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The Impact of Parenting Stress: A Meta-analysis of Studies Comparing the Experience of Parenting Stress in Parents of Children With and Without Autism Spectrum Disorder

Hayes, Stephanie A., Watson, Shelley L.·2013·Journal of Autism and Developmental Disorders

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Abstract

Researchers commonly report that families of children with autism spectrum disorder (ASD) experience more parenting stress than families of typically developing (TD) children or those diagnosed with other disabilities [e.g., Down syndrome (DS), cerebral palsy, intellectual disability]. The authors reexamined the research using comparison groups to investigate parenting stress and conducted a meta-analysis to pool results across studies. The experience of stress in families of children with ASD versus families of TD children resulted in a large effect size. Comparisons between families of children of ASD and families with other disabilities also generated a large effect size however, this result should be interpreted with caution as it may be associated with the specific experience of parenting a child with DS.

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“Hayes and Watson, in a meta-analysis found that parents of children who had the diagnosis of autism spectrum disorder had a much higher stress level, even more than those of children with severe physical disabilities.(48) Although many patients with childhood disabilities also have a component of intellectual disabili…”
Self-Management Support Intervention for Parents of Children with Developmental Disorders: The Role of Gratitude and Hope
Martin, F., Clyne, W., Pearce, G., & Turner, A. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-018-01308-1 · Cited by 49
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Kirby, A. V., Williams, K. L., Watson, L. R., Sideris, J. H., Bulluck, J., & Baranek, G. T. (2019) · American Journal of Occupational Therapy · doi:10.5014/ajot.2018.027391 · Cited by 41
“…disorder (ASD) and other developmental disabilities (DD) have unique and varied experiences that warrant close examination to inform more effective interventions for children (Freuler et al., 2014; Hanna & Rodger, 2002) and family-centered care (Hodgetts et al., 2013; Kuhaneck et al., 2015).”
An analysis of mother stress before and during COVID-19 pandemic: The case of China
Tchimtchoua Tamo, A. R. (2020) · Health Care for Women International · doi:10.1080/07399332.2020.1841194 · Cited by 39
Effectiveness of the stepping stones triple P group parenting program as an additional intervention in the treatment of autism Spectrum disorders: effects on parenting variables
Schrott, B., Kasperzack, D., Weber, L., Becker, K., Burghardt, R., & Kamp-Becker, I. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3764-x · Cited by 40
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Warreman, E. B., Lloyd, S. E., Nooteboom, L. A., Leenen, P. J. M., Terry, M. B., Hoek, H. W., van Rossum, E. F. C., Vermeiren, R. R. J. M., & Ester, W. A. (2023) · EClinicalMedicine · doi:10.1016/j.eclinm.2023.102211 · Cited by 43
Career Disruption
Stoner, J. B., & Stoner, C. R. (2014) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/1088357614528798 · Cited by 44
“Not surprisingly, recent meta-analysis has provided general acceptance that those families with a child with ASD experience higher levels of stress than more typical families (Hayes & Watson, 2012).”
Background
Trouble du spectre de l’autisme et évaluation du stress perçu des parents et des professionnels : étude des propriétés psychométriques d’une adaptation francophone de l’Appraisal of Life Event Scale (ALES-vf)
Cappe, É., Poirier, N., Boujut, É., Nader‐Grosbois, N., Dionne, C., & Boulard, A. (2016) · L Encéphale · doi:10.1016/j.encep.2016.08.001 · Cited by 44
Emotional and behavioral functioning of typically-developing sisters of children with autism spectrum disorder: The roles of ASD severity, parental stress, and marital status
Tomeny, T. S., Baker, L. K., Barry, T. D., Eldred, S. W., & Rankin, J. A. (2016) · Research in Autism · doi:10.1016/j.rasd.2016.09.008 · Cited by 45
Comparing the initial impact of COVID-19 on burden and psychological distress among family caregivers of children with and without developmental disabilities.
Chafouleas, S. M., & Iovino, E. A. (2021) · School Psychology · doi:10.1037/spq0000426 · Cited by 40
Evaluation of a French parent-training program in young children with autism spectrum disorder
Ilg, J., Jébrane, A., Paquet, A., Rousseau, M., Dutray, B., Wolgensinger, L., & Clément, C. (2017) · Psychologie Française · doi:10.1016/j.psfr.2016.12.004 · Cited by 39
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Lee, C. E., Burke, M. M., Arnold, C. K., & Owen, A. (2018) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.12521 · Cited by 39
Parent and professional perspectives on behavioral inflexibility in autism spectrum disorders: A qualitative study
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“Relatedly, parents of children with ASD are among the most stressed of those with children with disabilities (Boyd, 2002; Hayes and Watson, 2013), so gathering their perspectives on difficult behavior, such as inflexibility, may inform our understanding of parent coping and resilience to counteract the negative effect…”
Background
Expressed Emotion in Families of Children With and Without Autism Spectrum Disorder, Cerebral Palsy and Down Syndrome: Relations with Parenting Stress and Parenting Behaviors
Clercq, L. D., Prinzie, P., Warreyn, P., Soenens, B., Dieleman, L. M., & Pauw, S. S. W. D. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05075-9 · Cited by 44
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Child Behavior Problems and Parenting Stress in Underserved Families of Children with ASD: Investigation of Family Resources and Parenting Self-efficacy
