J Child Fam Stud (2014) 23:975988

DOI 10.1007/s10826-013-9753-y

ORIGINAL PAPER

Keeping a Sound Marriage: How Couples with Children

with Autism Spectrum Disorders Maintain Their Marriages
Julie L. Ramisch Esther Onaga Su Min Oh

Published online: 1 May 2013

Springer Science+Business Media New York 2013

Abstract This study focused on strengths and variables

that contribute to marital successes for couples with children
with autism spectrum disorders (in this article, referred to as
autism). Particularly, the purpose of this study was to
examine what husbands and wives with children with autism
in contrast to couples with children who are typically
developing identify as helpful to maintaining their marriages. Concept mapping methodology was used for this
research study. Couples with children with autism and couples with children who are typically developing participated
in telephone interviews and then grouped and rated the
statements generated from their interviews. Groupings were
translated into pictorial maps showing relationships and
patterns. Couples with children with autism shared common
perceptions about factors that help to keep their marriages
strong: communication and shared foundational ideas about
marriage. Communication was a cluster for all groups of
husbands and wives. Only mothers of children with autism
identified time for self-care as a distinct cluster.
Keywords Autism
Communication
Concept mapping

Couples
Marriage

J. L. Ramisch (&)
School of Family, Consumer, and Nutrition Sciences,
Northern Illinois University, DeKalb, IL 60115, USA
e-mail: jramisch@niu.edu
E. Onaga
Michigan State University, East Lansing, MI, USA
S. M. Oh
Michigan Department of Community Health, Lansing, MI, USA

Introduction
The prevalence of children diagnosed with autism spectrum disorders (in this article, referred to as autism) is
increasing (Centers for Disease Control and Prevention
[CDC] 2012) and parents are reporting that there are many
stressors associated with raising children with autism.
Parental stress can be predicted from a variety of aspects of
raising a child with autism: stress can develop from
struggling to get a correct diagnosis for a child (OBrien
2007; Siklos and Kerns 2007), behaviors of the child that
are difficult (Brobst et al. 2009; Davis and Carter 2008;
Higgins et al. 2005), and from social isolation (Hock et al.
2012; Myers et al. 2009). Many researchers have found that
parents of children with autism are at increased risk for
physical and emotional stress and possible mental health
difficulties (Benson 2006; Gau et al. 2012; Gray 2002;
Hamlyn-Wright et al. 2007; Lecavalier et al. 2006; Little
2002; Sivberg 2002; Woodgate et al. 2008).
If a parent of a child with autism is married, individual
methods of dealing with associated stressors of raising a
child with autism seem to be associated with the quality of
the marital relationship. Kersh et al. (2006) reported that
lower parenting stress and fewer depressive symptoms
were associated with greater marital quality for mothers
and fathers with children with developmental disabilities.
Again, in a study a few years later, Benson and Kersh
(2011) found that marital quality had a negative relationship with maternal depressed mood and a positive relationship with maternal well-being for mothers with
children with autism. Even though marital quality appears
to have had positive associations with well-being, many
parents of children with autism have reported that they are
stressed (Benson 2006; Gray 2002; Hamlyn-Wright et al.
2007; Lecavalier et al. 2006; Little 2002; Sivberg 2002;

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Woodgate et al. 2008) and that their marriages are strained

(Fletcher et al. 2012; Myers et al. 2009; Phelps et al. 2009).
More specifically, spouses have reported feeling disconnected from each other (Woodgate et al. 2008) and experiencing overall decreased marital satisfaction (Brobst et al.
2009; Higgins et al. 2005; Lee 2009).
It is important that researchers investigate ways to help
couples decrease stress levels and increase marital satisfaction because, in general, spouses who are under significant stress tend to report lower satisfaction in their
marriages (Neff and Karney 2009). When these stressors
are repeated or prolonged, stress may be a detriment to the
relationship (Neff and Karney 2009). The results of
research on the prevalence of divorce among couples with
a child with autism have not been consistent. While the
mass media has reported divorce rates as high as 80 %,
there is no empirical research to support this. Freedman
et al. (2012) found no evidence to support that children
with autism were at a higher risk of living in a house
without both biological or both adoptive parents than
children without autism. Conversely, Hartley et al. (2010)
reported that the prevalence of divorce is higher for couples
with children with autism as compared with that of couples
with children who were typically developing. About one in
four (24 %) couples with children with autism divorced
during the 6-year study period versus one in seven (14 %)
couples with children who were typically developing.
Couples with children with autism continued to have a high
risk of divorce through their childrens childhood, adolescence, and early adulthood, whereas parents of children
who were typically developing had low divorce rates once
their children left childhood (Hartley et al. 2010).
While the stress of raising a child with autism can lead to
divorce, it certainly does not have to. Rather than focusing on
failures, focusing on parents strengths and variables that
predict marital success in couples who have children with
autism can be helpful (Eddy and Walker 1999). In some
cases, having a child with autism actually can bring the
couple closer together and enrich their marriage (Myers et al.
2009). Additionally, Hock et al. (2012) discussed how the
stress of parenting a child with an autism forced significant
changes within couple relationships that later brought about a
new level of closeness. The authors reported that for married
couples, having children with autism was a crucible to their
relationships. In other words, parenting children with autism
tested relationships and forced changes to be made. If couples
remained together, they developed new and more effective
ways of interacting (Hock et al. 2012).
Differences in managing stress within the couple relationship can place strain on a couple raising a child with
autism. Despite not having a consistently verified divorce
rate, concentration on the fact that Hartley et al. (2010)
found that 76 % of parents of children with autism remained

