Stress and coping strategies among Balkan mothers of children with developmental disorders

Maša Marisavljević; Nikola Petrović; Olja Jovanović; Milica Ćirović; Nina Stanojević; Nevena Folić

doi:10.19090/pp.v17i4.2526

Autori

Maša Marisavljević Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Center”, Belgrade, Serbia https://orcid.org/0000-0003-3779-2737
Nikola Petrović Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia https://orcid.org/0000-0001-8333-3596
Olja Jovanović Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia https://orcid.org/0000-0001-8860-6717
Milica Ćirović Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Center”, Belgrade, Serbia https://orcid.org/0000-0003-3286-0999
Nina Stanojević Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Center”, Belgrade, Serbia https://orcid.org/0000-0002-8631-7206
Nevena Folić Department of Pediatrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia https://orcid.org/0000-0001-9494-881X

DOI:

https://doi.org/10.19090/pp.v17i4.2526

Ključne reči:

parenting stress, developmental disorders, coping strategies, autism spectrum disorder, specific developmental disorders of speech and language

Apstrakt

This study explored stress in Balkan parents of children with developmental disorders (DD), taking into account the type of child’s DD, sociodemographic factors, and coping strategies. Sample comprised 139 mothers from Serbia (42%), Montenegro (27%), Bosnia and Herzegovina (14%), Croatia (16%), and Slovenia (2%), whose children were diagnosed with specific developmental disorders of speech and language (37%), autism spectrum disorders (39%) and mixed specific developmental disorders (24%). Mothers completed the Parenting Stress Index-SF and Brief COPE, and provided information on sociodemographic characteristics. The one-way ANOVA revealed that mothers of children with ASD reported the highest stress intensity. Linear regression suggests that having a child with autism spectrum disorder, lower education, and the use of Self-blame contribute to the prediction of stress. The results of several mediation analyses indicate that Religion and Behavioral disengagement mediate the relationship between parental stress and the child’s age: parents of older children with DD show a greater tendency to use these coping strategies, which consequently leads to higher stress levels.

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Reference

Abidin, R. R. (1992). The determinants of parenting behavior. Journal of Clinical Child Psychology, 21(4), 407–412. https://doi.org/10.1207/s15374424jccp2104_12 DOI: https://doi.org/10.1207/s15374424jccp2104_12

Abidin, R. R. (1995). Parenting Stress Index: Professional manual. Psychological Assessment Resources.

Abidin, R. R., Smith, L. T., Kim, H., & Youngstrom, E. A. (2022). Parenting stress. WikiJournal of Medicine, 9(1), 3. https://doi.org/10.15347/wjm/2022.003 DOI: https://doi.org/10.15347/WJM/2022.003

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 DOI: https://doi.org/10.1176/appi.books.9780890425596

Barker, E. T., Hartley, S. L., Seltzer, M. M., Floyd, F. J., Greenberg, J. S., & Orsmond, G. I. (2011). Trajectories of emotional well-being in mothers of adolescents and adults with autism. Developmental Psychology, 47(2), 551-561. https://doi.org/10.1037/a0021268 DOI: https://doi.org/10.1037/a0021268

Benderix, Y., Nordström, B., & Sivberg, B. (2007). Parents’ experience of having a child with autism and learning disabilities living in a group home: A case study. Autism, 10(6), 629–641. https://doi.org/10.1177/1362361307070902 DOI: https://doi.org/10.1177/1362361307070902

Bhushan Gupta, V. (2007). Comparison of parenting stress in different developmental disabilities. Journal of Developmental and Physical Disabilities, 19(4), 417-425. https://doi.org/10.1007/s10882-007-9060-x DOI: https://doi.org/10.1007/s10882-007-9060-x

Bornstein, M. H., & Hendricks, C. (2013). Screening for developmental disabilities in developing countries. Social Science & Medicine, 97, 307-315. https://doi.org/10.1016/j.socscimed.2012.09.049 DOI: https://doi.org/10.1016/j.socscimed.2012.09.049

Brezis, R. S., Weisner, T. S., Daley, T. C., Singhal, N., Barua, M., & Chollera, S. P. (2015). Parenting a child with autism in India: Narratives before and after a parent–child intervention program. Culture, Medicine, and Psychiatry, 39(2), 277–298. https://doi.org/10.1007/s11013-015-9434-y DOI: https://doi.org/10.1007/s11013-015-9434-y

