Thesis Full Draft

Running head: RELIGION AND ABA
Religion and Applied Behavior Analysis: Ignored Allies for Parents of Children with Autism Preeti Kumar Pennsylvania State University
Religion and Applied Behavior Analysis: Ignored Allies for Parents of Children with Autism The prevalence of autism, one of the leading developmental disorders in children, has increased from one in 150 children to one in 110 children (Autism Speaks, 2010), resulting in a 57% jump in a mere 4 years. This staggering increase in autism also means an increasing number of families facing the daunting task of raising a child with autism, a disorder characterized by severe deficits in language, social development, and presence of repetitive and stereotyped behaviors (American Psychiatric Asssociation, 2000). Given these debilitating symptoms, management and treatment of autism can result high levels of stress for parents (Osborne, McHugh, Saunders, & Reed, 2008). According to Gray (1994), sources of stress for parents of children with autism include absence of childrens adequate language skills, public behavior such as throwing tantrums, obsessive behaviors, repetitive and stereotyped behaviors, severe deficits in social skills, and extreme rigidity in daily routine. These stressors can increase the burden of caring for a child diagnosed with autism, and can further complicate choosing the proper course of treatment. Parents are faced with a buffet (Schreck & Mazur, 2008) of treatment options: Auditory Integration (AI), Discrete Trial Instruction (DTI), Facilitated Communication (FC), Floor Time, Gentle Teaching, Music Therapy, Nonaversive Treatment, Occupational Therapy, Picture Exchange Communication System, Person Centered Planning, Physical Therapy, Positive Behavior Support (PBS), Sensory Integration (SI), Treatment and Education of Autistic and Communication Handicapped Children (TEACCH), and Verbal Behavior (Jacobson, Foxx, & Mulick, 2005; Schreck & Mazur, 2008). Many of these treatment options have not been supported by scientific research and are thus considered fads. Parents are pulled towards fad treatments for various reasons (Jacobson, et al., 2005): Fad treatments enable parents to bridge
the gap between the child they hoped would be theirs and the one they have (Jacobson, et al., 2005, p. 10) more quickly than research-based treatments. Furthermore, fad treatments are often viewed as quick fixes compared to scientifically supported treaments (i.e., Applied Behavior Analysis). Given the stressors involved in raising a child with autism, parents are often drawn to these treatments because they are advertised to be the easiest and fastest way to cure their child of autism. Scientifically-validated treatments, on the other hand, are often more expensive (New York State Department of Health, 1999), stringent, and time-consuming (Green, 2007). Of all the various treatments available for autism, applied behavior analysis (ABA) is the only one that has been supported by scientific research (Lovaas, 1987; New York State Department of Health, 1999). Yet, it also the most difficult to implement and run (Green, 2007). The New York State Department of Health (1999) recomends the following in all early intensive behavioral interventions: a) Functional analysis of problem behavior; b) highly structured and supportive teaching environment; c) strategies in place to generlize skills to other environments and setting; d) strategies for smooth transition between daily activities; d) long-term strategies for transitions between invervention settings; and e) opportunities for family involvement. Successful implementionation of these elements require a large number of well-trained individuals to administer interventions in the home, leading to increased expense and disruption to the family (New York State Department of Health, 1999). Moreover, to ensure successful implemention of treatment, parents are often forced take on other roles(e.g., case manager, lead educator, data analyst, or primary therapist) (Cattell-Gordon & Cattell-Gordon, 1998), thus furuther increasing the difficulty in implemention of ABA programs. Also, behavioral intervention programs have been shown to be effective when implemented early (e.g., Fenske, Zalenski, Krantz, & McClannahan, 1985; Harris & Handleman,
2000). Children who began behavioral intervention at or earlier than five years of age were more likely to achieve a positive treatment outcomedefined as living at home with family, and enrolled full time in a public schoolcomapared to children who began behavioral intervention later than five years of age (Fenske, et al., 1985). In a more recent study, children who were enrolled in an intensive behavioral program at a younger age were more likely to be in a regular education setting during follow-up assessments compared to children who were older when enrolled in an intensive behavior program (Harris & Handleman, 2000). Along with early age of enrollment, ABA programs require many hours per week of intensive treatment. The New York State Department of Health (1999) recommends 18 to 40 hours of treatment with a minimum of 20 hours excluding time with parents. Parents are also trained in order to be able to provide treatment even in the absense of therapists (Lovaas, 1987; New York State Department of Health, 1999), thereby allowing treatment to be implemented in during all waking hours of the child. For parents under going training in order to understand and provide treatment for their child, the use of science in the treatment of autism can be difficult t o handle, especially for those who are unfamiliar with scientifc terminology. Behavior analytic procedures such as functional analysis, baselines measures, discrete trial instruction, extinction, among others, can lead to added frustration and confusion, (Maurice, Mannion, Letso, & Perry, 2001), depression, and personal strain (Poehlmann & Schwichtenberg, 2007) on the childs caregivers. All of this may cause parents extreme stress, increased difficulty in coping with their childs autism diagnosis, and a feeling of helplessness (Pisula & Kossakowska, 2010). These stressors are major contributing factors to parents electing scientifically un validated treatments over ABA even though parents report fad treatments to provide very minimal improvements
(Smith & Antolovich, 2000). Furthermore, parents of older children who already receive ABA/EIBI elect not to provide behavioral therapy to their younger children at risk for autism spectrum disorders, perhaps in response to the stressors involved (Regehr & Feldman, 2009). Even more distrubing is the fact that professionals trained in applied behavior analysis (i.e., Board-Certified Behavior Analysis)report they sometimes choose easier, non-validated treatments over ABA (Schreck & Mazur, 2008) . Such decisicions too, could be related to the stressors involved in behavior analytic treatment of autism. Applied behavior analysis, as a displicine, tries to convince parents who are already highly stressed to employ high-stress, scientific treatments for their child with autism. However, some parents may not come from a scientific background, but a religious one. They may find comfort in religious activies (e.g., prayer, attending church services), many of which reportedly aid in relieving stress for parents of children with disabilities (Bennet et al., 1995). Behaviorists, on the other hand,hold little interest in religion/spirituality ideas and activities (Miller, W.R., & Martin, J.E., 1988). This approach is no surprise as the founding father of behaviorism believed, What happens, happens, and we should accept it, no matter how inscrutable the reasons.[I do not] curse God or ask God to curse others for me when I have suffered (Skinner, 1987). Moreover, Skinner also believed,religious faithshave helped people behave well toward one another and manage their own lives more successfully. But the claimed power to intervene in supernatural rewards and punishments is the kind of power that corrupts(Skinner, 1987). Thus, parents of children with autism may not choose behavioral treaments because of ABAs complete reliance on science and disregard of religion and its role in many families strategy for stress reduction. This reduced point of view may result in many children with autism not getting proper treatment.
Thus, the purpose of this article is to argue that behavior analysts working with families of chldren with autism should consider acknowlement of religious coping strategies that families of children with developemental disabilities, including autism, use to reduce the stress related to having a child with a developmental disability.
RELIGIOUS COPING: Use of Religion to Handle Stressful Circusmstances in Daily Life and in Times of Crisis
Psychology offers a theoretical viewpoint that, although seemingly very different from ABAs scientific approach, may provide parents with the necessary tools to fight the stresses related to raising their child with autism. Religious coping involves the use of religion to cope with a persons most stressful situations (Pargament, et al., 2000). Religion plays a variety of roles in everyday life and in times of crisis. Researchers pinpoint five functions of religion: a) meaning, b) control, c) comfort/spiritual, d) intimacy/spirituality, and e) life transformation (Pargament, Koenig, & Perez, 2000). Paragament, et al., (2000) further explore the five roles of religion by identifying strategies relevant to adult coping.
Meaning: Why? When a child is diagnosed with any kind of disability, medical or
developmental, one of the first questions that arise in parents mind is why? Why my child? Why autism? Why these behaviors? One function of religion is to provide a way of understanding and interpreting major events in life (Pargament, Koenig, & Perez, 2000). Pargament, Koenig, & Perez (2000) outline four different ways of understanding and interpreting a major, stressful life event: People may see the event as possibly beneficial and thus may actually praise God inspite of the event (Benevolent Religious Appriasal). On the other hand, people may see the event as Gods punishment for their sins (Punishing God Reappraisal), or question Gods powers in lieu of the event (Reappraisal of Gods Powers). Finally, people may blame the event on the Devil
rather than God (Demonic Reappraisal).