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married may provide evidence of positive marital outcomes

for couples with children with autism. An investigation into
the strategies used by couples who remain married while
raising children with autism is important. Specific to autism,
there are few researchers who have examined strategies
couples use to strengthen their marriages. Brobst et al.
(2009) found that even though couples with children with
autism had lower relationship satisfaction than comparison
couples, they did not differ from the comparison couples in
terms of perceived spousal support, respect for partners, or
commitment to relationships.
The current study further examines the strategies of
married couples with children with autism to help maintain
their marriages. The research questions for the study were:
(1) What do husbands with children with autism identify as
helpful to stay married? (2) What do wives with children
with autism identify as helpful to stay married? (3) Do wives
and husbands with children with autism have different ideas
of what helps to stay married? (4) How do wives and husbands with children with autism compare to wives and
husbands with children who are typically developing?

Method
Participants
Couples were recruited during two waves, using two listservs affiliated with a university in the Midwestern United
States. These listservs are available to staff, faculty, and
students affiliated with the university. In the first wave,
couples with children with autism were recruited using a
listserv for parents of children with special needs. The
initial email included an invitation for married parents with
children with autism between 4 and 12 years old to volunteer via email or phone. To participate, the couple had to
be married for at least 1 year, living together, and parenting
a child with autism. In the second wave, couples with
children who are typically developing were recruited using
a general listserv for parents. The initial email asked
married couples with at least one child between 4 and
12 years old to volunteer via email or phone. These couples
also had to be married for at least 1 year and living together, but not parenting any children with disabilities.
At the time that the email was sent out for this research
study, there were about 160 individuals on the listserv for
parents of children with special needs. It was not known how
many individuals had children with autism as compared to
children with other special needs. Eleven married couples
with children with autism participated in the first wave.
There were originally 12 couples who volunteered to participate; however, one couple did not complete the structuring stage. The statements of the twelfth couple remained

J Child Fam Stud (2014) 23:975988

in the list of statements so the structuring stage would not

have to be repeated with all participants, but all demographic and assessment information was removed.
For the sample in this study, the mean age for men was
41.27 years (SD = 5.33) and 37.91 years (SD = 5.09) for
women; the average length of marriage was 12.20 years
(SD = 3.93) and the average number of children per couple was two. There were nine male children and two female
children with autism; the mean age of the child was
7.49 years (SD = 2.42). About 36 % of the couples
reported annual household incomes between $40,000 and
$69,999, 27 % between $70,000 and $99,999, and 36 %
reported they earned $100,000 or more per year. About
73 % of the husbands and 55 % of the wives had achieved
at least a four-year college degree.
The listserv used to recruit couples with children who are
typically developing was a listserv designated for parents, in
general, who were staff, faculty, and students affiliated with
the university. At the time that the email was sent out for this
research study, there were about 800 individuals on that
listserv. Ten married couples with children who are typically
developing participated in the second wave. There were
originally 15 couples who volunteered to participate; however, five couples did not complete the structuring stage. The
statements of these couples remained as part of this study, but
all demographic and assessment information was removed.
The mean age for men was 38.40 years (SD = 4.17) and
37.30 years (SD = 4.35) for women. The average length of
marriage was 10.60 years (SD = 4.43) and the average
number of children per couple was two. About 20 % of the
couples reported annual household incomes between $30,000
and $69,999, 30 % between $70,000 and $99,999, and 50 %
reported they earned $100,000 or more per year. About 70 %
of the husbands and 80 % of the wives had achieved at least
a 4-year college degree.
Measures
Childhood Autism Rating Scale
The Childhood Autism Rating Scale (CARS; Schopler et al.
1980) was used to obtain an assessment of the mothers
perception of the childs level of involvement on the autism
spectrum. The CARS assesses 15 different dimensions of a
childs behavior and gives a total score ranging from 10 to
60. Each dimension is scored on a scale of (1) age-appropriate behavior to (4) deviance from age-appropriate
behaviors. According to the CARS manual (Schopler et al.
1980), scores between 10 and 30 suggest that the child is
Non-Autistic, scores between 30 and 36 indicate
Mildly-Moderately Autistic, and scores between 37 and
60 indicate Severely Autistic. For the purposes of this
study, the researcher conducting the phone interview