Brobst, J. B., Clopton, J. R., & Hendrick, S. S. (2008). Parenting children with autism spectrum disorders: The couple's relationship. Focus on Autism and other Developmental Disabilities, 24(1), 38-49. https://doi.org/10.1177/1088357608323699 DOI: https://doi.org/10.1177/1088357608323699

Bunijevac, M., & Čanadanović-Marinković, J. (2023). The effect of stress on the quality of the parental role of children with autism. Research in Education and Rehabilitation, 6(1), 46-55. https://doi.org/10.51558/2744-1555.2023.6.1.46 DOI: https://doi.org/10.51558/2744-1555.2023.6.1.46

Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4(1), 92-100. https://doi.org/10.1207/s15327558ijbm0401_6 DOI: https://doi.org/10.1207/s15327558ijbm0401_6

Chen, K. L., Iao, L. S., & Wu, C. C. (2024). Impact of child behavior problems on parenting stress and depressive symptoms among mothers of children with autism spectrum disorder: mediation of coping strategies. Journal of Developmental and Physical Disabilities, 36, 489–509. https://doi.org/10.1007/s10882-023-09919-3 DOI: https://doi.org/10.1007/s10882-023-09919-3

Connolly, M., & Gersch, I. (2016). Experiences of parents whose children with autism spectrum disorder (ASD) are starting primary school. Educational Psychology in Practice, 32(3), 245–261. https://doi.org/10.1080/02667363.2016.1169512 DOI: https://doi.org/10.1080/02667363.2016.1169512

Cooper, C., Katona, C., Orrell, M., & Livingston, G. (2008). Coping strategies, anxiety and depression in caregivers of people with Alzheimer’s disease. International Journal of Geriatric Psychiatry, 23(9), 929–936. https://doi.org/10.1002/gps.2007 DOI: https://doi.org/10.1002/gps.2007

Cramer, P. (2003). Personality change in later adulthood is predicted by defense mechanism use in early adulthood. Journal of Research in Personality, 37(1), 76–104. https://doi.org/10.1016/S0092-6566(02)00528-7 DOI: https://doi.org/10.1016/S0092-6566(02)00528-7

Croatian Institute of Public Health (2022). Mentalni poremećaji u Republici Hrvatskoj. Zagreb: Croatian Institute of Public Health. Retrieved from: https://www.hzjz.hr/wp-content/uploads/2022/09/Bilten_Mentalni-poremecaji_2022.pdf

Čarakovac, M., & Milačić Vidojević, I. (2019a). Correlation between the stress of parental role and the intensity and frequency of negative mass life events in the parents of children with autism spectrum disorder, in comparison to the parents of children with typical development. KNOWLEDGE - International Journal, 30(5), 1273–1277. Retrieved from: https://rfasper.fasper.bg.ac.rs/bitstream/id/3261/document.pdf

Čarakovac, M., & Milačić Vidojević, I. (2019b). Differences in coping strategies of parents of children with autism spectrum disorder and parents of typically developing children. 10th International scientific conference Special education and rehabilitation today. Belgrade, October, 25-26th, 2019. Retrieved from: https://rfasper.fasper.bg.ac.rs/bitstream/handle/123456789/3124/Proceedings-2019-CD.pdf?sequence=1&isAllowed=y

Čolić, M. (2023). Autism in Serbia: Insights into parental experiences, support networks, and systemic obstacles. International Journal of Developmental Disabilities, 1–10. https://doi.org/10.1080/20473869.2023.2294390 DOI: https://doi.org/10.1080/20473869.2023.2294390

Dabrowski, M., & Myachenkova, Y. (2018). The Western Balkans on the road to the European Union. Bruegel Policy Contribution, No. 2018/04, Bruegel, Brussels. Retrieved from: https://www.econstor.eu/bitstream/10419/208011/1/1014693047.pdf

Daniels, A. M., Como, A., Hergüner, S., Kostadinova, K., Stosic, J., & Shih, A. (2017). Autism in Southeast Europe: A survey of caregivers of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 47, 2314–2325. https://doi.org/10.1007/s10803-017-3145-x DOI: https://doi.org/10.1007/s10803-017-3145-x

Duarte, C. S., Bordin, I. A., Yazigi, L., & Mooney, J. (2005). Factors associated with stress in mothers of children with autism. Autism, 9(4), 416–427. https://doi.org/10.1177/1362361305056081 DOI: https://doi.org/10.1177/1362361305056081

