Parents of 44 autistic children rated their children's symptom severity and their own stress on a 14-item symptom scale. Thirteen child and family characteristics were also examined to assess how they affected symptom perception and stress. Preschoolers were rated less symptomatic by their parents than by clinicians. Lower functioning, nonverbal, odd-looking, self-abusive, seizuring and hyperirritable children were rated more symptomatic than their peers. Best predictor of stress for both parents was a child's self-abuse; for mothers hyperirritability and older age were also associated with elevated stress scores. Compared with parents of matched normal children, mothers of autistic children reported the most aggravations and expressed the need for additional support from their spouses.

The frequency of ear infections, ear tube drainage, and deafness was examined through parental reports in autistic and yoke-matched, normal children. For the autistic group these difficulties were additionally examined as a function of the children's cognitive and communication abilities, verbal versus nonverbal status, sex, and degree of autistic symptomatology. Autistic children had a greater incidence of ear infections than matched normal peers. Lower-functioning children had an earlier onset of ear infections than their higher-functioning autistic peers. Ear infections coexisted with low-set ears, and with a higher autistic symptomatology score. The findings are discussed in terms of greater CNS vulnerability in the autistic children, which is likely present since embryogenesis. The possible adverse consequences of intermittent hearing loss on language, cognitive, and socioaffective development are considered.

The Holroyd (1974) Questionnaire on Resources and Stress (QRS) although clinically useful may be too inclusive and not exclusively relevant to severely dysfunctional individuals. Hitherto, efforts at shortening and psychometrically validating the QRS have met with some success: the shorter forms however still target both mentally and physically handicapped children and are clinically not as useful as the original instrument. The 78-item Clarke modification of the QRS, mainly a subset of the original, was an attempt to remedy these problems. It was validated with mothers and fathers of autistic, mentally retarded, learning-disabled, and asymptomatic children. Good internal consistency, split-half reliability, and coefficient of stability were obtained. Construct and concurrent validities were also acceptable. The questionnaire discriminated best between the two more severely affected groups and the controls. Group differences were found for 8 of its 9 scales and sex of parent differences were found for 3. The Clarke modification of the QRS is recommended for clinical use with parents of children with autism and mental retardation.

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