Benevolent religious reappraisal: Gods will be done. Parents of children with
developmental disabilities incorporate Benevolent Religious Appraisal perhaps to search for an answer as to why their child has a developmental disability. With autism, parents may question why their child developed an autism diagnosis, and why the child may be engaging in socially inappropriate behaviors (or not engaging in socially appropriate behaviors). Although the causes of autism are still unknown, parents of children with autism may believe that the autism diagnosis of their child may be an act of God, through which God is/will testing/test their strength. Parents may believe that God is attempting to teach them a lesson. They may also see the autism diagnosis of their child as potentially, spiritually beneficial (Pargament et al., 2000). Research supports these assumptions. Many parents of children with various disabilities, including autism, interpret their childs disability as Gods will and/or a gift from God (Bennet, Deluca, & Allen, 1995; Erin, Rudi, &Njoroge, 1991;Heller, Markwardt, Rowittz, & Farber, 1994;). These parents believe God has especially chosen them to care for a child with a disability (Bennet, et al., 1995) and this belief can become more prevalent with time (Erin, et al., 1991). Parents of children with autism may also accept their childs inappropriate behaviors simply as Gods will and may not consider it necessary to fix the child (King, Baxter, Zwaigenbaum, & Bates, 2009). Research points out parents of some religious cultures strongly object emphasis on child deficits (e.g., Jegatheesan, Miller, & Fowler, 2010), and thereby perhaps consider it unnecessary to target inappropriate behaviors. Parents who attribute the cause of their childs disability to the will of God are likely to seek Gods help in managing the stresses involved in caring for their child. While some may leave everything in Gods hands, plead for a miracle, others may create a partnership and make a
commitment to work together with God in order to overcome any and all obstacles in their treatment of their childs disability. These behaviors may enable parents to feel that someone much more powerful than theyare in control of a situation that is beyond their own control.
Punishing God reappraisal: What did I do wrong?On the hand, parents may believe
that their childs disability is a result of Gods punishment for poor parenting or punishment for sins (e.g., Cho, 2000; Gabel, 2004). In the Biblical book of Exodus, God says, If you listen carefully to the LORD your God and do what is right in his eyes, if you pay attention to his commands and keep all his decrees, I will not bring on you any of the diseases I brought on the Egyptians, for I am the LORD, who heals you(Exodus, 15:46, NIV). Religious teachings such as these can lead parents to believe that their child has a disability because either they or their child has been cursed by God, is being punished for sins commited in this or a past life, or the disability has been cause by the evil eye (Groce & Zola, 1993). As a result, they may question what sins they may have commited in order to receive a child with a disability in form of punishment from God (Pargament, Koenig, & Perez, 2000). They may attribute the punishment to a lack of devotion or a lack of faith towards God (Pargament, Koenig, & Perez, 2000). These beliefs can result in parental shame and hesitation in seeking services for their child (Groce & Zola, 1993), thereby delaying intervention and losing precious time. Morever, when parents do seek services, they may be less likely to turn toward God for strength and courage. Rather, they would be more likely to attempt to face the challenges alone.
Demonic reappraisal: The devil did it! Parents may also attribute the cause of their
childs autism to Satan/devil,an embodiment of evil. Parents may blame their childs disability on the devil. They may wonder if the devil had a hand in their childs disability, and/or they may believe that the devil used their childs disability as a way to turn them away from God
(Pargament, et al., 2000). Biblical teachings support this view of disability. Although no recent research articles were found supporting this idea, Geisler (1974) (as cited in Ratcliff, 1980) suggested developmental disability was a type of phyical evil and can be caused by demons. Biblical teachings also point a finger at Satan as the cause of illness and disabilities (e.g., Matthew 9:32-33, 12: 22, 17:15, NIV NIV; Job 2:6-2:8, NIV). Such beliefs can cause parents to further feel ashamed and hesitate in seeking treatments.
Reappraisal of Gods power: Even God has limits. An autism diagnosis may also
Comment [P1]: Is NIV ok or should it be New International Version?
cause parents to question Gods powers. Parents may begin to think that some things that are beyond even Gods control, to see a limit to the prayers that God can answer, and to acknowledge a limit to things that God can change (Pargament, Koenig, & Perez, 2000). Although no articles were found showing that parents of children with disabilities utilize Pargament, Koenig, & Perez (2000)sReappraisal of Gods Power , it is not uncommon for people to question Gods power in the face of negative life events. Health care studies (e.g., Vandercreek, et al., 2004; Koenig, Pargament, & Nielsen, 1998)have assessed the use of negative religious coping techniques such as questioning Gods power in the face of lifechanging events such as illness. These studies show that patients utilizing negative religious coping techniques coping were more likely to have poorer physical and mental health compared to patients utilizing positive religious coping techniques.
Control: Finding order in chaos.
In the face of stressful life events, such as an autism diagnosis of their child,people feel that as if they have lost control over their lives. All of a sudden, daily routines shift from the regular care and upbringing of a child to endless meetings with therapists, strangers coming into the home to work with the child, meetings with school officials, perhaps decreased attention
10
from siblings of the child with autism. Added on are the financial burdens of paying for the treatment of the child with autism. It is but natural that parents feel that they have lost control of their lives. Another function of religion is to provide a means and sense of control in times when a person may he/she has lost control (Pargament, Koenig, & Perez, 2000). Pargament, Koenig, & Perez (2000) outline four different ways in which people use religion to gain a sense of control: A person may create a partnership with God, working together in order to meet all the requirements of the new, stressful life (Collaborative Religious Coping). A person may also develop an attitude to do his/her very best to handle the situation and then leave the result in Gods hands (Active Religious Surrender). On the other hand, a person may develop an opposite attiude, feeling that there is nothing he/she can do perhaps because he/she is not as powerful as God, and thus leave everything in Gods hands (Passive Religious Deferral). A person may also pray for a miracle (Pleading for Direct Intervention). Furthermore, a person may also deny the need of God in order to handle the situation (Self-directing Religious Coping).
Collaborative religious coping: There is no I in TEAM. Through Collaborative Religious Coping, one creates a partnership with God in order to face the challenges brought
upon by the stressful event. This approach helps a person gain a sense of control by believing that God, the All-Powerful, is on his/her side and assisting the person through difficult times. Parents of children with autism may incorporate this technique by agreeing to work with God as a team member. They may partner with God to work towards understanding the stressful situation (e.g., their childs autism). Although no articles were found showing that parents of children with disabilities used this coping technique to buffer stress, research with other populations (e.g., emergency
11
healthcare workers, (as cited in Pargament, 1997) ,church members (Pargament, et al., 1990), college students (Pargament, et al., 1994), flood victims (Pargament & Park, 1995), and middleaged, single men and women) use Collaborative Religious Coping to cope with stressful circumstances. These studies show that Collaborative Religious Coping results in better mental health, less depression (as cited in Pargament, 1997), greater sense of personal control, and greater self-esteem (Pargament, Kennell, Hathaway, Grevengoed, Newman, & Jones, 1988), and is thus a very worthwhile and beneficial coping technique.
Active religious surrender: Im doing my best; the rest is in Gods hands. Although
Comment [P2]: Friedel&Pargament, 1995
Comment [P3]: Rutledge and Spika , 1993
no research has been found showing that parents of children with autism use Active Religious
Surrender, research with parents of children with other disabilities shows some parents adopt the Active Religious Surrender method by making a commitment to do their best to care for their
child with a disability, and turn towards God for strength during stressful times (Bennet, et. al, 1995; Weisner, Beizer, & Stolze, 1991). A mother of a young boy with hearing impairment stated she turns to God for the courageand understanding to do whatever it is [she] needs to do (Bennet, et. al, 1995, p. 308) and leaves the rest in Gods hands because he knows what is beyond and he knows what is best (Bennet, et. al, 1995, p. 307). Families of South Asian cultures are perhaps more likely to use this technique because of the idea behind Active Religious Surrender . Active Religious Surrender is similar to the idea that a person should concentrate on doing hi/her best in any situation and leave the results in Gods hands, one of the central aspects of Hindu philosophy.The Bhagvad Gita, a central text of Hindu teachings, clearly states that one should do his/her duty and be detached from its outcome. A person should not be driven by the end product, but enjoy the process of getting there (2:47 SRIMAD BHAGVAD GITA). Islamic teachings also point toward working towards
Comment [P4]: Put in reference list
12
righteousness and putting trust in God about the success and ultimate results of ones deeds (Abdul Bahro, personal communication, June 14, 2011). Such beliefs can motivate parents in providing the best for their child.
