Review of the Book “Chaos to Calm” by Dr. Lee A. Wilkinson

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The demands placed on parents caring for a child with autism can contribute to a high level of parental distress and adversely affect family functioning. Unfortunately, families are often exposed to unsubstantiated, pseudoscientific theories, and related clinical practices that are ineffective and compete with validated treatments. The time, effort, and financial resources spent on ineffective treatments can create an additional burden on families. As a result, parents and caregivers everywhere are eager for credible, research-based information on the most effective treatments for autism. Chaos to Calm: Discovering Solutions to the Everyday Problems of Living with Autism by Martha Gabler describes an evidence-based method that can be used by parents and caregivers to address the everyday challenges associated with autism and improve the quality of life for their children and families.

The book is a personal account of Martha Gabler’s journey from chaos to calm and how she discovered and implemented an effective teaching method for decreasing the challenging behaviors of her non-verbal son Doug, who was diagnosed with severe autism. Gabler shows parents how to use a method called TAGteach to address many of the common and difficult problems of autism. Briefly, the acronym TAG stands for “Teaching with Acoustical Guidance.” The method utilizes an acoustical signal such as a click or a hand clap to “mark” the behavior that will earn positive reinforcement. TAGteach is based on the principles of applied behavior analysis (ABA) and relies on the use of positive reinforcement, prompting, fading, and shaping to increase desired behaviors. It is a completely positive approach that is relatively easy to learn and implement by parents and other “non-experts.”

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Fatigue and wellbeing in mothers of children with autism spectrum disorder (ASD)

Stress and health concept - woman in pain from a headacheBy Lee Wilkinson PhD, CCBT, NCSP
Reprinted with permission from

Parents are often overwhelmed by the challenges presented by a child with an autism spectrum disorder (ASD). Studies indicate that the demands placed on parents caring for a child with autism contribute to a higher overall incidence of parental stress, depression, and anxiety and adversely affects family functioning and marital relationships compared with parents of children with other intellectual, developmental, or physical disabilities. Mothers of children with ASD, in particular, appear to face unique challenges that potentially have an impact on their health and wellbeing.

Parents of children with ASD are increasingly involved in the provision of early intervention and learning activities to promote positive outcomes for their children. However, several studies have documented that parental stress as well as a lack of time and energy are barriers to providing early intervention activities. Because autism impairs social relatedness and adaptive functioning, parent stress can decrease helpful psychological processes and directly influence the parent or caregiver’s ability to support the child with disabilities. Consequently, understanding factors, such as lack of energy or fatigue that may limit the capacity of the parent to assist in promoting their child’s development is critical for this group.


A study published in the journal Autism examined the extent to which parents experience fatigue and its relationship to other aspects of wellbeing and parenting. Fifty mothers of children ages 2-5 years with ASD participated in the study and completed questionnaires assessing level of fatigue, parenting self-efficacy (belief about the ability to parent successfully), children’s behavioral and emotional problems, sleep quality, parent support needs, and overall physical activity. The study found that compared with mothers of typically developing children, mothers of children with ASD reported significantly higher fatigue, with overall scores in the moderate range. Factors associated with high levels of fatigue were poor maternal sleep quality, a high need for social support and poor quality of physical activity. Fatigue was also significantly related to other aspects of wellbeing, including stress, anxiety and depression, and lower parenting efficacy and satisfaction.

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