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completed the CARS assessment over the phone with each

mother with a child with autism. Mothers rather than fathers
participated in the phone interview regarding the CARS due
to greater scheduling flexibility for longer interviews.
Kansas Marital Satisfaction Scale
The Kansas Marital Satisfaction Scale (KMSS; Schumm
et al. 1985) is a three-item scale used to measure overall
relationship satisfaction. Participants rate each items on a
seven-point Likert scale that ranges from (1) extremely
dissatisfied to (7) extremely satisfied. Higher scores on the
KMSS indicate greater levels of relationship satisfaction.
Procedure
Concept mapping (Trochim 1989) has been used in a
number of studies (e.g., Brown 2007; Herman et al. 2005;
Johnson et al. 2000). It is a structured process beginning
with participants responding to a question. The ideas or
statements generated are then translated into a pictorial
map showing relationships and patterns. This method was
appropriate to generate ideas from husbands and wives
about factors they felt helped to keep their marriages intact.
See Jackson and Trochim (2002) for a detailed description
about how concept mapping methodology has strengths in
terms of reliability and validity.
Trochim (1989) defined six steps to the cluster mapping
process: preparation, generation of statements, structuring
of statements, representation of statements, interpretation
of maps, and utilization of maps. The first five steps were
utilized in this study.
Preparation
The preparation step involves the development of the focal
question and the selection of participants (Trochim 1989).
The researchers determined that the main focal question
should be: In your opinion, what has helped you to
maintain a strong marital relationship with your spouse?
It was also during this stage that the researchers determined
that couples with children with autism and couples with
children who are typically developing should participate.
The researchers developed the question and selected the
two groups of participants in order to help identify ideas,
beliefs, or actions regarding how couples with children
with autism maintained their marriages.
Generation of Statements
To generate a list of statements to start the conceptual
mapping process (Trochim 1989), separate telephone
interviews for each member of each couple were

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conducted. After the participant agreed to the informed

consent, the researcher posed the focal question. Participants were allowed to have as much time as they needed to
provide an unlimited number of statements. The interviews
were audio recorded, and each statement was added to one
of four lists (men or women by children with autism or
children who are typically developing). Statements that
were identical were not entered multiple times to a particular list of unique statements (see Appendix).
Structuring of Statements
According to Trochim (1989), the structuring stage consists
of sorting the different statements to help identify statements that were related. In order to increase the reliability
of this data analysis, the original participants were asked to
sort the statements into groups. Following the telephone
interviews, the list of statements for each group was sent
back only to participants in that group. That is, husbands
were given a list of statements compiled from the husbands
in their respective wave, and wives were given a list of
statements compiled from the wives in their respective
wave. Each individual was asked to group statements
together into similar concepts. Participants were given
three rules: (1) Each statement can only be used once; (2)
Do not put all statements into one group; and (3) Do not
create a miscellaneous pile. They were given a worksheet to list groups of statements and they were also asked
to assign a title to describe each group. Finally, participants
were asked to rate each statement on a scale of (1) not at all
to (5) very much in terms of how much the statement
related to how he or she maintained a strong marriage with
his or her spouse. Each participant who grouped and rated
the statements received a $10 gift certificate.
Representation of Statements
Based on Trochims (1989) method, four concept maps
were created: husbands with children with autism, wives
with children with autism, husbands with children who are
typically developing, and wives with children who are
typically developing, using multidimensional scaling
analysis following the structuring stage. The results (i.e.
groups of statements) from the Structuring of Statements
stage were put into a binary square, symmetric matrix
(SN9N, where N equals the total number of statements) for
each participant. The value for a pair of statements (Sij)
was assigned either 0 or 1 in the matrix, based on whether
the statements were grouped together (i.e., Sij = 1 if a
participant placed statement i and statement j together,
otherwise Sij = 0). The number of individual matrices was
different for each of the four groups of individuals
depending on how many people participated in this step.

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Individual matrices were aggregated into a group matrix

for each group of individuals. The group matrices indicated
how the participants in each group of individuals sorted the
statements. Higher values of Sij in the group matrix indicate people put together statements i and j in the same
group, which implies that the statements were conceptually
in the same domain. The group matrix then was used as
data for ALSCAL (SPSS), which was used to analyze each
matrix into two dimensions and provide a plot of each
statement. The distances between two points on a map
indicate how they were similar or dissimilar in the group
matrix generated in the previous step. In other words,
points further apart were grouped together less frequently
than points closer together.
Hierarchical cluster analysis using Wards algorithm
was completed to help generate clusters based on results
from the two-dimensional scaling map. Wards method is
regarded as efficient, because it keeps the sum of squares as
small as possible each time any two clusters are merged
(Everitt et al. 2011). Wards algorithm produces a list of
the statements with values that indicate how statements are
related to each other, or how often they were grouped
together by participants. The algorithm also produces a
dendrogram (a cluster tree) to help researchers determine
the final clusters. The information from Wards method
was used to guide the research team in defining the final
clusters that are visually distinct on the map and conceptually make sense for the statements. In the current study,
the researchers reviewed the maps and drew lines delineating clusters that conceptually made sense. When cases
were located close together, the researchers made a decision about which cluster was the best fit.
Interpretation of Maps
Trochim (1989) suggested that the participants or a focus
group could be involved in the interpretation of the maps
and the labeling of the clusters. Because participants in this
study did not live in close proximity to one another, the
research team (a faculty member and a graduate student)
determined the group labels based upon conceptual themes
as well as the labels participants gave for their own groups.
The team met and discussed the labels until consensus was
reached for each cluster.

Results
Childhood Autism Rating Scale
All mothers with children with autism indicated that their
children had been diagnosed with autism prior to their
participation in this study. The purpose for using the CARS

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assessment was to give the researchers the mothers own

assessment of the severity of autism for her child. The
CARS scores ranged from 23.50 to 50.00. The mean CARS
score, on a scale from 10 to 60, was 34.14 (SD = 7.25).
Three of the children diagnosed with autism had scores that
indicated that they were Severely Autistic, four children
had scores that indicated that they were Mildly-Moderately Autistic, and four children had scores that indicated
that they were Non-Autistic. Again, this assessment was
used to gather information about mothers perceptions of
the level of autism of their children, and was not intended
to challenge diagnoses given by other professionals.

