**1. Introduction**

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by longstanding deficits in social communication along with stereotyped, restricted, and repetitive patterns of behaviors and interests. Parenting a child with ASD can be particularly stressful and challenging due to the particular characteristics of the disorder, the difficulty obtaining services, and the burden on the family's finances [1–4]. Parents of children with ASD report low quality of life, increased parental stress, and more mental health issues compared to parents of children with typical development or other developmental disabilities [5–14]. In particular mothers, who are often reported to be the primary caregivers of children with ASD, are more vulnerable to psychological stress than fathers [2,15–17]. Social support, coping style, locus of control, self-efficacy, and positive family functions are among the factors that have been previously found to be associated with resilience in families of individuals with developmental disabilities and autism [18,19].

A crisis is a transitional period in which a person's biopsychosocial integrity is temporarily disrupted or threatened [20]. The Family Adjustment and Adaptation Response

**Citation:** Papanikolaou, K.; Ntre, V.; Gertsou, I.-M.; Tagkouli, E.; Tzavara, C.; Pehlivanidis, A.; Kolaitis, G. Parenting Children with Autism Spectrum Disorder during Crises: Differential Responses between the Financial and the COVID-19 Pandemic Crisis. *J. Clin. Med.* **2022**, *11*, 1264. https://doi.org/10.3390/ jcm11051264

Academic Editor: Michele Roccella

Received: 26 December 2021 Accepted: 24 February 2022 Published: 25 February 2022

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(FAAR) models [21] describe crisis in a family as an imbalance arising from the number of demands exceeding the capacities of the family. More specifically, the crisis in mothers of people with ASD is reported to be composed of the combination of demands, internal capabilities, external resources, and subjective appraisal [22].

The COVID-19 pandemic is the most recent cause of a worldwide crisis. It resulted in unprecedented changes in daily lives that increased demands and has been a source of stress for millions of individuals and families across the world. In Greece during this period, all schools including special education schools were closed, and students were receiving tele-education. Even special treatment centers shut down, and children with ASD or other disabilities had to spend the whole day at home. Moreover, many companies had to suspend their operation resulting in a loss of income in many families. Changes in daily structure, attempts to mitigate lost opportunities for children's learning and social interactions, increased screen time, and reduced physical activities are factors that have been discussed as important stressors for parents [23,24]. The population of children with disabilities, in particular autism, gained special attention; both opinion [25–27] and research papers discussed the possible impact of the COVID-19 pandemic on individuals with ASD [28–33] and their families [28,31,32,34,35]. They suggested strategies for them to better accommodate to the situation. Parents of individuals with ASD were more likely to have mental health problems compared to parents whose children had an intellectual disability, a visual or a hearing impairment [36], or parents of typically developing youths [37]. They reported high levels of psychological distress and disruption in their lives during the pandemic [31,34,37–42]. Some possible positive aspects of experiences during the pandemic have been also reported by parents of typically developing children [43,44] and caregivers of children with ASD [28,32,35,44–46]. These include the elimination of many daily pressures [32,45]; creating a more relaxing environment [28]; having more time to teach new skills, such as autonomy or house care-related skills [46]; having opportunities for increased family interaction and strengthening relationships [35]; developing positive characteristics such as appreciation, gratitude, and tolerance; and finding new hobbies [44].

When the COVID-19 pandemic emerged, Greek parents were in the unpleasant position of already having experienced the devastating impact of a recent financial crisis. Even before the emergence of the pandemic, the economic crisis had depleted Greek people's psychological and financial resources while public health services deteriorated [47]. Several reports showed that depression and suicide increased in adults during the period of the financial crisis [48–51]. Child and adolescent mental health services underwent budget cuts leading to some services not being fully operational. Many non-profit child and adolescent mental health centers and psychosocial rehabilitation units, including establishments specialized for autism, also closed during the economic crisis. In addition, parents had to discontinue their children's treatments because of their inability to cover by their own means the expenses the treatments entail [52].

The aim of the present study was to assess the parental stress, quality of life, coping strategies, and presence of depressive symptoms in a cohort of parents, mainly mothers, of children with ASD during the first phase of the COVID-19 crisis. It also aimed to compare our findings to the responses that the same cohort of parents gave to the same set of questionnaires during the financial crisis, approximately six years ago.