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“Parents of children with autism experience significant stress (Hayes and Watson 2013; Huang et al. 2014; Milgram and Atzil 1988).”
BackgroundResult
Effectiveness of parent-focused interventions for improving the mental health of parents and their children with autism spectrum disorder: A systematic review and meta-analysis
Li, S. N., Chien, W. T., Lam, S. K. K., Chen, Z. Y., & Ma, X. (2024) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2024.102389 · Cited by 40
Parent-mediated cognitive behavioural therapy for young children with high-functioning autism spectrum disorder and anxiety: a randomized control trial
Cook, J. M., Donovan, C. L., & Garnett, M. S. (2019) · Early Child Development and Care · doi:10.1080/03004430.2017.1303684 · Cited by 38
A Comparative Analysis of Chewing Function and Feeding Behaviors in Children with Autism
ŞAHAN, A. K., Öztürk, N., Demır, N., Karaduman, A. A., & Arslan, S. S. (2021) · Dysphagia · doi:10.1007/s00455-020-10228-6 · Cited by 40
A qualitative study exploring experiences and support needs of parents of children with autism spectrum disorder in Singapore
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Parenting a Child with a Neurodevelopmental Disorder
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An Analysis of Naturalistic Interventions for Increasing Spontaneous Expressive Language in Children With Autism Spectrum Disorder
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“…share wants and interests with social partners; broader implications include decreased opportunities for peer-topeer interactions (Wetherby & Woods, 2006) and increased dependence on parents/caregivers across the lifespan, a source of stress for many families (cf. Hayes & Watson, 2013).”
Background
Pre-diagnostic and Diagnostic Stages of Autism Spectrum Disorder: A Parent Perspective
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“2012; Hayes and Watson 2012; Lee et al.”
Challenging child behaviours positively predict symptoms of posttraumatic stress disorder in parents of children with Autism Spectrum Disorder and Rare Diseases
Stewart, M., Schnabel, A., Hallford, D. J., McGillivray, J., Forbes, D., Foster, M., Shandley, K. A., Gardam, M., & Austin, D. (2019) · Research in Autism · doi:10.1016/j.rasd.2019.101467 · Cited by 38
Bidirectional Relations between Parent Warmth and Criticism and the Symptoms and Behavior Problems of Children with Autism
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Stress and Coping Styles in Mothers of Children with Autism Spectrum Disorder
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Relationship between Parental Burnout Level and Perceived Social Support Levels of Parents of Children with Autism Spectrum Disorder
Ardıç, A. (2020) · International Journal of Educational Methodology · doi:10.12973/ijem.6.3.533 · Cited by 46
“Psychological well-being of parents of children with disabilities is affected more negatively than parents of children with natural development (Hartley et al., 2012; Hayes & Watson, 2013; Hsiao, 2016; Manor-Binyamini & Abu-Ajaj, 2017).”
Background
Long-Term Treatment Outcomes of PEERS® for Preschoolers: A Parent-Mediated Social Skills Training Program for Children with Autism Spectrum Disorder
Tripathi, I., Estabillo, J. A., Moody, C. T., & Laugeson, E. A. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05147-w · Cited by 46
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“Parents of children with ASD typically report higher levels of stress, anxiety, and depressed mood than do parents of typically developing children or children with other developmental disabilities (Hayes and Watson 2013; Singer 2006).”
Background
Parent, child, and family outcomes following Acceptance And Commitment Therapy for parents of autistic children: A randomized controlled trial
Maughan, A. L., Lunsky, Y., Lake, J., Mills, J. S., Fung, K., Steel, L., & Weiss, J. A. (2024) · Autism · doi:10.1177/13623613231172241 · Cited by 37
“Given the high stress experienced by parents of autistic children (Hayes & Watson, 2013), it follows that parents would experience their own challenges that require parent-focused support.”
Background
Parental Stress Related to Caring for a Child With Autism Spectrum Disorder and the Benefit of Mindfulness-Based Interventions for Parental Stress: A Systematic Review
Yesilkaya, M., & Magallón-Neri, E. M. (2024) · SAGE Open · doi:10.1177/21582440241235033 · Cited by 54
“…of children with autism spectrum disorder experience a higher level of parenting stress than parents of children without any developmental disabilities (DD) and parents of children with other types of developmental disabilities (Estes et al., 2009; Hayes & Watson, 2013; Rodriguez et al., 2019).”
Collateral Effects of Youth Disruptive Behavior Disorders on Mothers’ Psychological Distress: Adolescents with Autism Spectrum Disorder, Intellectual Disability, or Typical Development
Blacher, J., & Baker, B. L. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3347-2 · Cited by 48
“A meta-analysis of studies with mothers of children with ASD included a number of different measures of parenting stress (Hayes and Watson 2013).”
Method
“We are in this together”: Experiences of relationship satisfaction in couples raising a child with autism spectrum disorder
Chamberlain, A., Cordier, R., Vaz, S. M. A., & Falkmer, T. (2018) · Research in Autism · doi:10.1016/j.rasd.2018.11.011 · Cited by 50
Comparative Effectiveness of Parent–Child Interaction Therapy for Children with and Without Autism Spectrum Disorder
Zlomke, K. R., & Jeter, K. M. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-03960-y · Cited by 43
“However, families of children with ASD also report experiencing significantly more stress than parents of children with other medical and developmental disorders, such as cerebral palsy, Down syndrome, Attention-Deficit/Hyperactivity Disorder, and fetal alcohol spectrum disorder (Hayes and Watson 2013), and their repo…”
Background