Every couple returned their lists together in the same

packet or email so there were no instances where data was
collected for only one partner of a couple.

Kansas Marital Satisfaction Scale

Wives with Children with Autism

According to Crane et al. (2000), a score on the KMSS of

17 or above indicates that the individual sees their relationship as nondistressed. A score of 16 or below indicates
some degree of marital distress. Of the 20 parents with
children who are typically developing, only one mother
reported a score below 17. Of the 22 parents of children
with autism, six parents reported scores below 17. To test
for differences between the two groups, the non-parametric
MannWhitney U test was chosen because the assumptions
for an analysis of variance (ANOVA) were not met.
Results yielded no significant differences in KMSS scores
between parents with children who are typically developing (Mdn = 18) and parents with children with autism
(Mdn = 18), U = 163.50, ns, r = -.19. So, while past
research indicates that parents of children with autism have
lower marital satisfaction compared with parents of children who are typically developing (Brobst et al. 2009;
Higgins et al. 2005; Lee 2009), this was not the case in the
current study.

The wives concept map yielded five clusters (See Fig. 2): (1)
We communicate, (2) We spend time to be a couple, (3) We do

Representation of Statements
Husbands with Children with Autism
For parents of children with autism, the husbands concept
map yielded four clusters (See Fig. 1): (1) We communicate, (2) We work out our differences, (3) We care for and
love each other, and (4) We have foundational expectations.

Fig. 1 Cluster map for husbands with children with autism

Generation of Statements
Both the husbands and the wives from all couples who
responded to the invitation to participate completed this
stage. The Generation of Statements stage yielded 57
unique statements from wives and 43 unique statements
from husbands with children with autism. There were 69
unique statements from wives and 62 unique statements
from husbands with children who are typically developing.
See the Appendix for a list of all of the statements.
Structuring of Statements
Eleven out of 12 couples with children with autism and 10
out of 15 parents of children who are typically developing
completed the structuring stage. Each participant who
completed this step of the process correctly followed the
instructions for grouping and rating of the statements.

Fig. 2 Cluster map for wives with children with autism

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things for ourselves, (4) We have foundational expectations,

and (5) We encourage positive qualities for the marriage.

for the marriage, (3) We share religion and faith, (4) We

parent in the context of strong family values and support.

Husbands with Children Who Are Typically Developing

Comparisons Within and Between Couples

For parents of children who are typically developing, the

husbands concept map yielded six clusters (See Fig. 3):
(1) We care for and love each other, (2) We have commitment to each other, (3) We share religion and faith, (4)
We have foundational expectations, (5) We communicate,
and (6) We work as a team and share responsibilities.

Comparison of Couples with Children with Autism

Wives with Children Who Are Typically Developing

The wives concept map yielded four clusters (See Fig. 4):
(1) We communicate, (2) We encourage positive qualities

Fig. 3 Cluster map for husbands with children who are typically
developing

Fig. 4 Cluster map for wives with children who are typically
developing

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Similarities and differences between wives and husbands

with children with autism were examined by comparing
Figs. 1 and 2. Both husbands and wives mentioned communication and having foundational expectations as
important to their marriage. Items in the communication
cluster include talking about anything and having open
communication. The cluster labeled We have foundational expectations is less straightforward. Grouped in this
cluster are statements about expectations held before the
couple was married or before having children. For example, husbands mentioned statements such as We knew
what we wanted from a partner, and We were prepared
for cost of children. Wives mentioned statements such as
We knew marriages were not easy when we got married,
and We both have a strong belief in commitment of
marriage and raising our family together.
Husbands and wives with children with autism did have
unique clusters with respect to their genders. For example,
two clusters are unique to husbands: We work out our
differences and We care for and love each other.
Working out differences includes statements about working
through problems or talking about differences. The cluster
about care and love includes statements about how husbands love and trust their wives. Wives in this group did
not mention any significant statements about working out
problems, love, or trust. Wives have three unique clusters:
We spend time to be a couple, We do things for ourselves, and We encourage positive qualities for the
marriage. The wives cluster about spending time to be a
couple includes statements regarding going out just as a
couple without the children, as well as sharing common
interests. On the other hand, in the cluster We do things
for ourselves, wives discussed the importance of going
out and spending time alone. In this cluster there are two
statements that do not seem to conceptually fit within that
group (V35 and V29). It is important to acknowledge that
the method of concept mapping is exploratory in nature and
does not always lead to distinct concepts. Sometimes there
is overlap between the clusters as seen here. Even though
this cluster contains statements that do not seem to conceptually fit, the titled was selected to identify the three
statements that did fit together. Finally, wives discussed
positive qualities for the marriage such as Friendship,
Passion, and Having his support with everything.
Husbands did not talk about going out alone or with their
wives.

