significant relationship between sense of coherence and parenting stress.

1 INTRODUCTION

Autism spectrum disorder is a developmental

disorder in case of speaking and communicating,

social interaction, playing and imagining, as well as

there are restricted interest and repeating behavior

(American Psychiatric Association, 2013). The total

amount of patients who suffered from autism

spectrum disorder in every country continues to

increase every year. The data from KK Women’s

and Children Hospital and National University

Hospital have mentioned that one out of 150

children in Singapore has suffered this kind of

disorder. This number is higher compared with the

prevalence of autism spectrum disorder by WHO, in

which one out of 160 children in the world (Goy and

Tai, 2016). The total amount of patients who

suffered from autism spectrum disorder and

following health treatment in RSUD Dr. Soetomo

Surabaya are also arising. In 2009 there are 92

patients, in 2010 there are 100 patients, and in 2011

becomes 125 patients (Anna, 2012). Those data

simply show that there are more parents of children

with autism spectrum disorder.

The treatment for children with autism spectrum

disorder is different and need more efforts compared

to the normal one. Aggressive behavior and the

appeared tantrum as a response towards children’s

environment changing, makes the mothers have to

adapt with children’s condition. The symptoms of

autism spectrum disorder that appear on children

make parenting become such a burden as well as a

hard process to be followed by parents (Ooi, et al.,

2016). Mothers who taking care of children with

autism spectrum disorder will also be facing with

some challenges and difficulties. The challenges in

taking care of children with autism spectrum

disorder will affect on the physical condition and

emotion of the parents. That condition makes the

parents tend to experience parenting stress (Ludlow,

Skelly and Rohleder, 2011). Parenting stress is a

process which appearing philological reaction and

negative psychology in case of fulfilling the role as

parents. Commonly, that negative reaction is in a

form of feeling as well as a negative thought towards

themselves and children in which it related with the

role as parents (Deater-Deckard, 2004).

Some research towards parents of children with

autism spectrum disorder have mentioned that

mothers are experiencing more critical and higher

level of parenting stress than fathers (Pisula, 2011).

The tendency of mothers who tend to experience

parenting stress is due to the mothers’ intensity that

is often spending time with children. The condition

of children with autism spectrum disorder is needed

more attention, support, and direction that are much

higher and long terms compared to normal children.

That condition then asks the mothers to give most of

their time and energy to take care of their children

(Kuhaneck, et al., 2010).

Kurniandini, P. and Hartini, N.

The Relationship between Sense of Coherence and Parenting Stress in Mothers of Children with Autism Spectrum Disorder.

DOI: 10.5220/0008585700910096

In Proceedings of the 3rd International Conference on Psychology in Health, Educational, Social, and Organizational Settings (ICP-HESOS 2018) - Improving Mental Health and Harmony in

Global Community, pages 91-96

ISBN: 978-989-758-435-0

The level of parenting stress towards mothers of

children with autism spectrum disorder is influenced

by many factors. Some of the factors are related with

children’s condition such as the severity level of

autism (Pastor-Cerezuela, et al., 2016), children ages

(McStay, et al., 2014), problematic behavior that

arises, obstacle in self-regulation, and the cognitive

development in children tend to significantly

influence the level of parenting stress in mothers

(Pisula, 2011). Parenting stress towards mothers of

children with autism spectrum disorder is also

related with the cognitive development on children,

the needs of children to be observed (dependent),

with the problematic behavior that arises (Bouma

and Schweitzer, 1990). The other factors such as the

acceptance of mothers towards children’s diagnosis,

lack of professional and social supportsas well as the

family acceptance towards the children condition

also influence the level of parenting stress in

mothers (Pisula, 2011). The supports and social

acceptance that are being given will mean nothing if

the mothers valued themselves as receiving no

support at all. Therefore, the individual factor is

factors that influence mothers in valuing the

supports and social acceptance as well as the cause

to influence the stress.

One of the individual factors that influence

parenting stress towards mothers is that their

perspective on the problemsthat are experienced

(Pisula, 2011). The mothers’ perspective or

orientation related to parenting that has been done

will influence their level of parenting stress and

psychological health (Olsson, Larsman and Hwang,

2008). The intended perspective here is the sense of

coherence.