Authors: Hayes, S. A., & Watson, S. L.
Affiliations: University of Alberta (CA)
Laurentian University (CA)
Corresponding author: Hayes, Stephanie A.
Venue: Journal of Autism and Developmental Disorders
Publisher: Springer Science and Business Media LLC
Published: 2012-07-13
Volume: 43
Issue: 3
Pages: 629-642
ISSN: 0162-3257 (ISSN-L)
1573-3432
DOI: 10.1007/s10803-012-1604-y
OpenAlex: W2069698478
Cited by: 1,847
References: 97
Citations by year: 2026: 164 · 2025: 184 · 2024: 185 · 2023: 189 · 2022: 166 · 2021: 194 · 2020: 149 · 2019: 152 · 2018: 145 · 2017: 92 · 2016: 102 · 2015: 64 · 2014: 43 · 2013: 15
FWCI: 5.68
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Journal of Autism and Developmental Disorders (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords: parental stress, autism spectrum disorder, typically developing children, Down syndrome, cerebral palsy, intellectual disability, family stress, comparison groups, effect size
MeSH terms: Adaptation, Psychological, Adult, Child, Child Development Disorders, Pervasive, Humans, Parents, Social Support, Stress, Psychological, Parenting

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The Impact of Parenting Stress: A Meta-analysis of Studies Comparing the Experience of Parenting Stress in Parents of Children With and Without Autism Spectrum Disorder

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