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Comparison Between the Groups of Wives

Wives with and without children with autism mentioned
communication as important. They also both mentioned
encouraging positive qualities in the marriage. Wives with
children who are typically developing had about twice as
many statements in this cluster as did wives with children
with autism; however, the statements seemed to be qualitatively similar. Additionally, wives with children who are
typically developing included statements about spending
time with their husbands as a couple without children in
their We encourage positive qualities for the marriage
cluster, whereas for wives with children with autism had a
separate cluster titled We spend time to be a couple.
The two clusters, We have foundational expectations
(wives with children with autism) and We parent in the
context of strong family values and support (wives with
children who are typically developing), are similar in that
statements about family values are present in both clusters.
What makes the two clusters different is that wives with
children who are typically developing included many more
statements about the present supports, such as family, in
addition to foundational ideas about the relationship. For
example, in this cluster are statements such as Other
couples are a support system and Extended family plays
a large role in our relationship.
Uniquely, wives with children who are typically developing had a separate cluster about religion and faith. Wives
with children with autism also mentioned statements about
God and faith, but these statements were grouped within
other clusters and not separated into a distinct cluster.
Finally, wives with children with autism had a unique
cluster about doing things for themselves. Wives with
children who are typically developing did not mention any
statements about spending time alone.
Comparison Between the Groups of Husbands
Like other between-group comparisons, a common cluster
between the two groups of husbands is about communication. Other common clusters include: We have foundational expectations and We care for and love each
other. Distinctly different, husbands with children with
autism included statements that were clustered into We
work out our differences. Husbands with children who are
typically developing did not mention any statements about
working through problems with their wives. Additionally,
husbands with children who are typically developing have
clusters such as We have a commitment to each other,
We share religion and faith, and We work as a team to
share responsibilities. As in the comparison between the
two groups of wives, husbands with children with autism
do mention commitment, God, and faith, but these

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statements are fewer in number, and they are included

within other clusters. Husbands with children with autism
do not mention any statements in terms of sharing
responsibilities.
Correlations of Assessments
The CARS assessment did not correlate significantly with
the KMSS scores nor did the CARS significantly correlate
with the clusters for either the husbands or wives with
children with autism. The KMSS scores did significantly
correlate with the mean ratings of statements for wives and
husbands with children with autism, but not for wives and
husbands with children who are typically developing (See
Table 1). We communicate was a husbands cluster that
significantly correlated with the KMSS score. We communicate, We encourage positive qualities for the marriage, and We spend time to be a couple were clusters
that significantly correlated with KMSS scores for the
wives with children with autism.

Discussion
A core research question for this study sought to discover
how husbands with children with autism compare to their
wives regarding how they keep their marriages strong. In
the current study, common perceptions about the factors
that help to maintain marriages emerged: communication
and foundational expectations. Communication was a significant factor for intact marriages for these husbands and
wives, as mean ratings for these statements within these
clusters (the cluster for husbands and the cluster for wives
pertaining to communication) positively correlated with
scores on the KMSS. Higher participant ratings of the
statements (i.e., how much that statement related to how he
or she maintained a strong marriage with his or her spouse)
were associated with higher scores on the KMSS. Communication for these couples means that they can openly
discuss topics related to their children as well as other
feelings and concerns. Spouses indicated that they are able
to work things out and make decisions together as a couple.
It also appears that shared ideas about marriage, established
prior to having a child with autism, helped couples to
develop strong foundations for their relationships. Participants mentioned the commitment that they made to their
spouses when they got married and that they were prepared
to take on the responsibility of children when that time
came. How the statements found within the clusters are
used in the relationship is unknown, but husbands and
wives could use these tenets to balance negative thoughts
or perceptions in the relationship in times of stress.

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Table 1 Correlations of
statement ratings with KMSS
scores

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Cluster name

Participant ratings
Mean

SD

Correlation of
ratings w/KMSS

Husbands with children who were typically developing

We care for and love each other

4.41

.25

We have commitment to each other

3.98

.38

.36
.11

We share religion and faith

4.25

.33

.09

We have foundational expectations

4.12

.32

.19

We communicate

4.00

1.10

-.30

We work as a team and share responsibilities

4.44

.33

.19

Wives with children who were typically developing

We parent in the context of strong family values and support

4.13

.30

-.50

We share religion and faith

3.50

1.43

.20

We communicate
We encourage positive qualities for the marriage

3.65
3.74

.50
.58

.26
-.09

Husbands with children with autism

We have foundational expectations

3.75

.81

.01

We communicate

3.83

.68

.83**

We work out our differences

3.98

.72

.59

We care for and love each other

3.94

.59

.54

Wives with children with autism

We have foundational expectations

4.01

.90

.37

We communicate

3.95

.83

.83**

* Significant at the 0.05 level

(2-tailed)

We encourage positive qualities for the marriage

3.88

.96

.95**

We spend time to be a couple

3.54

.51

.73*

** Significant at the 0.01 level

(2-tailed)

We do things for ourselves

3.74

.70

.42

Within the group of husbands with children with autism,

being able to work out differences and having love for their
wives also appear to be important factors for keeping the
marriage intact. The statements in the We work out our
differences cluster echo statements about communication,
but the husbands seemed to have conceptualized these
statements differently from those in the communication
cluster (as indicated by a separate cluster). With their
statements, husbands imply that resolving problems and
being able to tolerate disagreement through the resolution
process are what helps them in their marriages. The
absence of parallel statements from wives is noteworthy.
The wives did not mention in their communication cluster,
or elsewhere, statements that pertain to working out
problems or resolving differences.
The husbands with children with autism also had a
distinct cluster about having love for their wives. Husbands
indicated that love, trust, and a willingness to meet the
needs of their wives are important to them. They desire to
support their wives and be there for them emotionally. How
well these husbands are able to communicate these desires
and positive affirmations in their marital relationships,
however, is unknown. The wives mentioned two parallel
statements: We lean on each other and Having his
support with everything, which are grouped within the