Sense of coherence (SoC) is a point of view or

individual’s orientation about his/her life, in which

one individual sees his/her life in general structured,

can be controlled, and meaningful. SoC reflects a

person’s perspective towards his/her life and

capacity in responding the situation that causing

stress, people with the high level of SoC is capable

of recognizing themselves and using what they have

to improve their own welfare (Eriksson and

Lindström, 2006). Individuals with a high level of

SoC tend to feel the stimulus of the environment in a

structured way that allows them to anticipate all

possibilities and be able to manage the existing

resources in order to fulfil the demands as

challenges that need to be faced andnot as a threat or

stressor (Antonovsky, 1987).

According to Antonovsky (1987), SoC is the

source of a person’s healthiness and welfare,

therefore SoC is associated with the effort to

decrease the stress level or individual’s depression.

One of the researches that have been conducted by

Mak, Ho, and Law (2007) found that mothers of

children with autism spectrum disorder in Hongkong

with a high level of SoC are having more low level

of parenting stress, even though that autism

spectrum disorder is considered as a severe autistic

disorder. The existence of high level of SoC is

marked with a good development of stress and the

ability to control the environment become a

meaningful action, this condition makes mothers for

having positive perception towards parenting,

whereas parenting is a clear process, manageable,

and give them meaning. Therefore, it can minimalize

the level of parenting stress that is experienced by

mothers.

Sense of coherence (SoC) to mother and its

relation with the level of parenting stress that

experienced by mothers of children with autism

spectrum disorder are the aspect that is going to be

examined in this research.The writer is interested in

examining there is a relation or not between sense of

coherence with parenting stress that experiences by

mothers of children with autism spectrum disorder.

Based on the previous research, the writer also

hypothesized that there is a negative and significant

relationship between SoC and parenting stress in

mothers of children with autism spectrum disorder.

2 METHOD

2.1 Type and Variable

The type of research that used in this study is

quantitative research with a technique of survey. The

variable that used in this study consists of sense of

coherence as an independent variable and parenting

stress as a dependent variable.

2.2 Subject

The determining subject of this research has been

done by using a technique of purposive sampling,

whereas the writer uses assessment to choose the

cases with specified criteria (Neuman, 2007). The

subject in this research is married women; live with

her husband and children in ages between 5-13 years

old that diagnosed with autism spectrum disorder.

There are 32 respondents that are suitable with those

criteria and they are coming from many different

schools and children therapy center for special needs

in Surabaya, Sidoarjo, Gresik, and Tangerang.

ICP-HESOS 2018 - International Conference on Psychology in Health, Educational, Social, and Organizational Settings

2.3 Data Collection

The data collection is using a questionnaire that’s

spread via online and offline to several schools and

children therapy center for special needs that is

located in Surabaya and Sidoarjo. The spreading

process of this questionnaire is done by sharing a

link via online to social media and giving it via

offline through teachers in school and therapists.

The questionnaire that’s used to measure sense

of coherence in this research is Sense of Coherence

Scale (SOCS, α = 0.92) which arranged by

Antonovsky (1987). This questionnaire has 29 aitem

and unidimensional, also has one dimension which

is sense of coherence and there are three indicators

such as comprehensibility, manageability, and

meaningfulness. Sample items of the scale are: ‘Do

you have very mixed up feelings and ideas?’

(comprehensibility), ‘How often do you have

feelings that you’re not sure you can keep under

control?’ (manageability), and ‘How often do you

have the feeling that there’s little meaning in the

things you do in your daily life?’ (meaningfulness).

The questionnaire in order to evaluate parenting

stress in this research is the Parenting Stress Index-

Short Form (PSI-SF, α = 0.87). This questionnaire is

arranged by Abidin (1995). This questionnaire has

36 aitem and consisted of three dimensions such as

parent distress, difficult child, and parent-child

relationship. Sample questions consisted of the

following: “There are quite a few things that bother

me about my life,” “My child gets upset easily over

the smallest thing,” “My child smiles at me much

less than I expected.”

2.4 Technique of Analysis

This research is a test relation or correlation;

therefore, it used the correlation technique of

Pearson Product Moment. It is because the data in

this research fulfil the parametric statistic

assumption test.

3 RESULTS

The subjects are domiciled in Surabaya, Sidoarjo,

Gresik, and Tangerang. The subject age range is in

between 28 years old until 49 years old. The

majority of the subject lives in Surabaya. The

subject’s last education is starting from Junior High

School graduate until bachelor degree. The subject

consisted of housewives, teachers, and employees.

