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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
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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“Parenting stress is particularly higher among parents of autistic children compared to caregivers of children with other neurodevelopmental conditions (e.g.language delay, intellectual disability) or non-autistic children (Craig et al., 2016;S. A. Hayes & Watson, 2013).”
From Mindfulness and parenting stress among parents of autistic children: The mediation of resilience and psychological flexibility (2025) · cites this paper as S. A. Hayes & Watson, 2013
In the citing paper
“Parents of children with a neurodevelopmental disorder (NDD) experience more stress than parents of typically developing children.”
In the citing paper
“Hence, reducing parental stress can strengthen a family's functioning and balance, which in turn, moderates the effect of CB (40).”
In the citing paper
“which is consistent with many previous studies reporting that caregivers of children with ASD and/or IDD experience more parental stress compared to caregivers of typically developing children (40).”
In the citing paper
“It has been widely demonstrated that raising a child with autism involves chronic challenges consistently associated with high levels of psychological distress [3,4,5,6].”
In the citing paper
“Parenting a child with ASD is associated with increased parental stress (Hayes and Watson 2013)”
From Towards a Treatment for Intolerance of Uncertainty in Young People with Autism Spectrum Disorder: Development of the Coping with Uncertainty in Everyday Situations (CUES©) Programme. (2017) · cites this paper as Hayes and Watson 2013
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“Further supporting these findings, in a meta-analysis of parent stress, Hayes and Watson (2013) found that parents of children with ASD experience higher levels of stress than parents of typically developing children and those of children with other disabilities.”
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“For example, Hayes and Watson (2013) found that the Parenting Stress Index (PSI) which is designed for parents of children between 3 months and 10 years old (Abidin, 1995) had been utilized among parents of children with disabilities and those older than the recommended age range (Fedele et al.,…”
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“Furthermore, parents of autistic children report that RRB is one of the most challenging features associated with ASD (South et al., 2005; Raulston and Machalicek, 2018) and indicate high levels of stress associated with RRB (Hayes and Watson, 2013).”
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“Given the life-long nature of ASD, parents of children with ASD experience high levels of stress and anxiety [4].”
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BackgroundParents’ Perspectives on Surf Therapy for Children with Disabilities
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“The PSI has been used in numerous studies of parents of children with ASD (Hayes & Watson, 2013), as well as research evaluating Basic IY (Webster-Stratton, 2011).”
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“To date, research examining the parental and family experience has typically focused on maladaptive outcomes such as parent stress [10, 20], maternal mental health [7, 23], and caregiver burden [3, 17].”
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“Research suggests parents of children with ASD have a unique experience of stress compared to other parent groups (Hayes and Watson 2013), and so it is important to examine their experience in greater depth.”
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“Several studies have reported 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 (1, 2, 3, 4).”
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“There are very high levels of parenting stress for this population [30,31] associated with impaired immune function responses [32], and these levels of stress reach a peak during the diagnosis process [11].”
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“In fact, evidence from the literature suggests that ASD is the condition that produces the highest parental stress as compared to other neurodevelopmental conditions [6,20,21].”
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“These levels of consequences are high compared to parents of children with a normal development, but also high compared to parents with a child with another disability such as Down syndrome, cerebral palsy, fragile X or Fetal Alcohol Spectrum Disorder (Hayes and Watson 2013).”
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“A metaanalysis study showed that parental stress of parents of autistic children is higher than in families of healthy children and even in families of children with developmental delays [9].”
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“…suffering from a developmental disorder demands superlative parental care which adds to their burden of stress (Dyson, 1997; Hassal et al., 2006; Hayes & Watson, 2012; Ludlow et al., 2012; Myers et al., 2009; Whitaker, 2002) because a wide range of symptoms can be part of their disability…”
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Akkuş, P. Z., Bahtiyar‐Saygan, B., Bahadur, E. İ., Cak, T., & Özmert, E. N. (2020) · Turkish Journal of Pediatric Disease · doi:10.12956/tchd.731752 · Cited by 20
Christi, R. A., Roy, D., Heung, R., & Flake, E. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05704-x · Cited by 20
Filbay, S. R., Bennell, K. L., Morello, R., Smith, L., Hinman, R. S., & Lawford, B. J. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-065600 · Cited by 21
Xiaohong, W., Ren, J., Li, X., Li, J., & Chen, S. (2022) · Current Psychology · doi:10.1007/s12144-022-03869-3 · Cited by 20
“First, Model 1 in the SPSS macro compiled by Hayes and Watson (2013) was applied to examine the moderating effect of Neuroticism during the pandemic.”