123

cluster We encourage positive qualities for the marriage,

but one or two statements does not nearly compare to an
entire cluster of positive emotional affirmations.
The wives with children with autism had three unique
clusters, We spend time to be a couple, We do things for
ourselves, and We encourage positive qualities for the
marriage, which include many action-focused statements.
These statements imply that wives enjoy spending time
alone with their husbands as well as time alone with their
girlfriends or just out alone. Within the cluster about
spending time to be a couple are statements about friendship
with their husbands, having a solid relationship prior to
children, and taking time to spend with each other without
the children. We do things for ourselves is a much smaller
cluster, and statements do not fit together conceptually as
well as the statements in the cluster about doing things as a
couple. Therefore, for these wives, it appears that spending
time with their husbands and recognizing the importance of
that dyad is a critical factor, more so than spending time
alone. Although spending time alone or with friends is
important, these activities may not be as impactful to the
maintenance of their marriages. Finally, statements within
We encourage positive qualities for the marriage, which
seem not to fit together conceptually, are associated with
higher scores on the KMSS. Higher participant ratings of the

J Child Fam Stud (2014) 23:975988

statements in terms of how much that statement related to

maintenance of a strong marriage with a spouse were associated with higher scores on the KMSS. Interestingly, husbands do not mention going out with their wives or spending
time away from their families in any of their clusters. Perhaps this indicates that husbands do not see such activities as
essential to maintaining their marriages. The fact that wives
view these acts as important, however, may be indicative of
ways to help individuals with children with autism battle
social isolation (Hock et al. 2012; Myers et al. 2009).
Overall, it appears as though the statements given by the
wives were much more action-focused and were centered
on things that were done by each person to preserve the
marriage. Statements by the husbands seem more focused on
positive feelings that they have directed towards their wives.
This finding provides insight into some differences between
husbands and wives raising children with autism in terms of
their preferences for their marriages.
When comparing the wives with children with autism to
wives with children who are typically developing, the
clusters about communication and encouraging positive
qualities in the relationship were similar. It is noteworthy
that while wives with children with autism made statements
about spending time to be a couple and time alone, wives
with children who are typically developing did not mention
any statements about spending time alone. Spending time
alone, or making sure to reserve time to spend with friends,
may be a strategy that wives with children with autism have
developed that is particularly salient in their marital relationships. While wives with children who are typically
developing may do this as well, they do not code it as salient
to keeping their marriage together.
Another difference between the two groups of wives was
that wives with children who are typically developing
mentioned more statements about social and family support.
They also had a separate cluster about religion and faith.
Wives with children with autism had statements about religion and faith, but they were spread throughout other clusters. This difference between the two groups needs to be
considered when identifying factors to stay married. Perhaps, wives with children with autism did not mention family
or social support because they do not find extended family or
their social network to be contributing positively to their
marital relationship. This result would be in alignment with
research indicating that parents feel isolated from family
members who do not understand autism (Woodgate et al.
2008). In terms of family and friends, parents interviewed by
Myers et al. (2009) reported that a loss of family and friends
was related to negative responses to the childs autism.
Husbands with children with autism and husbands with
children who are typically developing were very similar in
their statements. They both mentioned communication,
common foundations, and care and love as important to

983

keeping a marriage intact. Again, there are more statements

about feelings directed toward their wives from husbands
with children with autism. Also, compared to husbands
with children who are typically developing, husbands with
children with autism had more statements about sharing
responsibilities in the relationship.

Limitations
Participants in both waves reported high incomes and
educational status; the results might have been different if
the participants were more diverse with respect to financial
and educational resources. Another limitation was that the
sample size for this study was small. Future studies should
aim to have a larger, more diverse sample.
Jackson and Trochim (2002) discussed that having
respondents help determine the final clusters would help to
increase the validity of a study. Ideally, the participants
themselves would provide member checking and cluster
labeling in a face-to-face meeting. Unfortunately, for this
particular project, participants were spread out geographically and such a meeting was not possible. Instead, the
researchers constructed the labels of the clusters while
allowing influence from the names that the participants
suggested for their groupings.

Future Research
It would be interesting to explore how some of the statements
and ideas are used within the marital relationship to maintain
the relationships of couples with children with autism. In
other words, through this study communication emerged as a
key aspect of maintaining a marriage for both husbands and
wives with children with autism, and it might be helpful for
future research studies to explore the idea of effective
communication for couples with children with autism.
Future research studies might also investigate how statements within the cluster about foundational expectations are
used within the relationship. For example, do such thoughts
and ideas help to balance stress or negative thoughts?
Additionally, husbands had a cluster about the love that they
have for their wives including statements about love and
trust. A logical next step might be to explore how the husbands communicate these concepts to their wives and why
wives did not include any of these types of statements in any
of their clusters. For wives with children with autism,
spending time with their husbands was mentioned; however,
husbands did not mention spending time alone with their
wives. It might be helpful to further explore whether husbands perceive spending time alone with their wives relates
to maintaining their marriage.

