Service Delivery

The influence of self-esteem and social support on the relationship between stigma and depressive symptomology in parents caring for children with intellectual disabilities.

Cantwell et al. (2015) · Journal of intellectual disability research : JIDR 2015
★ The Verdict

Stigma erodes parent self-esteem and raises depression—emotional support breaks that chain.

✓ Read this if BCBAs serving children with IDD or autism who write parent-training goals.
✗ Skip if Clinicians working only with typically developing clients or in school-only roles.

01Research in Context

01

What this study did

Parents of children with intellectual disability, Down syndrome, or autism filled out questionnaires. The team asked how much stigma they felt, how they rated their own self-esteem, what social support they had, and how many depressive symptoms they carried.

They used a quasi-experimental design to test a simple path: stigma → lower self-esteem → more depression, and checked if emotional support could soften the blow.

02

What they found

Stigma did predict higher depressive symptoms, but the damage ran through self-esteem. When parents felt judged, their self-worth dropped, and that drop led to more sadness and fatigue.

Good emotional support acted like a cushion. It weakened the link between stigma and low self-esteem, so parents with supportive friends or family felt less depressed even when stigma was high.

03

How this fits with other research

Werner et al. (2013) saw the same stigma sting two years earlier, but they measured overall well-being instead of depression. Their data also showed stigma hurt most when parents had few psychosocial resources, lining up perfectly with the self-esteem pathway found here.

Shawler et al. (2021) extended the idea by showing that actual social involvement—not just feeling supported—lifted well-being in stressed IDD parents. Their result adds action to the advice: don’t just listen, invite parents to activities.

Marsack et al. (2017) moved the lens to parents of adults with autism and found informal support, not formal services, buffered caregiver burden. Together these papers build a clear story: across child ages and diagnoses, real-life social ties protect parent mental health.

04

Why it matters

You already teach play skills and toilet routines. This paper reminds you to screen parents for stigma and self-esteem at intake. A five-question stigma scale and a quick self-worth item can flag families at risk for depression. When scores are low, add parent goals that boost emotional support—pair them with a peer mentor, schedule coffee with other moms, or script them to ask grandparents for specific help. Reducing parent depression can improve session attendance, follow-through, and ultimately child progress.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Add two questions about felt stigma and self-esteem to your parent intake form and schedule one peer-parent coffee hour this month.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
173
Population
intellectual disability, down syndrome, autism spectrum disorder
Finding
positive

03Original abstract

BACKGROUND: This study explored the synergistic relationship between stigma, self-esteem and social support, as predictors of depressive symptomology in parents of children with disabilities (e.g. Autism and Down syndrome). METHOD: One hundred and seventy-three parents (115 parents of children with disabilities and 58 control parents) completed measures of perceived stigma, self-esteem, social support and depressive symptoms. RESULTS: Parents of children with disabilities reported more depressive symptomology; additionally, stigma, self-esteem and social support were associated with depressive symptomology. Moreover, the association between stigma and depressive symptomology was mediated by self-esteem, i.e. parents who reported higher stigma were lower on self-esteem and more depressed. Further, this path varied as a function of emotional support. CONCLUSION: Results highlight the need for tailored interventions that offer parents effective strategies in dealing with stigma through social support and self-esteem.

Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12205