The impact of autism services on mothers’ psychological wellbeing S. Hodgetts,* D. McConnell,* L. Zwaigenbaum† and D. Nicholas‡ *Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada †Department of Pediatrics, University of Alberta, Edmonton AB Autism Research Centre, E209 Glenrose Rehabilitation Hospital, Edmonton, AB, Canada, and ‡Faculty of Social Work, University of Calgary (Edmonton Division), Edmonton, AB, Canada Accepted for publication 1 August 2016 Keywords autism spectrum disorder, continuity of services, family-centred services, maternal well- being, service delivery, service fragmentation Correspondence: Sandra Hodgetts, Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 8205 114St, 2-64 Corbett Hall, Edmonton, AB T6G 2G4, Canada E-mail: sandra.hodgetts@ualberta. ca Abstract Background Families with a child diagnosed with autism spectrum disorder (ASD) often utilize a variety of professional services. The provision of these services has many potential benefits for families; however, these services also place demands on parents, particularly mothers, to access, navigate and participate. Little is known about how involvement with these services and service systems influences the psychological wellbeing of mothers of children diagnosed with ASD. We examined the relationship between professional services and psychological wellbeing for mothers of children diagnosed with ASD. Methods Mothers (n = 119) of children (mean child age 10.1 years; range 2–24 years) diagnosed with ASD anonymously completed a comprehensive survey. The survey included data related to maternal psychological wellbeing, professional services received and perceptions of these services, and child, mother and household characteristics. Results Regression analyses revealed that maternal psychological wellbeing was positively associated with the perceived continuity of services, and negatively associated with the number of professionals involved. Child and maternal age, and household income were also statistically significant predictors of maternal psychological wellbeing. Conclusions The study findings draw attention to the potentially negative impact of systems-level challenges, especially fragmentation of services, on maternal psychological wellbeing, despite positive front-line services. In particular, our data suggest that psychological wellbeing among mothers of children with ASD may vary more as a function of service system variables than practitioner-level or child-level variables. Introduction Many parents and families with a child with an autism spectrum disorder (ASD) fare well. However, high levels of parental stress, anxiety and depression are well documented (VanLeit & Crowe 2000; Altiere & von Kluge 2009; Bourke-Taylor et al. 2010; Barker et al. 2011; Samadi et al. 2014). Moreover, there appears to be something particularly challenging about the experience of parenting a child with ASD as these parents tend to report lower levels of psychological wellbeing than parents of children with other intellectual and developmental disabilities, and of those without any known developmental delays or special health care needs (Bailey et al. 2007; Montes & Halterman 2007; Totsika et al. 2011; Hayes & Watson 2013). Most research related to the psychological wellbeing of parents of children with ASD has focused on the impact of Original Article doi:10.1111/cch.12398 © 2016 John Wiley & Sons Ltd 1 Child: care, health and development