Džamonja Ignjatović, T., Milanović, M., & Zegarac, N. (2017). How services for children with disabilities in Serbia affect the quality of life of their families. Research in Developmental Disabilities, 68, 1-8. https://doi.org/10.1016/j.ridd.2017.06.009 DOI: https://doi.org/10.1016/j.ridd.2017.06.009

Francis, A. (2012). Stigma in an era of medicalization and anxious parenting: How proximity and culpability shape middle-class parents’ experiences of disgrace. Sociology of Health & Illness, 34(6), 927-942. https://doi.org/10.1111/j.1467-9566.2011.01445.x DOI: https://doi.org/10.1111/j.1467-9566.2011.01445.x

Gau, S. S. F., Chou, M. C., Chiang, H. L., Lee, J. C., Wong, C. C., Chou, W. J., & Wu, Y. Y. (2012). Parental adjustment, marital relationship, and family function in families of children with autism. Research in Autism Spectrum Disorders, 6(1), 263-270. https://doi.org/10.1016/j.rasd.2011.05.007 DOI: https://doi.org/10.1016/j.rasd.2011.05.007

Gillberg, C., & Fernell, E. (2014). Autism plus versus autism pure. Journal of Autism and Developmental Disorders, 44(12), 3274-3276. https://doi.org/10.1007/s10803-014-2163-1 DOI: https://doi.org/10.1007/s10803-014-2163-1

Giovagnoli, G., Postorino, V., Fatta, L. M., Sanges, V., De Peppo, L., Vassena, L., De Rose, P., Vicari, S., & Mazzone, L. (2015). Behavioral and emotional profile and parental stress in preschool children with autism spectrum disorder. Research in Developmental Disabilities, 45–46, 411-421. https://doi.org/10.1016/j.ridd.2015.08.006 DOI: https://doi.org/10.1016/j.ridd.2015.08.006

Gosto, A. (2016). Having a child with autistic spectrum disorders in Bosnia and Herzegovina: parents´ experiences with coping strategies (Master’s Thesis). Department of Special Needs Education, Faculty of Educational Sciences, University of Oslo. Retrieved from: https://www.duo.uio.no/bitstream/handle/10852/51294/1/THESIS.pdf

Harper, A., Dyches, T. T., Harper, J., Roper, S. O., & South, M. (2013). Respite care, marital quality, and stress in parents of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(11), 2604-2616. https://doi.org/10.1007/s10803-013-1812-0 DOI: https://doi.org/10.1007/s10803-013-1812-0

Hastings, R., Kovshoff, H., Brown, T., Ward, N., Espinosa, F., & Remington, B. (2005). Coping strategies in mothers and fathers of preschool and school-age children with autism. Autism, 9(4), 377–391. https://doi.org/10.1177/1362361305056078 DOI: https://doi.org/10.1177/1362361305056078

Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. Retrieved from http://www.afhayes.com/ public/process2012.pdf

Herring, S., Gray, K. M., Taffe, J. R., Tonge, B. J., Sweeney, D. J., & Einfeld, S. L. (2006). Behaviour and emotional problems in toddlers with pervasive developmental disorders and developmental delay: Associations with parental mental health and family functioning. Journal of intellectual disability research, 50(Pt 12), 874-882. https://doi.org/10.1111/j.1365-2788.2006.00904.x DOI: https://doi.org/10.1111/j.1365-2788.2006.00904.x

Ibrahimagic, A., Junuzovic-Zunic, L., Duranovic, M., & Radic, B. (2015). Autism treatment in special schools in Bosnia and Herzegovina. Special Education, 1, 119-131.

Ilić, S. B., Nikolić, S. J., Ilić-Stošović, D. D., & Golubović, Š. S. (2020). Early identification of children with developmental delay and behavioural problems according to parents concerns in the Republic of Serbia. Early Child Development and Care, 190(16), 2605–2611. https://doi.org/10.1080/03004430.2019.1595610 DOI: https://doi.org/10.1080/03004430.2019.1595610

Kosić, R., Duraković Tatić A., Petrić, D., & Kosec, T. (2021). The impact of autism spectrum disorders on the family. Medicina Fluminensis, 57(2), 139-149. https://doi.org/10.21860/medflum2021_371644 DOI: https://doi.org/10.21860/medflum2021_371644

