Marital Relationship, Quality of Life, and Life Satisfaction for Saudi Parents of Children with Autism Spectrum Disorder

Ayah Moumenah; Mamdouh Al Enazi

Research Article

Austin J Autism & Relat Disabil. 2023; 9(2): 1067.

Marital Relationship, Quality of Life, and Life Satisfaction for Saudi Parents of Children with Autism Spectrum Disorder

Ayah Moumenah¹*; Mamdouh Al Enazi²

¹Master of Clinical Psychology, College of Medicine, Al Faisal University, Riyadh, Saudi Arabia

²Consultant, Transplant Psychology/Neuropsychology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

*Corresponding author:Ayah Moumenah Master of Clinical Psychology, College of Medicine, Al Faisal University, Riyadh, Saudi Arabia. Email: [email protected]

Received: August 02, 2023 Accepted: August 18, 2023 Published: August 25, 2023

Abstract

It is very stressful for parents to raise children with Autism Spectrum Disorder (ASD), which can create marital conflicts and relationship dissatisfaction. A variety of circumstances, including the intensity of their child’s behaviors, quality of life, and life satisfaction it plays significant role on the parents. This study aims to investigate the satisfaction of having a child with autism, on the marital relationship, life, and quality of life of the Saudi parents. A quantitative descriptive approach was used. A total of 49 Saudi parents of autistic children completed an online questionnaire. Overall results indicated that Saudi parents with autistic children are satisfied with their life, marital relationship, and their quality of life. In addition, results showed significant differences in life satisfaction and QOL of divorced Saudi parents of autistic children. On the other hand, there was no significant differences of married Saudi parents of autistic children. Furthermore, the study indicate that significant differences wasn’t observed between the Saudi fathers and mothers of autistic children.

Keywords: Autism spectrum disorder; Marital relationship; Life satisfaction; Quality of life; Saudi parents

Introduction

ASD

ASD is a neuro developmental syndrome marked by communication difficulties, restricted interests, and repetitive activities [1]. ASD, which includes a multitude of cognitive deficits in children, is frequently recognized in the first few years of life [2]. These behaviors may result in parental embarrassment, social exclusion, and loneliness, which may affect not just the person with high functioning autism, but also their family [3]. Children with ASD when they are stressed or their daily routines change, they may demonstrate antisocial behaviors such as aggression, social disengagement, or the urge for self-stimulation. The societal consequences make it difficult for parents to raise their autistic children. Parental isolation, humiliation, and social withdrawal may come from these practices [4]. According to a review of the literature Zeina [5], the amount of children with ASD in Saudi Arabia is not properly prevalent. However, according to The Saudi Ministry of Health [6], one in every 160 kids has an ASD. Unfortunately, little is understood about ASD, and there is virtually no information available about the needs of parents and siblings of children with ASD [7]. Therefore, Saudi Arabia sponsors a number of private institutions and provides aid for the care of children with ASD and their families; however, these services are limited and only available in major cities. Parents of children with ASD in the Kingdom of Saudi Arabia have various challenges and problems in parenting their children due to the disease's toll on children in Saudi culture, as well as traditional cultural issues impacting their people and their expanding social life [8].

Quality of Marital Relationship of Children with ASD

Several studies show that parents of impaired children, particularly those with children who have ASD, exhibit lower levels of marital satisfaction when compared to couples with children who are not disabled [9]. According to Anna’s study [10]. The overall evaluation result (4 sten-low result) on the quality of the marital relationship in the group of wives and husbands indicates a lack of contentment with the marital connection. Individual aspect scores on the scale, on the other hand, range from 4 to 7, indicating low to moderate marital satisfaction. In terms of marital discontent, the females were more dissatisfied than the husbands. The study's result of poor overall marital happiness is puzzling because couples have choices for coping with stress. Despite disappointment and a willingness to make their relationship look different, they accept things as they are and manage the emotional, cognitive, and behavioral problems that come with caring for a child with ASD during the pandemic, even if the relationship's overall level of satisfaction may be lower.

Life Satisfaction in Parents of Children with ASD

Most fathers who have children who have been diagnosed with ASD do not quit their jobs to take on the role of main caregiver, due to the difficulties they have raising their autistic child at home, they work longer hours to get away from their house [11]. According to Montes [12] Mothers, on the other hand, stated that their child's disability had a significant personal impact on them and were honest about their feelings. Even though working women regularly missed work, they were frequently forced to acquire part-time employment or even give up their outside jobs in order to care for their autistic children. The level of care necessary in an autistic child's everyday life is a significant source of stress, particularly for mothers. All of these factors may have an influence on the enjoyment of the parents' life. Life satisfaction is a person's appraisal of their degree of contentment with their current position based on comparisons to criteria they have set for themselves [13].