Passive Religious Deferral: I cant do anything. Gods the one in control. Some
parents of children with disabilities may also turn to Passive Religious Deferral as a coping technique. Passive Religious Deferral involves waiting for God to take control of the situation without necessarily making any effort to solve the problem. Only one article (Leyser, 1994) was found showing that parents of children with disabilities such as autism adopted a Passive
Religious Deferral, but only in certain aspects of the childs life.In his study, Leyser (1994)
interviewed Orthodox Jewish families with children with disabilities (e.g., intellectual, learning, organic, physical, and sensory disability, and autism). Twenty-eight percent of these families reported that they left certain aspects of their childs life, such as his/her future, in Gods hand while taking up active roles in the treatment of their childs disability by using available services. Parents may adopt this technique because they may believe that they can never be as powerful and/or influential as God, thus they themselves cannot do anything to eradicate their childs autism.
Pleading for direct intervention: Miracles happen to those who believe, Parents of
children with debilitatiing disabilities such as autism may also turn to God for to ask for miracles, miracles such as those that might result in their child no longer showing symptoms that would result in an autism diagnosis. Parents who pray for miracles adopt Pargament, Koenig, & Perez (2000)s Pleading for Divine Intercession techinque. Praying for miracles can perhaps give parents with hope that in the future, their childs autism and associated behaviors can be minimized.
13
Self-directing Religious Coping: I can do this on my own. People who may not have
relied on God in the past, they may be less likely to turn to God in times of stress. Parents of children with autism who adopt this technique may make decisions about their childs treatment without relying on God for direction. They may choose to depend on their own strength in managing their childs autism without relying on God for strength. They may also attempt to interpret their childs autism and its cause without any help from God.
Comfort: Reassurance during Turmoil
In stressful times, people seek comfort. While many turn to family and friends, they may also turn to religion. Pargament, Koenig, & Perez (2000) outline five different ways in which people get comfort from religion. People may seek comfort in the faith that God is with them, and look to God for strength and guidance (Seeking Spiritual Support). Stressful events may also lead a person to develop a stronger spiritual connection by looking for a stronger connection with God or experiencing a stronger feeling of spirituality (Spiritual Connection). Stressful events and all that is involved in dealing with them often force a person to think constantly about the stressor, rarely allowing any mental rest. Religion also provides people an opportunities to engage in activities such as prayer or going to church, that can take their mind off of the stressor (Religious Focus). For people who believe that the stressful event in their life is a result of sin, they may turn to religion for spiritual cleansing by confessing their sins and asking for forgiveness from God (Religious Purification). On the other hand, people may be confused about Gods relationship with them, as a result of the stressful event (Spiritual Discontent). Finally, some people may create boundaries, separating religious and unreligious behaviors and then staying within those religious boundaries (Marking Religious Boundaries). Beliefs such as these can bring comfort and assurance to parents. Even though they cannot
14
control what is happening to their child, someone is in control (i.e., God), and He will lead them to answersthey seek.
Seeking spiritual support: Gods love prevails. Given the stress associated with
raising a child with autism, parents may turn to God and for comfort and support. Parents may seek Gods love, strength, guidance, and care.
Religious focus: Get me out of here! Effective management of a childs autism
Comment [P5]: What more can I add here??
involves multiple sacrifices on the behalf of parents. Parents may utilize religion as a way to step away from all things autism. Parents may choose to pray, attend church, and focus their thoughts on religious and spiritual matters rather than autism.
Religious purification: He washed my sins away. Those who believe that negative,
life-changing events are a result of sin may gain comfort in confession of sins. Parents of children of autism who believe that their childs autism is a result of sin may turn to God/church to confess their sins, ask God for forgiveness of any trespasses, and ask God for the strength to prevent them from committing any more sins.
Spiritual connection: Im part of something bigger. Life-changing events can increase
not only religiosity, but spirituality as well. Parents of children with autism may increase spirituality by seeking a stronger connection with God and other people. They may also feel they are a part of a larger spiritual force, wish to create a stronger bond with a higher power or experience more spirituality.
Spiritual Discontent: Why did He do this to me?
Similar to expressing anger towards God in the face of stressful circumstance, people may also express spiritual discontent. Parents of children with autism may feel that God has deserted them in their most difficult time, which may result in anger towards God.\
15
Marking Religious Boundaries: Do this but not that. In order to increase spirituality
and religiosity, people create rules that create boundaries, which specify the acceptable in their new, religious/spiritual lifestyle. These people may avoid others who are not of their faith and stick people, teachings, and practices of their own faith in order to avoid false religious teachings.
How Intimacy is Used to Cope with Stressful Circumstances
Religion and thereby religious institutions such as church provide ways in which people can congregate with other people, thereby gaining and providing much-needed spiritual support during stressful times. Pargament, Koenig, & Perez (2000) outline four different ways in which people use religion to gain intimacy and spiritual support from others: People may seek spiritual support from clergy and members of the congregation (Seeking Support from Clergy or Members). By sharing their experiences with the stressful event, people may also provide help and support to others in similar circumstance (Religious Helping). On the other hand, if people do not receive the needed support from their church, they may express discontent (Interpersonal Religious Disconent).
Seeking Support from Clergy Members: Strength in numbers. Parents of children
with disabilities such as autism need sufficient social support in order to adequately buffer the effects of stress caused by their childs disability (Webster, Majnemer, Platt, & Shevell, 2008; Gray, 1994). Parents of children with autism greatly rely on social support systems as a major stress coping strategy (e.g., Twoy, Connolly, & Novak, 2006), especially when the demands of raising their child exceed the resources available to the family (Donovan, 1988). Religious institutions such as churches can provide parents with socioemotional support, practical aid, and information (Skinner, Correa, Skinner, & Bailey, Jr., 2001; Gray, 1994; Bennett, Deluca,
16
&Allen, 1995; Beresford, 1994). Research shows that parents of children with other disabilities have turned to churches for love, care, support, and reassurance (Bennet, et. al, 1995; Corrigan, McCorkle, Shell, & Kidder, 2003; Erin, Rudi, &Njoroge, 1991). Parents report the most common types of support they receive in churches are prayers and emotional support (Erin, Rudi, &Njoroge, 1991).
Religion Helping: I can help others in the same boat. Parents of children with autism
understand the plight of families of children with autism perhaps much better than anyone else, and thus may be more willing and able to provide each other comfort. Families of children with autism may offer to pray for each other, offer spiritual support, strength, and comfort to each other (Pargament, Koenig, & Perez, 2000). Parents of children with autism are also speaking out in the public about their experiences, their struggles with incorporating religion into their lives (e.g., going to church). By publishing articles (e.g., Lewis, 2007; Lewis, 2007b; Buell, 2011; Kornman, 2007) and blogs on the Internet and in print,parents are finding(Shift in Tense, how do I fix?) ways to help each other. With the advancements in technology, reliance on fast distribution of information through the Internet, more families are being reached and helped by people who can understand them the best --families facing the same struggles as they.
Interreligious Discontent: This is Gods house. How am I not welcome?While many
churches are open to children with disabilities, others have turned them away. The church is a place where people come for comfort, acceptance, and peace, especially in times of sorrow and life challenges. Little do they expect to be turned away for the mere fact that their child has a disability. The main question is: Why? Why do churches tend to turn away families of children with disabilities such as autism? The answer lies in the unpreparedness of churches. Even though
17
