Introduction:
Mothers of children with autism spectrum disorder (ASD) experience sustained functional impairment that simultaneously affects all areas of daily life. Available instruments for assessing this impact, designed within the clinical-psychological framework, capture internal states such as stress or anxiety but fail to measure the mother’s functional capacity to sustain her own life. Naturopathy, through its conceptual framework of Health Status Indicators (HSI), offers an alternative perspective grounded in real-world vital functioning.
Objective:
To describe the development process, structure, and content of a naturopathic instrument for the assessment of HSI in caregiving mothers of children with ASD, and to present the baseline health status indicator profile generated by the instrument in a sample of 62 participants.
Methods:
The instrument was developed using the naturopathic expert method, based on the systematic observation of more than 1,000 family narratives accumulated over 15 years of naturopathic practice. The resulting questionnaire comprises 107 items organized into four thematic blocks with thirteen subsections, rated on a 0-to-5 scale. It was administered retrospectively to 62 caregiving mothers of children with ASD from 15 countries, all with a minimum of 12 months’ participation in a personalized naturopathic health program.
Results:
Baseline HSI revealed a transversal and severe pattern of functional impairment across all evaluated blocks. Low functioning rates (scores 0-2) prior to program entry exceeded 80% in the personal block (mean: 81.0%), 72% in the social life and community block (72.5%), and 77% in the family and school block (77.0%). High functioning rates (scores 4-5) did not exceed 15% in any subsection at baseline, reaching as low as 2.5% in fears and anxieties and 4.6% in emotions and personal growth. Following program participation, substantial reductions in low functioning and increases in high functioning were observed across all blocks.
Conclusions:
The instrument captures dimensions of caregiving impact in mothers of children with ASD that standard clinical-psychological instruments do not measure, by focusing on real-life situations rather than internal states. The baseline data constitute in themselves a scientific contribution: the first systematic functional portrait of what these mothers experience before any intervention, built from direct naturopathic observation of more than one thousand narratives. The instrument demonstrates sensitivity for detecting functional changes in daily life and represents a contribution to the corpus of assessment tools in naturopathy.
Keywords:
autism spectrum disorder – caregiving mothers – health status indicators – naturopathy – instrument development – quality of life – functional assessment – observational study