Kostić, J., Milosavljević, L., & Stanković, M. (2017). Evaluation of stress and support to parents of children with developmental disabilities–our experience. European Psychiatry, 41(S1), S215-S215. https://doi.org/10.1016/j.eurpsy.2017.01.2191 DOI: https://doi.org/10.1016/j.eurpsy.2017.01.2191

Lai, K., & Green, S. B. (2016). The problem with having two watches: Assessment of fit when RMSEA and CFI disagree. Multivariate Behavioral Research, 51(2-3), 220-239. https://doi.org/10.1080/00273171.2015.1134306 DOI: https://doi.org/10.1080/00273171.2015.1134306

Lopez, V., Clifford, T., Minnes, P., & Ouellette-Kuntz, H. (2008). Parental stress and coping in families of children with and without developmental delays. Journal on Developmental Disabilities, 14(2), 99-104.

Lunt, M. (2015). Introduction to statistical modelling 2: Categorical variables and interactions in linear regression. Rheumatology, 54(7), 1141–1144. https://doi.org/10.1093/rheumatology/ket172 DOI: https://doi.org/10.1093/rheumatology/ket172

Matišić, I. (2021). Stres i otpornost obitelji djeteta s poremećajem spektra autizma (Master's thesis). University of Zagreb, Faculty of Education and Rehabilitation Sciences. Retrieved from: https://urn.nsk.hr/urn:nbn:hr:158:334675

May, C., Fletcher, R., Dempsey, I., & Newman, L. (2015). Modeling relations among coparenting quality, autism-specific parenting self-efficacy, and parenting stress in mothers and fathers of children with ASD. Parenting: Science and Practice, 15(2), 119-133. https://doi.org/10.1080/15295192.2015.1020145 DOI: https://doi.org/10.1080/15295192.2015.1020145

May, M., & Hansen, B. (2016). Strength-based assessment for children with autism and related disabilities in Bosnia. Journal of Undergraduate Research, 2016(1), article 7. Retrieved from: https://scholarsarchive.byu.edu/jur/vol2016/iss1/7

McClain, B., Hasty Mills, A. M., & Murphy, L. E. (2017). Inattention and hyperactivity/impulsivity among children with attention-deficit/hyperactivity-disorder, autism spectrum disorder, and intellectual disability. Research in Developmental Disabilities, 70, 175-184. https://doi.org/10.1016/j.ridd.2017.09.009 DOI: https://doi.org/10.1016/j.ridd.2017.09.009

Međaković, J., Čivljak, A., Zorčec, T., Vučić, V., Ristić-Medić, D., Veselinović, A., Čivljak, M., & Puljak, L. (2024). Perceptions on support, challenges and needs among parents and caregivers of children with developmental disabilities in Croatia, North Macedonia and Serbia: A cross-sectional study. BMC Pediatrics, 24, 297. https://doi.org/10.1186/s12887-024-04770-7 DOI: https://doi.org/10.1186/s12887-024-04770-7

Milačić Vidojević, I. (2008). Stress in parents of autistic children. Psihijatrija Danas, 40(1), 37-49. Retrieved from: http://rfasper.fasper.bg.ac.rs/handle/123456789/169

Ministry of Health - Government of Montenegro (2018). Strategija zaštite i unapređenja mentalnog zdravlja u Crnoj Gori 2019–2023. Retrieved from: https://www.gov.me/dokumenta/60af25aa-a65e-4957-84d8-e77a3182ab9b

Miranda, A., Mira, A., Berenguer, C., Rosello, B., & Baixauli, I. (2019). Parenting stress in mothers of children with autism without intellectual disability. Mediation of Behavioral Problems and Coping Strategies. Frontiers in Psychology, 10(464). https://doi.org/10.3389/fpsyg.2019.00464 DOI: https://doi.org/10.3389/fpsyg.2019.00464

Nedović, G., Sretenović, I., Potić, S., & Arsić, R. (2016). Early intervention in the world: implications for improvement in Serbia. In Early intervention in special education and rehabilitation (Ed. S. Nikolić, R. Nikić, V. Ilanković). pp. 25-41. University of Belgrade – Faculty of Special Education and Rehabilitation. Retrieved from: http://rfasper.fasper.bg.ac.rs/handle/123456789/2525

Negri, L. M., & Castorina, L. L. (2014). Family adaptation to a diagnosis of autism spectrum disorder. Handbook of Early Intervention for Autism Spectrum Disorders, 117-137.