Quality of Life (QOL) in parents of Children with ASD

Autism is becoming more common, prompting issues regarding its origins and how it affects the QOL of both people with autism and those who care for them in their families [14]. A study by Mohammad [15] on the QOL and its predictors of primary parents of autistic children revealed that gender, age, monthly income, and marital status were major factors of careers’ QOL for autistic children. Despite the acknowledged importance of QOL, research, and the significant impact of having a child with autism, the QOL of parents of children with autism has gotten very little attention in comparison to other childhood difficulties [16]. A good QOL among married participants in an Eastern Saudi Arabia study may have been a result of their partners' support and care, particularly while coping with autistic children, and an investigation of the effects of monthly income on parents of autistic children discovered that those with higher monthly incomes had better social functioning, mental health, and vitality than those with lower monthly incomes [17]. Autistic parents frequently report feeling less satisfied with their quality of life [18].

Materials and Methods

The study focused on Saudi parents of children with ASD. The information was gathered from 49 parents. The participant was given a link of the permission form. The length of the assessments was probably between 10 and 20 minutes. For the participants, there are no anticipated risks. Additionally, they had the option to interrupt the evaluation at any time and refuse to answer a particular question. All participants was informed that taking part in the study will not provide any additional advantages beyond advancing our understanding of the requirements of families with children with ASD.

Study Design

For this study, a qualitative descriptive design was employed. Finding summative trends in relation to the data set was the main goal of the descriptive design. Different measures have been used in the study to measure how satisfied parents of children with ASD are with their lives, their marriages, and their quality of life.

The Questionnaire Tool

1. Appendix E. Satisfaction with Life Scale (SWLS) in Arabic.

2. Appendix G. Relationship Questionnaire (RQ) in Arabic.

3. Quality of Life Scale in Arabic.

Statistical Analysis

Data were analyzed with the use of computer software. The Statistical Package for Social Sciences (SPSS) version 29.0.1.0 (171), the collected data was examined in accordance with the goals of the current study using various statistical procedures including the independent sample t-test and the mean. P<0.05 was considered as significant.

Results

The results of the mean in Table 1 suggested that Saudi parents with autistic children are satisfied with their life, marital relationship, and their quality of life.

Table 1:




  
    
    SWLS Score 
    RAS Score 
    QOL Score 
  
  
    Mean 
    17.95918367 
    65.173913 
    144.782609 
  
  
    Std 
    3.807663236 
    16.533205 
    31.2622691 
  
  
    Var 
    14.49829932 
    273.34686 
    977.329469 
  
  
    SWLS:    Appendix E. Satisfied with Life Scale, RAS: Appendix D. Relationship    Assessment Scale, QOL: Quality of Life Scale, Std: standard deviation, Var:    variance.



Table 1:

Results reported in Table 3 indicate that significant differences wasn’t observed t(41) = 2.019, p=0.129, in life satisfaction of Saudi parents of Autistic Children. The mean in table 2 indicate that the Saudi parents of Autistic Children are satisfied in their life. Findings further, suggested that significant differences wasn’t observed t(41) = 2.019, p=0.839, in marital relationship satisfaction. In table 2 the mean indicate that the Saudi parents of Autistic children are slightly satisfied in their marital relationship. It also indicate that quality of life satisfaction of Saudi mothers of Autistic children they are slightly satisfied about it. On the other hand, fathers of Autistic children are satisfied about their quality of life. Findings further, suggested in table 2 that significant differences wasn’t observed t(41) = 2.019, p=0.097.

Table 2:




  
    
    Relation
    N
    Mean
    Std. Deviation
    Std. Error Mean
  
   
  
    SWSL
    Father
    22
    18.9545
    3.28745
    0.70089
  
  
    Mother
    21
    17.2381
    3.96112
    0.86439
  
  
    RAS
    Father
    22
    64.7727
    12.3015
    2.62269
  
  
    Mother
    21
    65.8095
    20.29684
    4.42913
  
  
    QOL
    Father
    22
    151.727
    25.89941
    5.52177
  
  
    Mother
    21
    135.667
    35.71881
    7.79448
  
  
    SWLS:    Appendix E. Satisfied with Life Scale, RAS: Appendix D. Relationship    Assessment Scale, QOL: Quality of Life Scale, N: number of participant.