religious institutions are a great source of support and strength for parents of children with disabilities, many feel that churches are ill equipped to provide proper services to children with disabilities (Azmi, Hatton, Emerson, & Caine, 1997; Tarakeshar & Pargament, 2001; Marshall, Olsen, Mandleco, Dyches, Allred, & Sansom, 2003). This situation results in parents being turned away from the church. For example, one study reported children with autism were 70 percent less likely to attend a weekly religious service compared to children with ADHD and typically developing children (Lee, Harrington, Louie, & Newschaffer, 2008). Parents report churches are insensitive to their childs autism and the behaviors associated with autism (Tarakeshar& Pargament, 2001). Other parents report being given incorrect advice from church members, fear of not fitting into the church community, and not being able to participate in church activities due to their childs disability and the associated behaviors (Marshall, Olsen, Mandleco, Dyches, Allred, & Sansom, 2003). The media also reports of families being turned away from the church. For example, a Catholic church denied Communion to a boy with autism because he was extremely selective eater and would not consume the host, but simply spit it out, an act that would desecrate (Clancy, 2006, p. 2) the host. This decision was made despite the fact that in the Guidelines for the Celebration of the Sacraments with Persons with Disabilities (Catholic Diocese of Richmond, 2008), it is clearly stated that a person of disability of any type should not be denied any sacrament for the simple fact that they have a disability. The document also gives a solution for persons who may not be able take communion as others do: The criterion for reception of holy communion is the same for persons with developmental and mental disabilities as for all persons, namely, that the person be able to distinguish the Body of Christ from ordinary food, even if this recognition is evidenced through manner, gesture, or reverential silence rather than verbally
Comment [P6]: Double check if this is cited correctly in the reference list.
18
(Catholic Diocese of Richmond, 2008, p.8). Another church, in Minnesota, obtained a restraining order from the court for a thirteenyear old boy with autism (Meryhew& Brown, 2008). The ruling was given due to objectively unreasonable..conduct (Meryhew& Brown, 2008, p. 1) during church services. The article reports that the teen engaged in behavior that included repeated, disruptive or distracting acts, sounds, and gestures (Meryhew& Brown, 2008, p. 1). As a result of this ban, the family was forced to attend another church in a nearby town.
How Life Transformation is Used to Cope with Stressful Circumstances
Comment [P7]: Article url no longer available so how do I cite?
Stressful events may also cause people to step back and look at life from a more general, bigger perspective. Religion provides ways in which people can redefine what sources hold most significance and what do not really matter anymore, as a result of the stressful event. Pargament, Pargament, Koenig, & Perez (2000) outline three ways in which people use religion to make a life transformation: People may turn to religion to find a new purpose for life (Seeking Religious Direction). They may use religion to make a complete tranforation of their life (Religious Conversion). Finally, they may seek religions help in letting go of negative emotions and seek ways to bring peace to themselves and others (Religious Forgiving).
Seeking religious direction: A new purpose. Life changing events can force one to take
a step back and reassess ones entire life and his/her outlook on life. The diagnosis of a child with autism may have similar results, such as parents attempting to reassess their outlook on life, and their faith. Parents may come to believe that their life, their concept of life, and their way of living it may not be applicable anymore. Thus, they may turn to God for a new purpose, new direction, or new reason for living (Pargament, Koenig, & Perez,2000) as a way to cope with their childs diagnosis with autism.
19
Religious conversion: Born again. In the face of stressful events, people may also turn
to religion for a completely different, completely new life. This coping technique is most likely used by people who believe in Gods existence, but may not have ever really relied on Him. For parents of children with autism who may not have turned to religion in the past, such a diagnosis of a child may force parents to turn to God, perhaps realizing that God and His path can help them through this situation in ways that other people and other ways of life may not be able to help. Parents may turn to religion as a new way of life, pray for a spiritual reawakening and/or rebirth.
Religious Forgiving: From chaos to peace. The diagnosis of developmental disabilities
such as autism in a child can cause emotional reactions in parents (e.g., anger, hurt, fear, ADD MORE AND CITE A PAPER). Religion provides a way for parents to manage these negative emotions. Parents may request help from God to be more forgiving of oneself and others. They also may request help from Gods help to release their negative emotions, and may seek spiritual help to give up these negative emotions.
How Can Behavior Analysts Help?
Parents of children with disabilities such as autism are under tremendous stress, and many turn to religion in order to cope. Behavior analysts can help these parents by taking to time to understand the functions of these parents religious coping behaviors. Understanding the functions of these behaviors can allow behaviorists to understand and respond to parental needs. Table 1(See Appendix A) describes each of Pargament, Koenig, & Perezs (2000) religious coping behaviors and the approach that behaviorists should take in response to these behaviors.
Meaning.Parents holding positive beliefs such those that help them accept their child
with autism as a gift from God are very likely to do their ultimate best in order to provide their
20
child with the optimal environment for effective learning and management of the symptoms of autism. Behaviorists should encourage parents to continue to view their childs autism and associated behaviors as an opportunity [given by God] to help (Weisner, Beizer, &Stolze, 1991, p. 656; Haworth, Hill & Glidden, 1996), and improve the childs life by reducing behaviors that impair child functioning. Furthermore, in order to avoid the possibility of violating certain parental beliefs about their childs negative behaviors, behaviorists should acknowledge parental belief of Gods will and the role it plays in their childs autism. Behaviors should ask parents their opinion of what behaviors should be targeted and take parental opinions into consideration when determining target behaviors. By doing so, behaviorists incorporate parental beliefs into the course of the treatment the childs autism. Parents holding negative beliefs regarding their childs autism (e.g., questioning Gods powers, blaming themselves, blaming Satan/evil), on the other hand, may hesitate in seeking treatment for their childs autism, thus loosing precious time. These parents may not perhaps be able to understand the relationship between their negative beliefs and the impact these beliefs are having on their child. Behaviorists can help parents assess this relationship. For negative beliefs that lead to negative consequences, Miller (1988) suggests self-monitoring of negative thoughts (e.g., sadness, anger, guilt, a feeling of helplessness) and the consequences that follow these thoughts (more stress, and further delays in childs treatment). Miller (1988) further suggests endorsement of alternative beliefs systems (such as Active Religious Surrender and
Collaborative Religious Coping) that would lead to positive consequences (such Early Intensive
Behavioral Therapy). Targeting negative beliefs and replacing them with positive beliefs can develop and increase motivation for parents to help their child in all ways possible to overcome autism (Miller, 1988).
21
Control.Autism and the stresses involved in its management can often cause parents to
feel as if they are losing control of not only their child but also their lives. In these situations, while some parents may turn to God and seek His help and partnership in facing the stressors involved in combating their childs autism, others may simply wait for a miracle or other forms of help from God to take away their worries and stresses. Parents who actively seek Gods help and partnership in facing and overcoming the challenge that life has presented to them should be highly encouraged to continue doing so by behaviorists. In fact, behaviorists may actually strengthen these religious beliefs by assessing the functions of inappropriate behaviors in children with autism and implementing interventions based on those functions. In this way, behaviorists can provide parents concrete ways in which they can take on collaborative and active roles with God in managing their childs autism. On the other hand, parents who passively wait for Gods help in removing the stressors accompanied by their childs autism have perhaps lost hope (Baugh, 1988), and are sitting back and waiting the solutions to their problems to simply fall into their laps (i.e., a miracle that makes everything better). Behaviorists can encourage these parents to take on a more active role in their childs treatment by providing treatment options such as EIBI. Early intervention can perhaps be the solution these parents are seeking. By taking a more active role, parents can motivated by even the smallest improvements in their childs functioning. Over time, these small improvements can then grow into larger and larger achievements to the ultimate goaltypical or near-typical child functioning. Parents can then attribute these improvements to miracles from God, and passive waiting can then be applied to future aspects of a childs life (e.g., will my child get a job, get married, raise a family?). These worries can be surrendered into Gods hands and parents can turn their attention to their childs immediate future and ways in which they can
22
make the foreseeable future bright. By doing so, parents can overcome frustration, conflict, struggle, and resistance, and find joy in tackling their childs autism (Brenner, 1985). In times of stress, some may also turn away from God/religion and attempt to face the challenges alone. However, doing so may not be emotionally or physically healthy (Martin & Carlson, 1988). Facing life challengessuch as raising a child with autismalone may also result in further stress because the lack of social support that religion can provide. When parents of children with autism are willing to adopt religious coping techniques that involve belief in God and attendance of religious services, behavior analysts should encourage parents to adopt these techniques. Religious beliefs and visits to religious institutions such as church can provide parents with much needed social support that can help reduce stress (e.g., Twoy, Connolly, & Novak, 2006). However, behaviorists must keep in mind that parents who are not willing to adopt religious beliefs and practices into their lives should not be forced to do so. For these parents, behaviorists can simply guide parents in the treatment of their child.
Comfort. Life challenges, such the diagnosis of a child with autism, can leave parents
