children (e.g., Bailey et al., 1998; Szatmari et al., 1998). For this reason, discussion of recurrence risks should be part of the overall delivery of services, and it is important that younger siblings of children with an autistic spectrum disorder be followed carefully after birth to determine whether they show any indication of a disorder on the autism spectrum. Careful tracking would enable very early intervention with this group of youngsters.


In general, the research literature examining methods of training parents to be teachers has been of somewhat higher quality and more systematic than the work looking at the effects of raising a child with autism on the quality of family life. One of the common flaws in a number of studies of family stress has been the failure to include two comparison groups, one of typically developing children of the same developmental level and the other of children with a different disability. Both of these groups are important because raising any child affects parents, and most serious chronic disabilities of childhood are likely to influence the quality of family life. There is also a striking lack of research examining how socioeconomic status, ethnicity, and race influence vulnerability to stress, which forms of support and training that are most helpful when and for whom, and the most effective modalities for service delivery (Wolery and Garfinkle, 2000). Although researchers tend to look where the light is brightest (i.e., the easiest places to find research participants), if we are to fully appreciate the impact of autism on families and become expert at teaching parents how to work with and advocate on behalf of their child, we need to understand different kinds of families. Research has also not paid sufficient attention to interactions between child factors—such as degree of cognitive and language impairment, severity of autistic involvement, and specific diagnosis on the spectrum of autism—and family characteristics that may influence both the ease with which parents can teach their child and the stress level in the household.

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