Based on table 1, it is known that the highest

score aspect in the variable of parenting stress is the

aspect of parent-child relationship with average

score 31.41. While the highest score aspect in

variable of sense of coherence is the aspect of

manageability with average score 51.16.

Table 1: Descriptive Statistical Analysis

Dimension

Mea

Parenting Stress

– Parent

Distress

23.78

7.25

Parenting Stress

– Parent-Child

Relationship

31.41

7.04

Parenting Stress

– Difficult Child

31.22

7.81

SoC –

Comprehensibili

50.41

10.7

SoC –

Manageability

51.16

8.58

SoC –

Meaningful

42.22

8.94

Correlation test of Pearson Product Moment

between sense of coherence and parenting stress are

basically showing that there is a negative and

significant relationship between those two variables

(r = -0.73, p < .01).

Based on the above correlation test, it can be

concluded that there is a high and significant

correlation between those two variables. The

negative tendency relation shows that there is an

inverse relationship between sense of coherence and

parenting stress.

4 DISCUSSION

The result of this research agrees with the hypothesis

that proposed as well as matched with the previous

research that has been conducted by Mak, Ho, and

Law (2007), in which there is a negative and

significant relationship between sense of coherence

and parenting stress in mothers of children with

autism spectrum disorder. Based on Mak, Ho and

Law’s research (2007) sense of coherence is one of

the protective factors towards parenting stress in

mothers of children with autism spectrum disorder.

The level of parenting stress tends to become low

when mothers have a high level in sense of

coherence.

The Relationship between Sense of Coherence and Parenting Stress in Mothers of Children with Autism Spectrum Disorder

Autism spectrum disorder is a developmental

disorder that tends to persist and difficult to restore

or heal the sufferers to be “normal”. The

development aspects that are constrained are also

important aspectsof one’s life, such as

communication, social interaction, and behaviour.

The treatment of children with autism spectrum

disorder need a long time, long terms, as well as

need more cost (Mak, Ho and Law, 2007). Low

level of supports and social acceptance has also

become pressure for mothers (Sharpley, Bitsika and

Efremidis, 1997). All of those things are not only

affected the patient’s life, but the various aspect of

parents’ life who taking care of the children as well.

These can lead to the emergence of pressure that led

to the emergence of parenting stress (Mak, Ho and

Law, 2007). The experience of children parenting

with autism spectrum disorder is understood as a

burden to the parents’ (Williamson, et al., 2013).

Abidin (1995) stated that there are three aspects

of parenting stress (parent distress, difficult child,

parent-child relationship) and they are influencing

each other in the increasing of parenting stress that is

experienced by parents who took care of their

children. Parent’s distress results after parent’s

personal factors necessary to functioning in the role

of a parent and subsequent execution of parenting

tasks are utilized. The perception of a difficult child

is arising from the appraisal that this child’s

characteristics make him or her hard to parent. The

parent-child relationship is about the parent’s

perception that the child does not meet expectations,

and that their reciprocal interactions do not reward

the role of the parent (Abidin, 1995).

The dominant aspect is the dominant stress

sources that felt by the parents. In this research, the

relation between parents and children (parent-child

relationship) is a dominant aspect in parenting stress

variable. This aspect focused on the expectation

level of the parents towards the children (Abidin,

1995). This aspect is also about how far parents feel

the characteristics of children in accordance with the

expectations of parents and how far the parents feel

close to the children. Based on that explanation,

there is an indication that mothers who become the

subject in this research are having hope and or

certain expectation about their children who suffered

from autism spectrum disorder, but unfortunately,

that kind of hope and or expectation is not fulfiled.

This case is related with Hayes and Watson’s

statement (2013) that said parenting stress is started

to appear when parents are forcing an ideal or

general thought to be applied while taking care of

children with specified characteristic, such as autism

spectrum disorder.

For Indonesian society that tends to follow the

eastern culture, they still considered that the task of

parenting, treatment, and responsibility towards

children are given specifically to mothers. This case

is certainly improving the tendency of high level in

parenting stress to mothers, whereas in fact, mothers

who more intensely interact with children in daily

activities. This is supported by data that shows most

mothers in this research are the housewives, whereas

they play a greater role in providing daily needs,

nurturing, and interacting with children. This

parenting stress that is experienced by mothers will

later become such a manifestation in emotional

condition, the negative way of thinking and or

belief, bad relationship with spouse, and also

parenting behaviour that has a negative tendency

(Montgomery and Whiddon, 2010).