feeling stressed, angry, and isolated. Parents may feel the need to ask for forgiveness for sins or express their anger towards God. Others may turn to religion in order to escape the stress by engaging in activities such as such as prayer and attendance of church services. Parents may also use these activities in order to find comfort and encouragement from God to face the battle of autism. How can we help? Support groups can provide parents a safe and secure environment (Dugosh, 1997)to express and explore their emotions. These support groups can also be a place where parents come together to discuss their experiences, challenges, and questions about their childs autism and its
Comment [PK8]: No page number because it s a website is that ok?
23
treatment within the context of their religious beliefs. Here, behaviorists can step in by providing answers to parents questions and reinforcement for beginning and continuing behavioral therapy for the child with autism. Behaviorists can also provide parents with ways of taking a break from the stresses of raising a child with autism by directing them to available respite care or other similar services. Behaviorists may even help churches to create assistance programs for children with disabilities during church-services and church-sponsored events (e.g., Christ Fellowship Church, 2011). In this way, parents of children with disabilities such as autism can attend worship services without worrying about their child.
Intimacy.People facing stressful circumstances in their lives, such as raising a child with
autism, are in dire need of social support (Webster, Majnemer, Platt, &Shevell, 2008; Gray, 1994). Those who are religiously oriented often turn to their religious institution, its congregation, and its leaders for support and comfort. However, opposite of what one might expect, religious institutions may not be a welcome place for people with disabilities. Many families of children with disabilities such as autism have been turned away from the church (e.g., Clancy, 2002; Meryhew& Brown, 2008). Behavior analysts can assist in helping more churches open their doors to families of children with disabilities such as autism by educating the church about autism, associated behaviors, and how to interact with children with autism. This goal can be reached through workshops, trainings, and support groups for parents. By providing religious institutions the tools to integrate children with autism and their families into their communities, behavior analysts can provide parents of children with autism much need social support and thereby help in decreasing stress caused by the childs disability.
24
Life Transformation.The diagnosis of autism in a child is a life-changing experience for
parents. Everything parents had imagined and dreamed for their child suddenly seems impossible. Such life-altering events often force a person to reassess his/her life, what things in life hold importance in light of the event, and what things no longer hold importance. Parents of children with autism may seek a new reason for living. They may also look to religion for help in increasing spirituality, and positive ways of dealing with negative emotions such as anger, hurt, fear, or guilt. Behaviorists should encourage these endeavors of parents. These endeavors can give parents the inner strength and motivation to provide the best for their child with autism. In fact, behaviorists can provide parents with ways in which they can increase spiritual/religious practices through behaviorally well-known techniques such as goal setting, self-monitoring, behavioral contracting, shaping, stimulus control, chaining, and overlearning (Martin & Booth, 2000). In doing so, behaviorists can help parents enhance their religious/spiritual life, thereby indirectly giving them the tools parents need to overcome stress and provide the best for their child.
Sanctification
Related to religious coping is the idea of santification, yet another resource parents can use to cope with the stressors in raising a child with autism. Sanctification involves viewing aspects of life as having divine character and significance (Pargament& Mahoney, 2005). Pargament and Mahoney (2005) further divide sanctification into two types: theistic and nontheistic. Theistic sanctifiation involves associating objectsmaterial objects, time and space, events and transitions, cultural products, people, psychological atrributes, social atrributes, and roles such as parentingwith ones beliefs or experiences of God (Pargament & Mahoney, 2005). Nontheistic sanctification, on the other hand, involves attributing objects with qualities
25
transcedence, timelesssness, and ultimate value and purpose such as blessed or sacredthat are usually associated with divine entities (Mahoney, Pargament, & Murray-Swank, 2003). Furthermore, increasing religious behaviors such as prayer, church attendance, etc., strengthen sanctification (Doerhring, et al., 2009). Sanctification also leads to feelings of responsibilty, duty, obligation, and protectiveness (Pargament & Mahoney, 2005)feelings that are deeply incorporated into role that people take up as parents. Nontheistic sanctification is commonly incorporated in the sanctification of family relationships such as children and parents. Many parents of children with developmental disabilities, including autism, sanctify the relationship to their child by believing their child is a gift from God and/or has a special purpose in life (Erin, Rudi, &Njoroge, 1991; Heller, Markwardt, Rowittz, & Farber, 1994; Bennet, Deluca, & Allen, 1995; Marshall, Olsen, Mandleco, Dyches, Allred, & Sansom, 2003), and is thus blessed or sacred. Holding this belief can encourage parents of children with autism to invest more of themselves into the care of their child (Murray-Swank, Mahoney, & Pargament, 2006; Dumas & Nissely-Tsiopinis, 2006).Pargament and Mahoney (2005) describe investment in the care of a child as consistent parenting. Parental investment in the care of a child with autism can be translated into meeting the childs needs by advocating for the child, encouraging independence, choosing the most appropriate treatment (i.e. EIBI), developing speech, monitoring diet needs, and consistent management of maladaptive behaviors (King, Baxter, Rosenbaum, Zwaigenbaum, & Bates, 2009). In Marshall, et. al (2003), a parent describes how sanctification has changed his/her perspective about his/her child with a disability: Its fun to sometimes think that maybe this is a great and noble person that is here to teach us. If you start looking at it that way, it really changes my whole perspective of why hes here and what I should be doing to help him. By adopting
Comment [P10]: Make sure this is cited correctly: Swank, Mahoney, and Pargament s study shows (as cited in Pargament & Mahoney, 2005). Comment [P9]: This sentence doesn t fit here where else could it go?
26
beliefs similar to this, and thereby sanctifying the parent-child relationship, parents can acquire the motivation to increase investment in their child with autism, improve the childs care, and ensure adherence to stressful, yet effective treatments such as Applied Behavior Analysis. The community of applied behavior analysis, wrapped in layers of science, may argue the coping techniques described above are nonscientific and subjective in nature. Behaviorists may assert the behaviors associated with religious coping and sanctification (prayer, attending church services, faith healing, taking communion) are simply maintained by adventitious/accidental reinforcement and are thus nothing more than superstitious behaviors. Although general psychology does regard religious beliefs and practices as superstition (Jahoda, 1968), studies show people around the world do not attribute religious/spiritual beliefs to superstition (e.g., Rudski, 2003; Torgler, 2007). Religious scholars (e.g., Gaddy, 2005) of the Christian faith differentiate religion and superstition by the denial and engagment with reality. Accordingly, a superstitious person engages in a specific behavior to avoid or change reality, whereas a religious person engages in specific behaviors in order to face and cope with reality (Gaddy, 2005). Thus, according to this differentiation, we can infer that parents of children with autism utilize religious coping and sanctification as a way to face and cope with the stressors associated with raising a child with autism. Behavior analysts may also argue that engaging in behaviors associated with religious coping and sanctification may result in neglecting the child and taking signficant time away from EIBI treatments. However, behaviorists must understand that religious coping and sanctification play quite the opposite role. These two techniques provide parents with the strength and motivation to cope with the childs behaviors and to continue with behavioral intervention. Religious coping techniques help parents to accept and understand their childs
27
disability and obtain much needed social support from religious institutions. Sanctifictiation of the parent-relationship can motivate parents to provide, adhere to, and persist with the most effective treatment for the childs autism, and provide communication and assistance from others during such a stressful time. Even though research does not exsist on establishing motivating operations that can be incorporated by parents of children with autism to cope with stressors associated with their childs diagnosis, religious coping and sanctification can very well play these roles. Establishing operations alter the value of a reinforcer and alter the frequency of behaviors that produce that reinforcer (Cooper, Heron, & Heward, 2007). For parents of children with autism, no greater reinforcer exsists than seeing their childs autistic symptoms and maladaptive behaviors minimized. Parents want nothing more than to see their child interacting with others in their environment, learning from their environment, and reaching their greatest potentials. All these are possible through early intensive behavioral intervention. Sanctification can increase the value of these reinforcers by giving parents the motivation to provide the best for their child because of the divine relationship of parents and their child and the belief of Gods presence in the parental role. Religious coping can increase the frequency of behaviors associated with proper treatment and can provide much needed social support. These two techniques combined can give parents the emotional tools necessary to place and encourage their children on the path for reaching their greatest potentials.
