INTERVIEW SCHEDULE

PERCEIVED STRESS AND COPING STRATEGIES IN PARENTS OF

CHILDREN WITH AUTISM SPECTRUM DISORDER (ASD)

Date: Center code: □□□□

Individual ID: □□□
PART-I: Questionnaire on factors associated with stress in parents of
children with ASD

SECTION A: Sociodemographic Information

SL NO: Categories Code
1 Age (as reported by the S01
respondent)
2 Sex 1-Male S02

2-Female

3 Marital Status 1-Married S03

2-Divorced

3-Seperated

4-Others

4 Educational status 1-No formal education S04

2-Primary

3-Secondary

4-Diploma/Graduation

5-Postgraduation or higher
 1-No formal education
5 Educational status of the
spouse 2-Primary S05
3-Secondary

4-Diploma/Graduation

5-Postgraduation or higher

6 Occupation 1-Govt Employed S06

2-Privated employed

3-Self employed

4-Daily wages

5-Homemaker

6-Unemployed

7 Occupation of the spouse 1-Govt Employed S07

2-Privated employed

3-Self employed

4-Daily wages

5-Homemaker

6-Unemployed

8 Social group 1-APL S08

2-BPL

3-Andhyodaya

4-No ration card

9 Family Tree: (Note: First generation)

SECTION B – Parental Perspective about the condition

10a What do you understand about your child’s condition?

10b What do you think is the cause of this condition in your child?

10c As a parent, which symptom in your child worries you the most?

10d How did your child’s condition affect you?

SECTION C- Child Characteristics

11 Age of the child C01
12 Age at diagnosis C02
 1-Minimally dependent C03
13 Level of care needed
for your child 2-Moderately dependent

3-Completely dependent

4-Independent

14 Does your child with

ASD have any other
□ 1- Yes C04

physical or medical If yes, specify?

conditions or
diagnoses? ……………………………

□ 2- No

SECTION D :Expenditure on child’s treatment

15 In the past month, E01
what was the
approximate
monthly expenditure
in your family?
16 Family monthly E02
expenditure on
treatment for the
child in the last
month?
17 Do you receive any
government fund for □
1-Yes
E03

your child’s
treatment?
□
2-No

SECTION E : Familial roles and responsibilities

18 How did your 1-I must work for F01
child’s ASD less hours
diagnosis affect
the employment 2-Me and my
status of your spouse must work
family? less hours
 3-I cannot go for
work

4-My spouse
cannot go for
work

5-Me and my
spouse cannot go
for work

6-Unaffected

Note: For the next 5 questions I will ask you about the role of you/your
spouse/others in matters related to responsibilities in household
1- Almost always myself
2-Mainly myself
3-Myself and my spouse equally
4-Mainly my spouse
5-Almost always my spouse
6-Others
7-Not applicable

19 Responsibilities 1 2 3 4 5 6 7

Care of the autistic child F02

Care of other children F03

Care of other family F04

members/elderly

Arranging travel/ money for care F05

seeking

Household activities like F06

cooking and cleaning etc

Decision making on health F07

care/Training
Accompanying the child for F08
treatment/training

20 What services do 1-Group F09

you currently Counselling/Support
access, or have group
you accessed in
the past, for 2-Family Therapy or
yourself? couples therapy

3-Individual
Therapy/Counselling

4-Others, Specify :
……………………

5-Not Applicable

Section F :Concerns about the child

1-Much Lower
2- Slightly lower
3-Higher
4-Much higher
5-Not at all
(Tick the appropriate option)
1 2 3 4 5
21 Are you anxious about A01
your child’s future?

Section G : Social support/cohesion

For the next 4 questions, select appropriate people in your life who help you the most
in various situations given. Indicate your answers according to the options below:-
1-Parents
2-Family
3-Sibling
4-Friends
5-Other
6-No one
22a Who is giving emotional support? SS01

22b Who is there to share happiness? SS02

22c To whom do you speak about your family SS03

problems?

22d Who helps you in taking decisions? SS04

23 Do you find difficulty in interacting with 1-Yes SS05

people around you?
2-No

24 Do you purposefully avoid any social 1-Most of the SS06

occasions/gatherings? time

2-Sometime

3-Seldom

4-Never

Remarks:
PART-II Perceived Stress Scale

The questions in this scale ask you about your feelings and thoughts during the
last month. In each case, you will be asked to indicate by circling how often you
felt or thought a certain way.

0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often

1. In the last month, how often have you been upset because of something that
happened unexpectedly? 0 1 2 3 4
2. In the last month, how often have you felt that you were unable to control the
important things in your life?
0 1 2 3 4

3. In the last month, how often have you felt nervous and “stressed”?

0 1 2 3 4

4. In the last month, how often have you felt confident about your ability to
handle your personal problems? 0 1 2 3 4

5. In the last month, how often have you felt that things were going your way?

0 1 2 3 4

6. In the last month, how often have you found that you could not cope with all
the things that you had to do?

0 1 2 3 4
7. In the last month, how often have you been able to control irritations in your
life?
0 1 2 3 4

8. In the last month, how often have you felt that you were on top of things?

0 1 2 3 4
9. In the last month, how often have you been angered because of things that
were outside of your control?

0 1 2 3 4

10. In the last month, how often have you felt difficulties were piling up so high
that you could not overcome them?

0 1 2 3 4

PART-III Questions on coping strategies

The following items deal with ways you've been coping with the stress in your
life. Each item says something about a particular way of coping. I want to know
to what extent you've been doing what the item says, how much or how
frequently. Use the given response choices.

1 = I haven't been doing this at all

2 = I've been doing this a little bit

3 = I've been doing this a medium amount

4 = I've been doing this a lot

Sl No: Strategies 1 2 3 4
1 I talk to someone about how I feel

2 I learned something from the experience

3 I pray more than usual
4 I get sympathy and understanding from
others
5 I look for something good in what is
happening
6 I put my trust in God
7 I try to get emotional support from
family/friends
8 I seek God’s help

9 I try to see it in different perspective, to

make it more positive

10 I learned to live with it

11 I accept my child’s condition and
understand that it can’t be changed
completely

12 I got used to my child’s diagnosis

13 I accept the reality of fact that it has

happened

14 I try to improve as a person of the

experience
15 I try to find comfort in my religion
16 I discuss my feelings to someone

Thank you for your participation!