The impact of caring for a child with autism on caregivers' health-related quality of life (HRQOL) is not fully understood. The objective of this study was to compare the HRQOL scores of caregivers of children with autism to those of the general US population and to identify the factors that influence HRQOL. Caregivers of children with autism had lower HRQOL scores than the general population. Care recipient level of functional impairment, social support, use of maladaptive coping, and burden influenced caregiver mental HRQOL. Care recipient extent of behavioral problems and social support influenced caregiver physical HRQOL. Findings emphasize the use of multi-pronged intervention approach that incorporates components aimed at improving family functioning, increasing support services, and assisting caregivers in developing healthy coping skills.

The purpose of this study was to test the psychometric properties of the Caregiver Strain Questionnaire (CGSQ) among caregivers of children with autism. The CGSQ was originally developed to assess burden experienced by parents of children and adolescents with serious emotional and behavioral disorders. Study data was collected from 304 primary caregivers of children with autism using a cross-sectional survey design. We tested the one-, two-, and three-factor CGSQ model. Though the three-factor CGSQ model fit better than the one- and two-factor model, it was still short of an acceptable fit. Minor modifications were made to the three-factor model by correlating error terms. The modified three-factor CGSQ model with correlated error indicated reasonable fit with the data. The 21-item CGSQ had good convergent validity, as indicated by the correlation of its three subscales with constructs including mental health-related quality of life, maladaptive coping, social support, family functioning, and care recipient level of functional impairment and extent of behavioral problems, respectively. The internal consistency reliability of the instrument was also good, and there were no floor and ceiling effects. The CGSQ was found to be a reliable and valid instrument to assess burden among caregivers of children with autism.

Service providers use several types of service-delivery models to support families of persons with autism. One model, positive behavioral support, has gained increasing attention in the literature. Positive behavioral support is a comprehensive approach used to address challenging behavior and improve broad lifestyle outcomes that serve to increase the overall quality of an individual's life. This article describes a service-delivery model for individuals with autism and their families that incorporates the philosophy and essential elements of positive behavioral support. A case study is presented to illustrate one family's experience with the family focus process. Child and family outcomes related to the case study are also described. The key elements of positive behavioral support are discussed in light of providing comprehensive and durable systems of training and supports for families and educators of individuals with autism. he provision of education and t training services for families of -~~ children with autism and other special needs has received increasing attention in the literature (Covert