Discussion
The diagnosis of autism, its associated behaviors, and effective treatments cause a tremendous stress for parents of children with autism. Long term effects of these stressors have
28
lead to great anxiety and depression for parents and have required them to turn to psychotherapy and/or medication as coping methods (Gray, 2002). Parents often turn to religious coping and sanctification in order to buffer the stresses caused by their childs autism. Understanding the reasons or functions of parental religious coping behaviors can help behavior analysts understand what parents need from them. Analysis of the literatudre revealed that parents of children with autism may turn to religion for various underlying reasons (e.g., reinforcement, attention, escape). Understanding these underlying reasons can help behavior analysts help parents in their struggle with autism and its treatment. For example, parents in need of reinforcement may turn to religion for assurance that they are doing the right things in caring for their child with autism (Seeking
Spiritual Support), and may turn to clergy or church members for this reinforcement (Seeking Support from Clergy or Members) . Being aware of the parental need for reinforcement can help
behavior analysts ensure they also provide adequate reinforcement for parents, not just the child with autism. Other parents may hold negative attitudes/beliefs about their childs autism (Punishing
God Reappraisal, Demonic Reappraisal, Reappraisal of Gods Powers) and thus may need
support and attention from others. While these parents may engage in religious activities (e.g.,
Religious Purification) in order to dissipate these negative beliefs, behavior analysts can help by
directing parents to or creating support groups that can provide the needed attention and support for parents of children with autism. Parents may also want/need to step away (i.e.,escape) from autism, its responsibilities, and stressors. Thus, parents may resort to passively waiting for Gods help in eradicating their
29
childs autism (Passive Religious Deferral) or may use religion in order to engage in activies that may allow them to focus other things (Religious Focus). Behavior analysts aware of this need may be able to help parents by providing them ways in which they can step away from autism (i.e., respite care, assistance programs for church services and activities). Functionalassessments are a core part of applied behavioral science. Application of functional assessments to the religious coping behaviors of parents of children with autism can allow behavioral scientists to understand the underlying parental needs and supplement these needs during the treatment of their child with autism. Thus, behavior analysts can provide parents strength, motivation, reinforcement for opting for and continuin even the most stressful, yet most beneficial treatment (ABA/EIBI) for their child with autism. On the other hand, if behavior analyts ignore the functions of these religious behaviors, they run into the risk of parents discontinuing treatment and children with autism not receiving necessary services. If parents of children with autism do not receive adequate reinforcement and attention from service providers for the efforts they put in for the treatment of their child, they may no longer be motivated to continue behavioral therapy and resort to simpler, yet noneffective treatments. Furthermore, if parents of children with autism are not given a break from autism and its stressors, they can easily become burnt-out. They may then find ways to escape treatment-related responsibilities and eventual discontinue services. If parents of children with autism discontinue behavioral therapy, children do not receive proper treatment . Parents may turn to simpler treatments that may or may not show effective results. Employingother, easier, and scientifically non-supported treatments could lead to great set backs in the development of children with autism. Furthermore, Applied Behavior Analysis
30
isalready notorious for being much more expensive, intensive, and stressful compared to other treatments for autism. Parental discontinuation of behavioral therapy for their child can lead to further discreditation for the science and the field. However, if behavior analystis can be more aware of the needs of parents of children with autism and provide them with support, attention, reinforcement, and escape, parents will be more likely to opt for, continue, and endorse Applied Behavior Analysis as the most beneficial treatment for chidlren with autism.
CONCLUSION
Autism and its treatment are stressful for parents. Religious coping and sanctification can act as coping methods and can also offer motivation, strength, and support for parents, thereby increasing resilience in families of children with autism (Bayat, 2007). The authors of this paper encourage behavior analysts to look beyond science, into a world of faith, prayer, and divinity. Even though such religious beliefs may be different or new to us, they are not to the people we serve. Parents of children with autism turn to these very things to understand why their child has autism, and how they as parents can help their child. Perhaps the dialogue between behavior analysts and parents of children with autism can be further improved if behaviorists can be more open to spirituality while encouraging parents to be more open to behaviorism. Religious coping and sanctification can help parents choose and continue the most effective treatments, which while intensive and stressful, can be the answer to their prayers. Thus, behavior analysts should consider parents perspectives and priorities, use this awareness to respond to parents beliefs (King, et.al., 2009), and take the time to understand how they can provide the miracle these parents so desperately seek.
31
Table 1.
Religious Coping Methods and Approach by Behaviorists
Religious Coping Method Used by Parent1
Approach with Parents
MEANING Benevolent Religious Reappraisal: Gods will be Reinforce positive beliefs. Acknowledge done belief of Gods will and the role it plays in childs behaviors. Ask parents their opinion of what behaviors should be targeted. Punishing God reappraisal: What did I do wrong? Demonic Reappraisal: The devil did it! Reappraisal of Gods Powers: Even God has limits Help parents understand the relationship between negative beliefs about the cause of their childs autism and the impact these beliefs are having on the child: selfmonitoring of negative thoughts (e.g., sadness, anger, guilt ,a feeling of helplessness, etc..) and the consequences that follow these thoughts (more stress, and further delays in childs treatment).Suggest alternative beliefs systems (such as Active Religious Surrender and Collaborative Religious Coping) that would lead to positive consequences (such Early Intensive Behavioral Therapy and thus improvements in child behaviors, learning, and development ). CONTROL Collaborative Religious Coping: There is no I in Highly encourage parents who actively seek TEAM Gods help and partnership in facing and Active Religious Surrender: I am doing my best, overcoming the challenge. Behavioral techniques of functional assessment and the rest is in Gods hands assessment-based interventions may actually provide parents concrete ways in which they can take on collaborative and active roles with God in managing their childs autism. Passive Religious Deferral: I cant do anything. Gods the one in control. Encourage parents to take on a more active role in their childs treatment by providing
32
Pleading for Direct Intercession: Miracles happen treatment options such as EIBI. By taking a to those who believe more active role, parents can be motivated improvements in their childs functioning. Over time, these small improvements can then grow into larger and larger achievements, which can then be attributed to miracles from God. Passive waiting can then be applied to future aspects of a childs life (e.g., will my child get a job, get married, raise a family, etc?). This can help parents can overcome frustration, conflict, struggle, and resistance (Brenner, 1985). Self-Directing Religious Coping: I can do this on my own. Attempting to face autism alone may not be emotionally or physically healthy (Martin & Carlson, 1988), and may result in further stress. For willing parents, encourage adoption of religious coping techniques that involve belief in God, attendance of religious services, prayer, etc. However, unwilling parents should not be forced into doing so. For these parents, simply guide parents in the treatment of their child.
COMFORT Seeking Spiritual Support: Gods love prevails Direct parents to or help to create religionReligious Purification: He washed my sins away. based support groups for parents. These Spiritual Connection: Im part of something support groups can be a place where parents bigger come together to discuss their emotions, Spiritual Discontent: Why did He do this to me? experiences, challenges, and questions about Marking Religious Boundaries: their childs autism and its treatment within the context of their religious beliefs. Offer to provide answers to parents questions about behavioral therapy for their child with autism. Religious Focus: A chance to think about something else Provide parents with ways of taking a break from their child with autism. Direct them to available respite care or other similar services. Help to create assistance programs
33
for children with disabilities during churchservices and church-sponsored events (e.g., Christ Fellowship Church, 2011). INTIMACY Seeking Support from Clergy or Members: Assist in helping churches open their doors Strength in numbers to families of children with disabilities such Religion Helping as autism. Educate churches about autism, Interpersonal Religious Discontent associated behaviors, and how to interact with children with autism via workshops, trainings, and support groups for parents. LIFE TRANFORMATION Seeking Religious Direction: A new purpose Encourage parental endeavors such as increasing spirituality/religiosity to deal with Religious Conversion: Born again Religious Forgiving: From chaos to peace negative emotions that arise as a result of childs autism. These endeavors can give parents the inner strength and motivation to provide the best for their child with autism. Provide parents with ways in which they can increase spiritual/religious practices through behaviorally well-known techniques such as goal setting, self-monitoring, behavioral contracting, shaping, stimulus control, chaining, and overlearning (Martin & Booth, 2000).