Table 2:

Table 3:




  
    
    
    Levene's Test for Equality of    Variances
    t-test for Equality of Means
  
  
    F
    Sig.
    t
    df
    Significance
    Mean Difference
    Std. Error Difference
    95% Confidence Interval of the    Difference
  
  
    One-Sided p
    Two-Sided p
    Lower
    Upper
  
  
    SWSL
    Equal variances assumed
    1.203
    0.279
    1.549
    41
    0.065
    0.129
    1.71645
    1.10796
    -0.52113
    3.95403
  
  
    Equal variances not assumed
    
    
    1.542
    38.921
    0.066
    0.131
    1.71645
    1.11284
    -0.53462
    3.96752
  
  
    RAS
    Equal variances assumed
    5.768
    0.021
    -0.204
    41
    0.42
    0.84
    -1.0368
    5.09095
    -11.3182
    9.2446
  
  
    Equal variances not assumed
    
    
    -0.201
    32.66
    0.421
    0.842
    -1.0368
    5.1474
    -11.5134
    9.43981
  
  
    QOL
    Equal variances assumed
    2.865
    0.098
    1.694
    41
    0.049
    0.098
    16.06061
    9.48168
    -3.08805
    35.20926
  
  
    Equal variances not assumed
    
    
    1.681
    36.384
    0.051
    0.101
    16.06061
    9.55217
    -3.30499
    35.4262
  
  
    SWLS:    Appendix E. Satisfied With Life Scale, RAS: Appendix D. Relationship    Assessment Scale, QOL: Quality of Life Scale, F: false, t: t-test, df: degree    of freedom.



Table 3:

Results reported in table 5 that significant differences wasn’t observed t(22) = 2.073, p=0.894 in life satisfaction of married Saudi parents of Autistic Children. The mean in table 4 indicate that the Saudi parents are satisfied in their life. Findings further, suggested in table 5 that, significant differences wasn’t observed, t(22) = 2.073, p=0.195, in marital relationship satisfaction of married Saudi parents of Autistic Children. It also indicate that significant differences wasn’t observed t(22) = 2.073, p=0.697, in quality of life satisfaction of married Saudi parents.

Table 4: For married sample.




  
    Group Statistics
  
  
    
    Relation
    N
    Mean
    Std. Deviation
    Std. Error Mean
  
  
    SWLS
    Father, Married
    11
    18.1818
    3.12468
    .94213
  
  
    Mother, Married
    13
    18.0000
    3.43996
    .95407
  
  
    RAS
    Father, Married
    11
    63.5455
    12.77782
    3.85266
  
  
    Mother, Married
    13
    72.1538
    17.77567
    4.93008
  
  
    QOL
    Father, Married
    11
    149.1818
    28.45986
    8.58097
  
  
    Mother, Married
    13
    144.3077
    31.57896
    8.75843



Table 4: For married sample.

Table 5: For married sample.




  
    
    
    Levene's Test for Equality of    Variances
    t-test for Equality of Means
  
  
    F
    Sig.
    t
    df
    Significance
    Mean Difference
    Std. Error Difference
    95% Confidence Interval of the    Difference
  
  
    One-Sided p
    Two-Sided p
    Lower
    Upper
  
  
    SWLS
    Equal variances assumed
    0.64
    0.432
    0.134
    22
    0.447
    0.894
    0.18182
    1.35208
    -2.62223
    2.98586
  
  
    Equal variances not assumed
    
    
    0.136
    21.865
    0.447
    0.893
    0.18182
    1.34084
    -2.59992
    2.96355
  
  
    RAS
    Equal variances assumed
    3.385
    0.079
    -1.338
    22
    0.097
    0.195
    -8.60839
    6.43284
    -21.9493
    4.73251
  
  
    Equal variances not assumed
    
    
    -1.376
    21.507
    0.092
    0.183
    -8.60839
    6.25689
    -21.6017
    4.38488
  
  
    QOL
    Equal variances assumed
    0.21
    0.651
    0.394
    22
    0.349
    0.697
    4.87413
    12.3726
    -20.7851
    30.53333
  
  
    Equal variances not assumed
    
    
    0.398
    21.89
    0.347
    0.695
    4.87413
    12.26145
    -20.5619
    30.31019



Table 5: For married sample.

Results reported in table 7 that significant differences was observed t(17) = 2.109, p<0.005, in life satisfaction of divorced Saudi parents of Autistic Children. In marital relationship satisfaction it indicate in table 7 that significant differences was observed t(17) = 2.109, p=0.187. Furthermore, results of quality of life satisfaction in divorced Saudi parents of Autistic children, showed that significant differences was observed t(17) = 2.109, p<0.05, in table 7. The mean in table 6 indicate that Saudi divorced mothers are slightly dissatisfied in their marital relationship. On the other hand divorced fathers are slightly satisfied.