Negri, L., & Castorina, L. (2014). Family Adaptation to a Diagnosis of Autism Spectrum Disorder. In: Tarbox, J., Dixon, D., Sturmey, P., Matson, J. (Eds.) Handbook of Early Intervention for Autism Spectrum Disorders. Autism and Child Psychopathology Series. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0401-3_7 DOI: https://doi.org/10.1007/978-1-4939-0401-3_7

Ni’matuzahroh, S. M. W., Ningrum, V., Widayat, Y. M. S., Hasanati, N., & Wang, J. H. (2022). The association between parenting stress, positive reappraisal coping, and quality of life in parents with autism spectrum disorder (ASD) children: A systematic review. Healthcare, 10(1), 52. https://doi.org/10.3390/healthcare10010052 DOI: https://doi.org/10.3390/healthcare10010052

Nixon, C. D. (1993). Reducing self-blame and guilt in parents of children with severe disabilities. In G. H. S. Singer & L. E. Powers (Eds.), Families, disability, and empowerment: active coping skills and strategies for family interventions (pp. 175-201). Baltimore, MD: Paul H. Brookes Publishing Co.

Nolcheva, M., & Trajkovski, V. (2015). Exploratory study: Stress, coping and support among parents of children with autism spectrum disorders. Journal of Special Education and rehabilitation, 16(3–4), 84–100. https://doi.org/10.1515/jser-2015-0013 DOI: https://doi.org/10.1515/jser-2015-0013

Norizan, A., & Shamsuddin, K. (2010). Predictors of parenting stress among Malaysian mothers of children with Down syndrome. Journal of Intellectual Disability Research, 54(11), 992-1003. https://doi.org/10.1111/j.1365-2788.2010.01324.x DOI: https://doi.org/10.1111/j.1365-2788.2010.01324.x

Östberg, M., & Hagekull, B. (2000). A structural modeling approach to the understanding of parenting stress. Journal of Clinical Child Psychology, 29(4), 615-625. https://doi.org/10.1207/S15374424JCCP2904_13 DOI: https://doi.org/10.1207/S15374424JCCP2904_13

Pastor-Cerezuela, G., Fernández-Andrés, M. I., Tárraga-Mínguez, R., & Navarro-Peña, J. M. (2016). Parental stress and ASD: Relationship with autism symptom severity, IQ, and resilience. Focus on Autism and Other Developmental Disabilities, 31(4), 300-311. https://doi.org/10.1177/1088357615583471 DOI: https://doi.org/10.1177/1088357615583471

Pejovic-Milovancevic, M., Stankovic, M., Mitkovic-Voncina, M., Rudic, N., Grujicic, R., Herrera, A. S., Stojanovic, A., Nedovic, B., Shih, A., Mandic-Maravic, V., & Daniels, A. (2018). Perceptions on support, challenges and needs among parents of children with autism: The Serbian experience. Psychiatria Danubina, 30(6), 354-364. Retrieved from: https://hrcak.srce.hr/262938

Pargament, K. I., Smith, B. W., Koenig, H. G., & Perez, L. (1998). Patterns of positive and negative religious coping with major life stressors. Journal for the Scientific Study of Religion, 37(4), 710–724. https://doi.org/10.2307/1388152 DOI: https://doi.org/10.2307/1388152

Pešić, J. (2009). Patrijarhalnost na Zapadnom Balkanu, komparativna analiza vrednosnih orijentacija – in: Porodice u Srbiji danas u komparativnoj perspektivi (A. Milić, S. Tomanović, eds.) Beograd, Institut za sociološka istraživanja Filozofskog fakulteta u Beogradu i Čigoja štampa.

Peters-Scheffer, N., Didden, R., & Korzilius, H. (2012). Maternal stress predicted by characteristics of children with autism spectrum disorder and intellectual disability. Research in Autism Spectrum Disorders, 6(2), 696–706. https://doi.org/10.1016/j.rasd.2011.10.003 DOI: https://doi.org/10.1016/j.rasd.2011.10.003

Piazza, V. E., Floyd, F. J., Mailick, M. R., & Greenberg, J. S. (2014). Coping and psychological health of aging parents of adult children with developmental disabilities. American Journal on Intellectual and Developmental Disabilities, 119(2), 186-198. https://doi.org/10.1352/1944-7558-119.2.186 DOI: https://doi.org/10.1352/1944-7558-119.2.186

Pickard, K. E., & Ingersoll, B. R. (2016). Quality versus quantity: the role of socioeconomic status on parent-reported service knowledge, service use, unmet service needs, and barriers to service use. Autism, 20(1), 106-15. https://doi.org/10.1177/1362361315569745 DOI: https://doi.org/10.1177/1362361315569745

Pinjatela, R. (2011). Influence of biopsychosocial factors on early mother-child interaction. (Dissertation). Zagreb: Edukacijsko-rehabilitacijski fakultet.