1
Adapted from The Many Methods of Religious Coping: Development and Initial Validation of the RCOPE, by K.I. Pargament, H.G. Koeing, and L.M. Perez, 2000, Journal of Clinical Psychology, 56(4) .
34
References
Alper, S., Schloss, P. J., & Schloss, C. N. (1994). Families of students with disabilities. Boston: Allyn and Bacon. American Psychiatric Asssociation. (2000). DSM-IV-TR: Diagnostic and statistical manual of mental disorders (4th ed.). Arlington: American Psychiatric Asssociation. Autism Speaks. (2010). CDC reports autism prevalence rate of 1 in 110 American children, 1 in 70 boys . Retrieved June 8, 2010, from Autism Speaks: http://www.autismspeaks.org/donate/we_need_answers.php Azmi, S., Hatton, C., Emerson, E., & Caine, A. (1997). Listening to adolescents and adults with intellectual disabilities from South Asians. Journal of Applied Research in Intellectual Disabilities,10, 250-263. Baugh, J. R. (1988). Gaining control by giving up control: Strategies for coping with powerlessness. In W. R. Miller, & J. E. Martin, Behavior therapy and religion: Integrating spiritual and behavioral approaches to change (pp. 125-138). Newbury, CA: SAGE Publications. Bayat, M. (2007). Evidence of resilience in families of children with autism.Journal of Intellectual Disability Research, 51 (9), 702-714. Bennett, T., Deluca, D. A., & Allen, R. W. (1995). Religion and children with disabilitie Journal of s. Religion and Health, 34 (4), 301-313. Beresford, B. (1994). Resources and strategies: How parents cope with the care of a disabled child. Journal of Child Psychology and Psychiatry, 35(1), 171-209. Biesinger, R., & Arikawa, H. (2007). Religious attitude and happiness among parents of children with developmental disabilities. Journal of Religion, Disability & Health, 23-34. Buell, J. (2011, June 24). Meet my son. Retrieved June 24, 2011, from Children's Ministry: http://www.childrensministry.com/articles/meet-my-son?p=3 Cassidy, A., McConkey, R., Truesdale-Kennedy, M., & Slevin, E. (2008). Preschoolers with autism spectrum disorders: The impact on families and the supports available to them.Early Child Development and Care, 178 (2), 115-128.
35
Cattell-Gordon, D., & Cattell-Gordon, D. (1998). The development of an effective applied behavior analysis program for a young child with autism: A parent's perspective.Infants & Young Chldren, 10 (3), 79-85. Cho, S. (2000). Adaptation and accommodation to young children with disabilities: A comparison of Korean and Korean American parents. Topics in Early Childhood Special Education, 20(4), 236-249. Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis. Upper Saddle River, New Jersey: Pearson. Coulthard, P., & Fitzgerald, M. (1999). In God we trust? Organized religion and person beliefs as resources and coping strategies, and their implications for health in parents with a child on the autistic spectrum. Mental Health, Religion, & Cultuer, 2 (1), 19-33. Dawson, G., & Osterling, J. (1997). Early intervention in autism. In M. J. Guralnick, & M. J. Guralnick (Ed.), The effectiveness of early intervention (pp. 307-326). Baltimore: Brookes. Doerhring, C., Clarke, A., Pargament, K. I., Hayes, A., Hammer, D., Nickolas, M., et al. (2009). Perceving sacredness in life: Correlates and predictors. Archive for the Psychology of Religion, 31, 55-77. Donovan, A. M. (1988). Family stress and ways of coping with adolescents who have handicaps: Maternal perceptions. American Journal on Mental Retardation, 92 (6), 502-506. Dumas, J. E., & Nissely-Tsiopinis, J. (2006). Parental global religiousness, sanctification of parenting, and psotiing and negative religious coping as predictors of parental and ch functioning. The International ild Journal for the Psychology of Religion, 16(4), 289-310. Fenske, E. C., Zalenski, S., Krantz, P. J., & McClannahan, L. E. (1985). Age at intervention and treatment outcome for autistic children in a comprehensive interven tion program. Analysis and Intervention in Developmental Disabilities, 5, 49-58. Flynt, S. W., & Wood, T. A. (1989). Stress and coping of mothers of children with moderate mental retardation. American Journal on Mental Retardation, 94 (3), 94. Friedrich, W. N. (1979). Predictors of the coping behavior of mothers of handicapped children.Journal of Consulting and Clinical Psychology, 47(6), 1140-1141. Friedrich, W. N., Cohen, D. S., & Wilturner, L. T. (1988). Specific beliefs as moderator variab in les maternal coping with mental retardation. Children's Health Care, 17 (1), 40-44. Gabel, S. (2004). South Asian Indian cultural orientations toward mental retardation.Mental Retardation, 42, 12-25. Gaddy, C. W. (2005, May 1). Superstition and religion. Retrieved April 16, 2011, from Scientific Commons: http://en.scientificcommons.org/17803559
36
Gray, D. E. (1994). Coping with autism: Stresses and strategies. Sociology of Health & Illness, 16 (3), 275300. Gray, D. E. (2002). Ten years on: A longitudinalstudy of families of children with autism .Journal of Intellectual & Developmental Disability , 215-222. Green, V. (2007). Parental experience with treatments for autism. Journal of Developmental and Physical Disabilities, 19, 91-101. Harris, S. L., & Handleman, J. S. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four- to six-year follow-up. Journal of Autism and Developmental Disorders, 30 (2), 137-142. Haworth, A. M., Hill, A. E., & Glidden, L. M. (1996). Measuring religiousness in parents of children with developmental disabilities. Mental Retardation, 34 (5), 271-279. Haworth, A. M., Hill, A. E., & Glidden, L. M. (1996). Measuring religiousness in parents of children with developmental disabilities. Mental Retardation, 34, 271-279. Heller, T., Markwardt, R., & Rowitz, L. (1994). Adaptation of Hispanic families to a member with mental retardation. American Journal on Mental Retardation, 99 (3), 289-300. Jacobson, J. W., Foxx, R. M., & Mulick, J. A. (Eds.). (2005). Controversial therapies for developmental disabilities: Fad, fashion, and science in professional practice.New York: Routledge. Jahoda, G. (1968). The psychology of superstition. London: Allen Lane, The Penguin Press. Jegatheesan, B., Miller, P. J., & Fowler, S. A. (2010). Autism from a religious perspectives: A study of parental beliefs in south asian muslim immigrant families.Focus on Autism and Other Developmental Disabilities, 25 (2), 98-101. King, G., Baxter, D., Rosenbaum, P., Zwaigenbaum, L., & Bates, A. (2009). Belief systems of families of children with autism spectrum disorders or down syndrome.Focus on Autism and Other Developmental Disabilities, 24 (1), 50-64. Kornman, S. (2007, January 30). New church welcomes kids with disabilities Retrieved June 24, 2011, . from Tucson Citizen Morgue: http://tucsoncitizen.com/morgue/2007/01/30/40078 -new-churchwelcomes-kids-with-disabilities/ Krauss, M. W., & Seltzer, M. M. (1993). Coping strategies among older mothers of adults with retardation. In A. P. Turnbull, J. M. Patterson, S. K. Behr, D. L. Murphy, J. G. Marquis, & M. J. BlueBanning (Eds.), Cognitive coping, families, and disability.Baltimore: Paul H. Brookes Publishing Co., Inc. Lee, L., Harrington, R. A., Louie, B. B., & Newschaffer, C. J. (2008). Children with autism: Quality of life and parental concerns. Journal of Autism and Developmental Disorders, 38 1147-1160. ,
Running head: RELIGION AND ABA Lewis, S. (2007). Helping autism families survive church. Retrieved June 24, 2011, from Meridian: The place where Latter-day Saints gather: htt://www.ldsmag.com/journey071105church.html Lewis, S. (2007b). Taking autism to church. Retrieved June 24, 2011, from Meridian: The place where Latter-day Saints gather: http://www.meridianmagazine.com/journey/070702church.html Leyser, Y. (1994). Stress and adaptation in orthodox Jewish families with a disabeld child.American Journal of Orthopsychiatry, 64 (3), 376-385. Lin, C., Tasi, Y., & Chang, H. (2008). Coping mechanism of parents of children recently diagnosed with autism in Taiwan: A qualitative study. Journal of Clinical Nursing, 17, 2733-2740. Lovaas. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3-9. Mahoney, A., Pargament, K. I., & Murray-Swank, N. (2003). Religion and the sanctification of family relationships. Review of Religion Research , 220-236.
37
Marcus, L. M. (1984). Coping with burnout. In E. Schopler, & G. B. Mesibov (Eds.),The effects of autism on the family. New York: Plenum Press. Marshall, E. S., Olsen, S. F., Mandleco, B. L., Dyches, T. T., Allred, K. W., & Sansom, N. (2003). "This is a spiritual experience": Perspectives of latter-day saint families living with a child with disabilities. Qualitative Health Research, 13 (1), 57-76. Maurice, C., Mannion, K., Letso, S., & Perry, L. (2001). Parent voice: Difficulty in accessing behavioral intervention for autism; working toward solutions. Behavioral Interventions, 16, 147-165. Murray-Swank, A., Mahoney, A., & Pargament, K. I. (2006). Sanctification of parenting: Links to corporal punishment and parental warmth among biblically conservative and liberal mothers.The International Journal for the Psychology of Religion, 16(4), 271-287. Murray-Swank, A., Mahoney, A., & Pargament, K. I. (2006). Sanctification of parenting: Links to corporal punishment and parental warmth among biblically conservative and liberal mothers.The International Journal for the Psychology of Religion, 16(4), 271-287. New York State Department of Health. (1999). Clinical practice guideline: The guideline techniqucl report , autism/pervasive developmental disorders, assessment and intervention for young children (age 0 -3 years). Albany, NY: Author. O'Brien, M. (2007). Ambiguous loss in families of children with autism spectrum disorders. Family Relations, 56, 135-146. Osborne, L. A., McHugh, L., Saunders, J., & Reed, P. (2008). A possible contra-indication for early diagnosis of autistic spectrum conditions Impact on parenting stress. Research in Autism Spectrum : Disorders, 2, 707-715.
38