Table 6: For Divorced sample.




  
    Group Statistics
  
  
     
    Relation 
    N 
    Mean 
    Std. Deviation 
    Std. Error Mean 
  
  
    SWLS 
    Father, Divorced 
    11 
    19.7273 
    3.40855 
    1.02772 
  
  
    Mother, Divorced 
    8 
    16.0000 
    4.65986 
    1.64751 
  
  
    RAS 
    Father, Divorced 
    11 
    66.0000 
    12.29634 
    3.70749 
  
  
    Mother, Divorced 
    8 
    55.5000 
    20.95574 
    7.40897 
  
  
    QOL 
    Father, Divorced 
    11 
    154.2727 
    24.17474 
    7.28896 
  
  
    Mother, Divorced 
    8 
    121.6250 
    39.64463 
    14.01649



Table 6: For Divorced sample.

Table 7: For divorced sample.




  
    
    
    Levene's Test for Equality of    Variances
    t-test for Equality of Means
  
  
    F
    Sig.
    t
    df
    Significance
    Mean Difference
    Std. Error Difference
    95% Confidence Interval of the    Difference
  
  
    One-Sided p
    Two-Sided p
    Lower
    Upper
  
  
    SWLS
    Equal variances assumed
    1.015
    0.328
    2.02
    17
    0.03
    0.049
    3.72727
    1.84555
    -0.1665
    7.62104
  
  
    Equal variances not assumed
    
    
    1.92
    12.213
    0.039
    0.079
    3.72727
    1.94177
    -0.49531
    7.94986
  
  
    RAS
    Equal variances assumed
    2.356
    0.143
    1.376
    17
    0.093
    0.187
    10.5
    7.63182
    -5.60173
    26.60173
  
  
    Equal variances not assumed
    
    
    1.267
    10.484
    0.116
    0.232
    10.5
    8.28482
    -7.84478
    28.84478
  
  
    QOL
    Equal variances assumed
    7.059
    0.017
    2.232
    17
    0.02
    0.039
    32.64773
    14.62716
    1.78711
    63.50835
  
  
    Equal variances not assumed
    
    
    2.067
    10.748
    0.032
    0.064
    32.64773
    15.79845
    -2.22426
    67.51972



Table 7: For divorced sample.

Results reported in Table 9 indicate that significant differences wasn’t observed t(44) = 2.011, p=0.214 in life satisfaction of Saudi parents who have low and high monthly income. In marital relationship satisfaction it indicate that significant differences wasn’t observed t(44) =2.015, p=0.633. Furthermore, results of quality of life satisfaction showed that significant differences wasn’t observed t(44) = 2.015, p=0.342, in Table 9. The mean in table 8 indicate that Saudi parents of children with ASD with high and low income are satisfied with their life, and they’re slightly satisfied with their marital relationship. On the other hand Saudi parents with low income are slightly satisfied with their QOL.

Table 8:




  
    Group Statistics
  
  
    
    Income
    N
    Mean
    Std. Deviation
    Std. Error Mean
  
  
    SWLS
    Low Income
    24
    17.4167
    3.88885
    0.79381
  
  
    
    High Income
    22
    18.8182
    3.62053
    0.7719
  
  
    RAS
    Low Income
    24
    64.0417
    18.94266
    3.86665
  
  
    
    High Income
    22
    66.4091
    13.7725
    2.93631
  
  
    QOL
    Low Income
    24
    140.5417
    37.35957
    7.62599
  
  
    
    High Income
    22
    149.4091
    22.86119
    4.87402



Table 8:

Table 9:




  
    
    
    Levene's Test for Equality of    Variances
    t-test for Equality of Means
  
  
    F
    Sig.
    t
    df
    Significance
    Mean Difference
    Std. Error Difference
    95% Confidence Interval of the    Difference
  
  
    One-Sided p
    Two-Sided p
    Lower
    Upper
  
  
    SWLS
    Equal variances assumed
    0.073
    0.789
    -1.262
    44
    0.107
    0.214
    -1.40152
    1.11075
    -3.64009
    0.83706
  
  
    Equal variances not assumed
    
    
    -1.266
    43.987
    0.106
    0.212
    -1.40152
    1.10723
    -3.63301
    0.82998
  
  
    RAS
    Equal variances assumed
    4.015
    0.051
    -0.481
    44
    0.316
    0.633
    -2.36742
    4.92221
    -12.2875
    7.55264
  