123

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J Child Fam Stud (2014) 23:975988

Practice Implications

Appendix continued

It is clear that the couples in this study valued communication between partners. It is important for professionals working with such couples to be prepared to offer
training in communication and to aid couples in developing adequate communication skills. The provider also
can help couples explore foundational expectations for
their relationships. If such foundational expectations are
found to be similar within dyads, they can be used to
build a united front in times of stress. Finally, providers
can work with couples and extended family members to
develop networks of support. The informal social support
of extended family members, family friends, and neighbors has been demonstrated by researchers to be very
helpful for families with children with autism (Altiere
and von Kluge 2009). Researchers have demonstrated
that informal social support can help lessen depression of
parents (Benson 2006).

Cluster title
(number
of statements)

Statement
# in
cluster

Statement

V32

Being there for each other

V38

Willingness to meet the others need

V5

Willingness to commit to the marriage

and make time to spend together

V21

We know that we will annoy each

other

V13

I have a strong and loving wife

V17

My wife is my best friend

V19

I love my wife

V31

Love

V14

My wife puts up with me

V42

Avoid situations with other people

that can promote infidelity

V36

Having trust in each other

V22

We recognize that we are different but

that is not bad

V41

Putting others need first; I do it for her

and she does for me

V29
V37

I try to support her

Having a commitment to each other

V6

We love each other

Appendix: Clusters and Statements

Cluster title
(number
of statements)

Statement
# in
cluster

Statement

We have foundational expectations (11)

Husbands with children with autism

We communicate (9)
V18

We communicate about anything

V20

We have open communication for the

good, bad, or otherwise

V26

Communication

V3

Were not territorial and we work

together

V30

Talking to her

V7

Work things out as they come up

V43

Communicating about changes of

what is a priority in life

V1

We work together to care for our child

V27

Staying on the same page

We work out our differences (5)

V4

We share a faith in God

V11

We were prepared for cost of children

V40

Desire to not to live the same life like

our parents

V24

We had a good foundation

V28

Faith

V39

Involvement in church, which is a

common interest of ours

V9

We had a strong foundation

V33

Knowing what the negative

experiences of people who have
divorced are like

V8

We were older when we got married

V10

We knew what we wanted from a

partner

V25

We took a year to just be a couple

before having kids

V16

We try to look forward

V35

Our verbal combats result in talking

about our differences

V15

We work through the problems

V9

Talk everything over

V23
V2

We work it out when we dont agree

We have mutual support instead of
his/her jobs

V32

We talk a lot

V18

Communication

V47

Open communication with each

other

V23

Open communication

V37

We communicate a lot about our

childs needs and how we can meet
those needs

Wives with children with autism

We communicate (17)

We care for and love each other (18)

123

V12

There is lots of caring between

partners

V34

Both of us are sympathetic with each

other

J Child Fam Stud (2014) 23:975988

Appendix continued

Appendix continued
Cluster title
(number
of statements)

985

Statement
# in
cluster

Statement

Cluster title
(number
of statements)

V24

We talk about our concerns

We have foundational expectations (14)

V38

We communicate about our own

feelings

V17

We stand strong together so not to be

divided and conquered by children

V25

We talk about all decisions affecting

our child

V31

We knew we had to work everything

out

V40

Compassion

V13

We have to work it out the best we can

V41

Compromise

V53

Faith

V20

We have to talk to one another before

making any decisions or believing
any doctor

V10

Our family values come before

difficulties that come up

V30

V48

We talk things out

Divorce was taken off the table when

we got married

V39

Honesty

V11

V56

Listening to him about what is

important to him

We knew marriages were not easy

when we got married

V4

We both believe in God

V3

We have similar beliefs in how handle

autism and our child
We agree about parenting

V54

Priority of marriage first

V57

Looking into the family unit and not

only the autism

V9

We both have a strong belief in

commitment of marriage and raising
our family together

V12

We made a commitment

V2

We want to make marriage work and

we have faith that it can work

V1

We have a commitment to the

marriage and to each other

V51

We spend time to be a couple (14)

V7

We were friends for many years

V50

We try to spend time with each other

V34

We make time to be just a couple

V55

Taking time to spend with each other

V49

Giving each other breaks

V6

We dont have any time now to spend

together alone so it was important to
have a good foundation to start

V26

Have someone to watch the kids

overnight

Statement
# in
cluster

Statement

We encourage positive qualities for the marriage (7)

V42

Friendship

V44

Passion
A sense of humor

V5

We had a really solid relationship to

begin with

V21
V22

Staying on the same page

V27

We find time for us without kids

V46

We lean on each other

V14

We share common interests

V16

V28

Be friends with each other

There is teamwork in terms of sharing

responsibilities

V8

We share everything and do

everything together

V45

Having his support with everything

V15

We enjoy traveling and exploring

together

V52

My husband takes my child out to do

things

We do things for ourselves (5)

V36
Mom goes out with girlfriends every
week

Husbands with children who are typically developing

We care for and love each other (13)
S32

Honesty

S40

Approach everyday with respect and

common sense towards your partner

S23

We try to meet each others needs

S34

Understanding

S22

I try to think of what my wife needs

and give that to her

V33

We make time for ourselves

V43

S24

We attended a marriage conference

that helped us

V35

We have things that we do together

but also we have things we do
separately
Being a couple is very important

S25

I accept who she is-the good and the

bad

V29

We started out on a good foundation

S2

No secrets

123

986

J Child Fam Stud (2014) 23:975988

Appendix continued

Appendix continued
Cluster title
(number
of statements)

Statement
# in
cluster

Statement

We have a personal investment in

each other

S27

You cant ignore things

S43

Bouncing ideas off each other

S38

We love each other

S30

Open communication

S48

We like each other

S50

We are pretty good friends.