Pargament, K. I., & Mahoney, A. (2005). Sacred matters: Sanctification as a vital topic for the psychology of religion. The International Journal for the Psychology of Religion, 15 (3), 179-198. Pargament, K. I., Koenig, H. G., & Perez, L. M. (2000). The many methods of religious coping: Development and initial validation of the RCOPE.Journal of Clinical Psychology, 56(4), 519-543. Pisula, E., & Kossakowska, Z. (2010). Sense of coherence and coping with stress among mothers and father of children with autism. Journal of Autism and Developmental Disorders, 40, 1485-1494. Poehlmann, J., & Schwichtenberg, A. (2007). Applied behaviour analysis: Does intervention intensity related to family stressors and maternal well-being? Journal of Intellectual Disability Research, 51 (8), 598-605. Pottie, C. G., & Ingram, K. M. (2008). Daily stress, coping, and well- being in parents of children with autism: A multi-level modeling approach. Journal of Family Psychology, 22 (6), 885-864. Regehr, K., & Feldman, M. (2009). Parent-selected interventions for infancts at-risk for autism specturm disorders and their affected siblings. Behavioral Interventions, 24, 237-248. Rogers-Dulan, J. (1998). Religious connectedness among urban African American families who have a child with disabilities. Mental Retardation, 36 (2), 91-103. Rudski, J. (2003). What does a "superstitious" person believe? Impressions of participants.Journal of General Psychology, 130 (4), 431-445. Schreck, K. A., & Mazur, A. (2008). Behavior analyst use of and beliefs in treatments for people with autism. Behavioral Interventions, 23, 201-212. Shannon, H. (1969). Beliefs that are basic. Grand Rapids: Zondervan Publishing House. Siegel, B. (2008). Gettting the best for your child with autism. New York, NY: The Guildford Press. Skinner, B. F. (1987, Spring). Skinner on Religion. Retrieved May 15, 2010, from Scientific Mindfulness: Putting a 2500 year old tradition under the microscope: http://www.scientificmindfulness.com/2010/03/skinner on-religion.html Skinner, D. G., Correa, V., Skinner, M., & Bailey, Jr., D. B. (2001). Role of religion in the lives of Latino families of young children with developmental delays.American Journal on Mental Retardation, 106 (4), 297-313. Smith, T., & Antolovich, M. (2000). Parental perceptions of supplemental interventions received by young children with autism in intensive behavior analytic treatment.Behavioral Interventions, 15, 83-97. Tarakeshar, N., & Pargament, K. I. (2001). Religious coping in families of children with autism.Focus on Autism and Other Developmental Disabilities, 16 (4), 247-260.
Running head: RELIGION AND ABA Thomas, K. C., Ellis, A. R., McLaurin, C., Daniels, J., & Morrissey, J. P. (2007). Access to care for autismrelated services. Journal of Autism and Developmental Disorders, 37 1902-1912. , Torgler, B. (2007). Determinants of superstition. The Journal of Socio-Economics, 36, 713-733. Twoy, R., Connolly, P. M., & Novak, J. M. (2006). Coping strategies used by parents of children with autism. Journal of the American Academy of Nurse Practitioners, 19, 251-260. Webster, R. I., Majnemer, A., Platt, R. W., & Shevell, M. I. (2008). Child health and parental stress in school-age children with a preschool diagnosis ofdevelopmental delay. Journal of Child Neurology, 23 (1), 32-38.
39
Weisner, T. S., Beizer, L., & Stolze, L. (1991). Religion and families of children with developmental delays. American Journ on Mental Retardation, 95 (6), 647-622.
References
Alper, S., Schloss, P. J., & Schloss, C. N. (1994). Families of students with disabilities. Boston: Allyn and Bacon. American Psychiatric Asssociation. (2000). DSM-IV-TR: Diagnostic and statistical manual of
mental disorders (4th ed.). Arlington: American Psychiatric Asssociation.
Autism Speaks. (2010). CDC reports autism prevalence rate of 1 in 110 American children, 1 in
70 boys . Retrieved June 8, 2010, from Autism Speaks:
http://www.autismspeaks.org/donate/we_need_answers.php Bennett, T., Deluca, D. A., & Allen, R. W. (1995). Religion and children with disabilities.
Journal of Religion and Health, 34 (4), 301-313.
Biesinger, R., & Arikawa, H. (2007). Religious attitude and happiness among parents of children with developmental disabilities. Journal of Religion, Disability & Health , 23-34.
40
Cassidy, A., McConkey, R., Truesdale-Kennedy, M., & Slevin, E. (2008). Preschoolers with autism spectrum disorders: The impact on families and the supports available to them. Early
Child Development and Care, 178 (2), 115-128.
Cattell-Gordon, D., & Cattell-Gordon, D. (1998). The development of an effective applied behavior analysis program for a young child with autism: A parent's perspective. Infants &
Young Chldren, 10 (3), 79-85.
Coulthard, P., & Fitzgerald, M. (1999). In God we trust? Organized religion and person beliefs as resources and coping strategies, and their implications for health in parents with a child on the autistic spectrum. Mental Health, Religion, & Cultuer, 2 (1), 19-33. Dawson, G., & Osterling, J. (1997). Early intervention in autism. In M. J. Guralnick, & M. J. Guralnick (Ed.), The effectiveness of early intervention (pp. 307-326). Baltimore: Brookes. Donovan, A. M. (1988). Family stress and ways of coping with adolescents who have handicaps: Maternal perceptions. American Journal on Mental Retardation, 92 (6), 502-506. Fenske, E. C., Zalenski, S., Krantz, P. J., & McClannahan, L. E. (1985). Age at intervention and treatment outcome for autistic children in a comprehensive intervention program. Analysis and
Intervention in Developmental Disabilities, 5, 49-58.
Flynt, S. W., & Wood, T. A. (1989). Stress and coping of mothers of children with moderate mental retardation. American Journal on Mental Retardation, 94 (3), 94. Friedrich, W. N. (1979). Predictors of the coping behavior of mothers of handicapped children.
Journal of Consulting and Clinical Psychology, 47 (6), 1140-1141.
41
Friedrich, W. N., Cohen, D. S., & Wilturner, L. T. (1988). Specific beliefs as moderator variables in maternal coping with mental retardation. Children's Health Care, 17 (1), 40-44. Gray, D. E. (1994). Coping with autism: Stresses and strategies. Sociology of Health & Illness,
16 (3), 275-300.
Green, V. (2007). Parental experience with treatments for autism. Journal of Developmental and
Physical Disabilities, 19, 91-101.
Harris, S. L., & Handleman, J. S. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four- to six-year follow-up. Journal of Autism and Developmental
Disorders, 30 (2), 137-142.
Haworth, A. M., Hill, A. E., & Glidden, L. M. (1996). Measuring religiousness in parents of children with developmental disabilities. Mental Retardation, 34 (5), 271-279. Heller, T., Markwardt, R., & Rowitz, L. (1994). Adaptation of Hispanic families to a member with mental retardation. American Journal on Mental Retardation, 99 (3), 289-300. Jacobson, J. W., Foxx, R. M., & Mulick, J. A. (Eds.). (2005). Controversial therapies for
developmental disabilities: Fad, fashion, and science in professional practice. New York:
Routledge. Krauss, M. W., & Seltzer, M. M. (1993). Coping strategies among older mothers of adults with retardation. In A. P. Turnbull, J. M. Patterson, S. K. Behr, D. L. Murphy, J. G. Marquis, & M. J. Blue-Banning (Eds.), Cognitive coping, families, and disability. Baltimore: Paul H. Brookes Publishing Co., Inc.
42
Lee, L., Harrington, R. A., Louie, B. B., & Newschaffer, C. J. (2008). Children with autism: Quality of life and parental concerns. Journal of Autism and Developmental Disorders, 38 , 11471160. Lin, C., Tasi, Y., & Chang, H. (2008). Coping mechanism of parents of children recently diagnosed with autism in Taiwan: A qualitative study. Journal of Clinical Nursing, 17, 27332740. Lovaas. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55 (1), 3-9. Marcus, L. M. (1984). Coping with burnout. In E. Schopler, & G. B. Mesibov (Eds.), The effects
of autism on the family. New York: Plenum Press.
New York State Department of Health. (1999). Clinical practice guideline: The guideline
techniqucl report , autism/pervasive developmental disorders, assessment and intervention for young children (age 0-3 years). Albany, NY: Author.
O'Brien, M. (2007). Ambiguous loss in families of children with autism spectrum disorders.
Family Relations, 56, 135-146.
Osborne, L. A., McHugh, L., Saunders, J., & Reed, P. (2008). A possible contra-indication for early diagnosis of autistic spectrum conditions: Impact on parenting stress. Research in Autism
Spectrum Disorders, 2, 707-715.
Pargament, K. I., Koenig, H. G., & Perez, L. M. (2000). The many methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology, 56 (4), 519543.
43
Pottie, C. G., & Ingram, K. M. (2008). Daily stress, coping, and well-being in parents of children with autism: A multi-level modeling approach. Journal of Family Psychology, 22 (6), 885-864. Rogers-Dulan, J. (1998). Religious connectedness among urban African American families who have a child with disabilities. Mental Retardation, 36 (2), 91-103. Schreck, K. A., & Mazur, A. (2008). Behavior analyst use of and beliefs in treatments for people with autism. Behavioral Interventions, 23 , 201-212. Siegel, B. (2008). Gettting the best for your child with autism. New York, NY: The Guildford Press. Tarakeshar, N., & Pargament, K. I. (2001). Religious coping in families of children with autism.
Focus on Autism and Other Developmental Disabilities, 16 (4), 247-260.
Thomas, K. C., Ellis, A. R., McLaurin, C., Daniels, J., & Morrissey, J. P. (2007). Access to care for autism-related services. Journal of Autism and Developmental Disorders, 37 , 1902-1912. Twoy, R., Connolly, P. M., & Novak, J. M. (2006). Coping strategies used by parents of children with autism. Journal of the American Academy of Nurse Pract itioners, 19, 251-260. Weisner, T. S., Beizer, L., & Stolze, L. (1991). Religion and families of children with developmental delays. American Journ on Mental Retardation, 95 (6), 647-622.
http://www.cdc.gov/mmwr/pdf/ss/ss5601.pdf
44

Thesis Full Draft

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Thesis Full Draft

Uploaded by

Copyright:

Available Formats

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

rather than God (Demonic Reappraisal).

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Comment [P2]: Friedel&Pargament, 1995

Comment [P3]: Rutledge and Spika , 1993

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Life Transformation.The diagnosis of autism in a child is a life-changing experience for

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Religious Coping Method Used by Parent1

Approach with Parents

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

Running head: RELIGION AND ABA

You might also like