  
    Equal variances not assumed
    
    
    -0.488
    41.911
    0.314
    0.628
    -2.36742
    4.85519
    -12.1662
    7.43137
  
  
    QOL
    Equal variances assumed
    6.506
    0.014
    -0.96
    44
    0.171
    0.342
    -8.86742
    9.23549
    -27.4803
    9.74547
  
  
    Equal variances not assumed
    
    
    -0.98
    38.578
    0.167
    0.333
    -8.86742
    9.05051
    -27.1802
    9.44537



Table 9:

Discussion

Parents of autistic children confront challenges that put them at risk of psychological disorders and consequences. This study aimed to investigate if children with ASD will negatively impact the life satisfaction, marital relationship, and quality of life of the Saudi parents. Findings showed that they are satisfied in their life and the quality of it. On the other hand, the mean of the marital relationship showed they are slightly satisfied. Time spent raising children had a detrimental influence on relationship quality since it directly impacted the time parents could devote to their personal connection. According to previous researches, the autistic child had an impact on relationship satisfaction [19]. Furthermore, the majority of other research revealed that ASD has a significant negative influence on Arab parents' mental health and well-being [20].

Additionally, the study aimed to investigate if the Saudi mothers will show lower level of life satisfaction, and marital satisfaction, and quality of life when it compared to fathers. Result showed there are no significant differences between them in the three variables. Although the results of the mean in QOL showed difference between them. The Saudi mother’s mean score indicate that they are slightly satisfied about their QOL. On the other hand, Saudi fathers mean score indicate that they are satisfied about their QOL. According to other research caring for children with intellectual disabilities has a clear detrimental influence on Saudi Arabian family quality of life evaluations [21].

Furthermore, the study aimed to investigate if there is a significant difference between the divorced Saudi parents, and the married Saudi parents of children with ASD. The result showed there are no significant differences of the married Saudi parents. Although the results of the mean in their marital relationship showed difference. The married mothers are satisfied in their marital relationship, but the fathers are slightly satisfied. Findings further showed that significant difference was observed, in life satisfaction and quality of life of divorced parents. On the other hand, there are no significant differences between the divorced parents in the marital relationship satisfaction. Although the mean score showed a difference. Most of the divorced mothers are slightly dissatisfied, and most of the fathers are slightly satisfied. Several studies have demonstrated that marital status has an impact on the QOL of parents with autism [22]. Previous research found that married persons had higher QOL than single or divorced people because of the social support they receive from their spouse [23].

Finally, the study aims to investigate if the Saudi parents of children with ASD will be significantly impacted by their low monthly income. The mean of the Saudi parents of children with ASD, with a low and high income showed that they are satisfied with their life, and they are slightly satisfied in their marital relationship. Saudi parents with high income are satisfied with their QOL. On the other hand, Saudi parents with low income are slightly satisfied. Furthermore, the result showed there is no significant differences between Saudi parents of children with ASD with high and low monthly income. In other studies, no influence of family income was found. While several researches discovered that family wealth had a substantial influence on marital happiness [24], others did not [25].

Unfortunately, due to the small number of parents, these findings cannot be generalized. The findings can serve as a motivator for more study on Saudi families of autistic children, as well as a beginning point for future clinical intervention. Furthermore, it may be useful to investigate these variables in connection to other variables that might impact parents functioning, such as the parents' sense of stress or coping techniques employed to deal with the child's impairment. This study focused on Saudi parents of children with ASD, but it might also be applied to parents of children with other forms of disabilities, such as learning disabilities or ADHD. With a larger participant sample, the variables may show a statistical significance.

Conclusion

Life satisfaction and QOL of Saudi divorced parents with autistic children, were significantly different. Furthermore, the results of the mean in the marital satisfaction of the divorced Saudi mothers of autistic children suggested they’re slightly satisfied. As a result, the study emphasizes the need of psychological intervention as an indication of social supports for Saudi parents of autistic children in order to improve their marital relationship, and their skills in dealing with their children and improve their QOL.

Author Statements

Author Contributions

The author indicates sole responsibility for the following: study conceptualization and design, data collection, data analysis and interpretation, and manuscript preparation.

Funding

This research received no external funding.

Informed Consent Statement

All participants gave their informed permission.

Conflicts of Interest

The authors confirm that there are no associations with or participation in any group or institution that would have a vested financial or non-financial interest in the topics or resources covered in this paper.

References

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Citation: Moumenah A, Enazi MA. Marital Relationship, Quality of Life, and Life Satisfaction for Saudi Parents of Children with Autism Spectrum Disorder. Austin J Autism & Relat Disabil. 2023; 9(2): 1067.

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