S46
S36

S8

We love each other

Knowing somebody long enough

We are straightforward with each
other

S61

We communicate more than any other

couple we know

Statement
# in
cluster

Statement

S3

We have commitment to each other (6)

Cluster title
(number
of statements)

S35

We make time to spend with each

other

S18

We check in about what is going on

S37

Trust

S6

S15

We have a commitment to each other

You have to know the needs of the

other person

S21

I express my commitment level on a

daily basis

S12

We know and understand each other

and accept each others faults

S9

Our love means commitment

S53

We have a lot of similarities in what

we like

We work as a team and share responsibilities (12)

S1
S2

We do best when we work as a team

S19

Faith

S29

We share responsibilities

S20

Christianity influences my life and my

commitment to my wife

S52
S62

We know we are on the same team

We have an ability to work together

S10

Our marriage involves God

S28

I know that we are a team and have to

work together

We have common interests and values

S26

Patience

We have common values

S39

I have a sense of responsibility

S55

We have a common sense of family

S4

S58

We share similar values in teams of

family and kids

Willingness to be a team player and

act for the good of the whole family

S33

We work as a team

S41

Raising our kids together

S57

We both enjoy spending time with the

family during our free times

We share religion and faith (3)

We have foundational expectations (9)

S13
S56

S59

Being children of divorced parents

you dont want your children to go
through that

S60

We want our family to be stable

Wives with children who are typically developing

S49

Shes very easy to get along with

We communicate (22)

S54

We have a lot of mutual friends

S52

Communication is the key

S14

Our kids help to unify us and remind

us that we are a family

S53

We talk about whatever we think is

important

S43

Open communication

We communicate (19)

123

My wife and I have a unified approach

to everything

S11

We have a willingness to compromise

S27

We talk a lot and everything

S45

It is important to be able to concede

when necessary

S28
S30

S47

We are able to negotiate

Were good at communicating

We try to communicate as much as
possible

S7

You have to communicate with each

other

S14

We talk about and address problem

when they come up

S16

We go out without the kids

S18

Communication

S5

I am willing and open to talk about

things

S57

You cant read each others minds

S64

Flexibility

S44

Neither of us are afraid to tell each

other no and why

S6

We like to take a time out when things

get rough

S31

There is nothing we wont talk about

S29

We pick our battles

S51

We talk a lot

S7

S17

Communication

Time away from each other helps us to

appreciate each other

J Child Fam Stud (2014) 23:975988

Appendix continued

Appendix continued
Cluster title
(number
of statements)

987

Statement
# in
cluster

Statement

S35

We rarely go to bed angry

S2

We talk about things besides the kids.

S41

We have our own activities that we

like to do

Cluster title
(number
of statements)

Statement
# in
cluster

Statement

S34

Whenever we get a few minutes with

each other, it is always beneficial

S56

Being together

We share religion and faith (4)

We try to take extra time to make sure

we communicate clearly

S5
S9

We have a central spiritual center

S44

We have realistic expectations for our

marriage

S22

We have a commitment before Jesus

Christ

S46

We are understanding with each other

S42

Our Christian faith

S58

We support one another in decisionmaking

S66

Letting go of the responsibility from

before the kids

S67

Understanding that we were raised

differently

S25

I talk to God

We parent in the context of strong family values and support (18)

We encourage positive qualities for the marriage (25)

S13
We have a strong relationship

S8

Other couples are a support system

S16

We are on the same page with our kids

S17

We present a united front with our

kids

S31

We want to see our children do better

than we did

S61

We have the same ideas about raising

our kids

S55

Having fun with friends

S4

When we took those vows, it was until

death do us part

S62

Our cultural traditions bound us

together

S38

We are really good friends as well as

husband and wife

S3

We ask for help from each other and

friends and family when we need it

S40

We try to make a little time each day

to check in with each other

S15

We back each other up in terms of

parenting

S68

We were older when we got married

S20

We go out with and without the kids

S32
S69

We try to present a united front

We work together as a team

S26

We dont get to see each other much

S39

We love our kids

S48

We use a babysitter to go out.

S47

Hes a great dad with the kids

S23

I think about my husband and try to

look out for his interests

S45

We had good examples of strong

marriages

S36

We didnt have kids right away

S60

S1

Making sure we prioritize time with

each other

We have a strong marriage because

we have a strong family

S63

S10

We were good friends for year before

dating each other

Extended family plays a large role in

our relationship

S21

S37

We both have a sense of humor

S49

We share a sense of humor

We surround ourselves with friends

and family that are family oriented
like we are

S50

We are always joking with each other

S12

We have similar values

S65

We laugh a lot

S59

We have the same family values

S33

We dated for a long time before we

got married

S54

Spending time together

S51

We try to not take things too seriously

S11

We share a lot of common interests

S19

Our marriage is a priority

S24

I try to make my husband feel loved

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