Having children with autism spectrum disorder is

also can be assumed as a life phenomenon that is

traumatic for mothers (Oelofsen and Richardson,

2006). An occurrence can be perceived as a

traumatic event certainly involves one’s cognitive

aspect. Cognitive activity is a key element in valuing

that traumatic event as a stressor or not. Because of

that, having and taking care of children with autism

spectrum disorder will not always be related to the

increasing of parenting stress because it depends on

the cognitive activity of the mothers. An event can

be valued as the cause of parenting stress if the

experienced attribute did not give a positive meaning

towards mothers.

Sense of coherence is one of the cognitive

activities that making mothers can value their

experience in parenting their children who suffered

from autism spectrum disorder as an experience that

is not causing parenting stress. Evolving the sense of

coherence becomes such a needed thing to be

considered in developing a successful adaptation

(Antonovsky and Sourani, 1988).

The dominant aspect of sense of coherence in

this research is the aspect of manageability. The

aspect of manageability is about how mothers can

flexibly manage the challenges in their life. This

aspect emphasized the importance of programs that

accessible to mothers, whereas discussing about how

to develop their ability in problem-solving, time

management, assertive, and relaxation (Oelofsen and

Richardson, 2006).

Aspects that tend to be less dominant is the thing

that mothers need in order to support them to take

care of the children in an optimal way. The aspect of

comprehensibilityis about how far an event is

ICP-HESOS 2018 - International Conference on Psychology in Health, Educational, Social, and Organizational Settings

perceived as an event that is able to be understood.

This aspect wants to emphasise on the importance

ofthe clarity of information that the mothers

understand regarding with the disorder condition

that experience by the children, a provided and

needed service or treatment for children, as well as

the mothers’ experience of parenting in a direct way.

The aspect of meaningfulness is about how far

mothers realized that life makes sense and that at

least some of the problems and demands posed by

living are worth the investment of energy. This

aspect emphasized on the importance of giving

support to mothers to have perception and positive

reaction towards the challenges that they are facing.

This aspect is also about how to cope with

helplessness, hopelessness by exploring all

caregivers’ experiences and give an understanding

that all of them are meaningful towards the mothers.

Through this way of thinking, it can be known a

specific need that must be developed in mothers,

since each family and parents are having different

kinds of required treatments (Oelofsen and

Richardson, 2006).

Mothers with a high sense of coherence can

manage their way of thinking towards their own

children, their role as parents, and the family role in

case of taking care. Those mothers are able to keep

thinking rationally in the middle of all life demands,

they have self-confidence and enough resource to

face all of the demands, and also having the

motivation to keep going through that challenges

and believe that kind of experience will give a

meaning or lesson to mothers. (Oelofsen and

Richardson, 2006). Positive adaptation process that

is experienced by mothers can be in form of

perspective (worldview) changing, particularly about

life and developmental disorder that experienced by

children as well as the consciousness of a positive

contribution by the presence of children to mothers,

family, and society in general. The experience of

taking care children with autism spectrum disorder

becomes the event that has positive meaning towards

mothers if mothers can have hope and always see the

available chances. This shows that having an

appropriate value and perspective are the important

factors in facing the demand of life, in this case,

taking care of children with autism spectrum

disorder (King, et al., 2006).

This research has some limitations in sampling,

in which the writer did not use the technique of

random sampling; therefore, the result could not be

generalized. Another factor that could be related to

parenting stress, such as the severe level of autism

and the total of siblings, can not be analyzed due to

incomplete data that had been gained.

5 CONCLUSION

The result of this study shows that there is a

tendency to a negative and significant relation

between sense of coherence andparenting stress in

mothers of children with autism spectrum disorder.

Mothers who have a high level in sense of coherence

will experience a low level in parenting stress. On

the other hand, mothers who have a low level in

sense of coherence will experience a high level in

parenting stress.

Based on the research that has been conducted,

the writer suggests to mothers of children with

autism spectrum disorder to consult their problem

related with children’s disorder condition with the

help of professionals in order to make mothers can

understand what can be done to make the children

keep growing optimally based on their own

condition. Besides, mothers can also involve in

many events that are held by foundations in which

specifically engaged in the ministry of children with

special needs in order to obtain new perspective in

parenting as well as can give positive supports to

each mother. By following those positive activities

with children, mothers can understand more of their

children and their needs.

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