Pistoljevic, N., Dzanko, E., & Ghaziuddin, M. (2021). Practice patterns and potential barriers to early diagnosis of autism in Bosnia and Herzegovina: A preliminary study. Journal of Autism and Developmental Disorders, 51, 4447–4455. https://doi.org/10.1007/s10803-021-04875-3 DOI: https://doi.org/10.1007/s10803-021-04875-3

Pratto, F., Žeželj, I., Maloku, E., Turjačanin, V., & Branković, M. (Eds.). (2017). Shaping social identities after violent conflict: Youth in the Western Balkans. Cham, Switzerland: Palgrave Macmillan. https://doi.org/10.1007/978-3-319-62021-3 DOI: https://doi.org/10.1007/978-3-319-62021-3

Preece, D., & Almond J. (2008). Supporting families with children on the autism spectrum to use structured teaching approaches in the home and community. Good Autism Practice, 9(2), 44–53. Retrieved from: http://www.ingentaconnect.com/content/bild/gap/2008/00000009/00000002/art00009

Rao, P. A., & Beidel, D. C. (2009). The impact of children with high-functioning autism on parental stress, sibling adjustment, and family functioning. Behavior Modification, 33(4), 437-451. https://doi.org/10.1177/0145445509336427 DOI: https://doi.org/10.1177/0145445509336427

Rutgers, A. H., van Ijzendoorn, M. H., Bakermans-Kranenburg, M. J., Swinkels, S. H. N., van Daalen, E., Dietz, C., Naber, F. B. A., Buitelaar, J. K., & van Engeland, H. (2007). Autism, attachment and parenting: A comparison of children with autism spectrum disorder, mental retardation, language disorder, and non-clinical children. Journal of Abnormal Child Psychology, 35(5), 859–870. https://doi.org/10.1007/s10802-007-9139-y DOI: https://doi.org/10.1007/s10802-007-9139-y

Shtayermman, O. (2013). Stress and marital satisfaction of parents to children diagnosed with autism. Journal of Family Social Work, 16(3), 243-259. https://doi.org/10.1080/10522158.2013.786777 DOI: https://doi.org/10.1080/10522158.2013.786777

Sim, A., Cordier, R., Vaz, S., Netto, J., & Falkmer, T. (2017). Factors associated with negative co-parenting experiences in families of a child with autism spectrum disorder. Developmental Neurorehabilitation, 20(2), 83-91. https://doi.org/10.3109/17518423.2015.1069414 DOI: https://doi.org/10.3109/17518423.2015.1069414

Sinha, D., Verma, N., & Hershe, D. (2016). A comparative study of parenting styles, parental stress and resilience among parents of children having autism spectrum disorder, parents of children having specific learning disorder and parents of children not diagnosed with any psychiatric disorder. Annals of International Medical and Dental Research, 2(4), 106-111. https://doi.org/10.21276/aimdr.2016.2.4.30 DOI: https://doi.org/10.21276/aimdr.2016.2.4.30

Sivberg, B. (2002). Family system and coping behaviors: A comparison between parents of children with autistic spectrum disorders and parents with non-autistic children. Autism, 6(4), 397–409. https://doi.org/10.1177/1362361302006004006 DOI: https://doi.org/10.1177/1362361302006004006

Skinner, E. A., Edge, K., Altman, J., & Sherwood, H. (2003). Searching for the structure of coping: A review and critique of category systems for classifying ways of coping. Psychological Bulletin, 129(2), 216–269. https://doi.org/10.1037/0033-2909.129.2.216 DOI: https://doi.org/10.1037/0033-2909.129.2.216

Službeni glasnik (2019). Program o zaštiti mentalnog zdravlja u Republici Srbiji za period 2019-2026. godine. br. 84/2019. Retrieved from: https://www.zdravlje.gov.rs/view_file.php?file_id=1199&cache=sr

Smith, T. B., Oliver, M. N. I., & Innocenti, M. S. (2001). Parenting stress in families with children with disabilities. American Journal of Orthopsychiatry, 71(2), 257-261. https://doi.org/10.1037/0002-9432.71.2.257 DOI: https://doi.org/10.1037//0002-9432.71.2.257

Smith, L. E., Hong, J., Mailick Seltzer, 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 DOI: https://doi.org/10.1007/s10803-009-0844-y

Stoll-Egger, S. (2019). Complicated grief of ambiguous loss in parents of children with autism (Doctoral thesis). Faculty of Pacific Graduate School of Psychology Palo Alto University. Retrieved from: https://www.proquest.com/docview/2298099540/abstract/9E364C183E4448D2PQ/1

Stošić, J., Lisak Šegota, N., & Preece, D. (2022). Primary teachers' knowledge and attitudes about autism, and experience of good practice approaches: Implications for policy and practice in Croatia. Support for Learning, 37(4), 573-588. https://doi.org/10.1111/1467-9604.12429 DOI: https://doi.org/10.1111/1467-9604.12429

Stuart, M., & McGrew, J. H. (2009). Caregiver burden after receiving a diagnosis of an autism spectrum disorder. Research in Autism Spectrum Disorders, 3(1), 86-97. https://doi.org/10.1016/j.rasd.2008.04.006 DOI: https://doi.org/10.1016/j.rasd.2008.04.006

Sudimac, S. (2017). Parental perceptions of socio-emotional responsiveness of children with ASD and children's impact on the family as factors of parental stress. Proceedings of the XXIII scientific conference empirical studies in psychology, March 24-26, Faculty of philosophy, University of Belgrade, pp. 170-175.

Tehee, E., Honan, R., & Hevey, D. (2009). Factors contributing to stress in parents of individuals with autistic spectrum disorders. Journal of Applied Research in Intellectual Disabilities, 22(1), 34-42. https://doi.org/10.1111/j.1468-3148.2008.00437.x DOI: https://doi.org/10.1111/j.1468-3148.2008.00437.x

Thomas, P., Zahorodny, W., Peng, B., Kim, S., Jani, N., Halperin, W., & Brimacombe, M. (2011). The association of autism diagnosis with socioeconomic status. Autism, 16(2), 201–213. https://doi.org/10.1177/1362361311413397 DOI: https://doi.org/10.1177/1362361311413397

UNICEF (2017). Situaciona analiza o položaju djece sa poteškoćama u Bosni i Hercegovini. UNICEF. Retrieved from: https://www.unicef.org/bih/media/376/file/Situaciona%20analiza%20o%20polo%C5%BEaju%20djece%20sa%20pote%C5%A1ko%C4%87ama%20u%20BiH.pdf

Vernhet, C., Dellapiazza, F., Blanc, N., Cousson-Gélie, F., Miot, S., Roeyers, H., & Baghdadli, A. (2019). Coping strategies of parents of children with autism spectrum disorder: A systematic review. European Child & Adolescent Psychiatry, 28, 747–758. https://doi.org/10.1007/s00787-018-1183-3 DOI: https://doi.org/10.1007/s00787-018-1183-3

Wang, P., Michaels, C. A., & Day, M. S. (2011). Stresses and coping strategies of chinese families with children with autism and other developmental disabilities. Journal of Autism and Developmental Disorders, 41(6), 783–795. https://doi.org/10.1007/s10803-010-1099-3 DOI: https://doi.org/10.1007/s10803-010-1099-3

Weiss, J. A., & Lunsky, Y. (2011). The brief family distress scale: A measure of crisis in caregivers of individuals with autism spectrum disorders. Journal of Child and Family Studies, 20, 521–528. https://doi.org/10.1007/s10826-010-9419-y DOI: https://doi.org/10.1007/s10826-010-9419-y

Weiss, J. A., Wingsiong, A., & Lunsky, Y. (2014). Defining crisis in families of individuals with autism spectrum disorders. Autism, 18(8) 985–995. https://doi.org/10.1177/1362361313508024 DOI: https://doi.org/10.1177/1362361313508024

Whitehead, K., Dorstyn, D., & Ward, L. (2015). Psychological adjustment in families affected by autism spectrum disorder. Journal of Developmental and Physical Disabilities, 27(5), 703–717. https://doi.org/10.1007/s10882-015-9446-0 DOI: https://doi.org/10.1007/s10882-015-9446-0

World Health Organization (2011). International Statistical Classification of Diseases and Related Health Problems: Instruction Manual. 10th revision. Vol. 2. Geneva: WHO.