Profiles of the parenting experience in families of autistic children
Greenlee, J. L., Hickey, E., Stelter, C. R., Huynh, T., & Hartley, S. L. (2023) · Autism · doi:10.1177/13623613221147399 · Cited by 31
Machine learning determination of applied behavioral analysis treatment plan type
Maharjan, J., Garikipati, A., Dinenno, F. A., Ciobanu, M., Barnes, G., Browning, E., Decurzio, J., Mao, Q., & Das, R. (2023) · Brain Informatics · doi:10.1186/s40708-023-00186-8 · Cited by 25
“The collective effect of these latter stressors is not trivial, as caregivers of patients with ASD have been shown to exhibit higher rates of stress, depression, anxiety, and other mental health disorders than the caregivers of patients having other developmental delays and disabilities [23, 24].”
BackgroundSealy, J., McMahon, C. A., & Sweller, N. (2023) · Journal of Child and Family Studies · doi:10.1007/s10826-023-02579-z · Cited by 20
“…contribute to low morale and parenting stress and there is evidence that parents raising children with a disability experience more parenting stress than parents of typically developing children (Hayes & Watson, 2012; Hintermair, 2006; Phillips et al., 2017; Seymour et al., 2012; Woodman, 2014).”
BackgroundLin, Y., Wang, Y., Lin, C., Ni, Q., Jia, R., Chang, Y., & Qi, Y. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1139618 · Cited by 20
Nedungadi, P., Shah, S. M., Stokes, M. A., Nair, V. K., Moorkoth, A., & Raghu Raman, R. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1294254 · Cited by 27
On the emergence of autism: neuroimaging findings from birth to preschool
Wolff, J. J., & Piven, J. (2013) · Neuropsychiatry · doi:10.2217/npy.13.11 · Cited by 19
McEvilly, M., Wicks, S., & Dalman, C. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2381-1 · Cited by 21
“Adverse health outcomes include high levels of stress (Hayes and Watson 2013) depression (Van Steijn 2013), fatigue (Giallo et al. 2011), poor sleep (Meltzer 2008), and selfrated poor health (Allik et al. 2006).”
BackgroundHodgson, A. R., Grahame, V., Garland, D., Gaultier, F., Lecouturier, J., & Couteur, A. S. L. (2016) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.12317 · Cited by 20
Radin, R. M., Mason, A. E., Laudenslager, M. L., & Epel, E. S. (2019) · PLoS ONE · doi:10.1371/journal.pone.0216541 · Cited by 23
“Compared to parents of neurotypical children, parents of children with ASD report greater levels of subjective distress [37].”
BackgroundMothers with disabled children: needs, stress levels and family functionality in rehabilitation
Yılmaz, G. (2019) · Scandinavian Journal of Caring Sciences · doi:10.1111/scs.12783 · Cited by 20
Dunst, C. J. (2021) · International journal of psychological research · doi:10.21500/20112084.5236 · Cited by 22
“This aim is based on findings from research syntheses, which indicate that the birth and rearing of a child with a disability (Hayes & Watson, 2013; Pinquart, 2018; Singer & Floyd, 2006), the diagnosis and treatment of a child with a chronic illness (Easter et al., 2015; Leeman et al., 2016; Pai et…”
A Pilot Study of a Behavioral Parent Training in the Republic of Macedonia
Hansen, B. D., Orton, E. L., Adams, C., Knecht, L. L., Rindlisbaker, S. V., Jurtoski, F., & Trajkovski, V. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3112-6 · Cited by 20
Bonnot, O., Adrien, V., Venelle, V., Bonneau, D., Gollier-Briant, F., & Mouchabac, S. (2021) · JMIR Mental Health · doi:10.2196/27803 · Cited by 19
“Parents of children with autism spectrum disorders have greater anxiety levels than parents of children without developmental disorders [3].”
BackgroundPredescu, E., & Șipoș, R. (2013) · Open Journal of Psychiatry · doi:10.4236/ojpsych.2013.32a003 · Cited by 19
“Parents of children with ASD reported more family problems and are at a higher risk for developing physical or psychological problems [11].”
BackgroundAnthony, N., & Campbell, E. (2020) · Advances in Neurodevelopmental Disorders · doi:10.1007/s41252-020-00171-w · Cited by 24
Kabashima, Y., Tadaka, E., & Arimoto, A. (2020) · PLoS ONE · doi:10.1371/journal.pone.0238652 · Cited by 19
Schiltz, H. K., & Hecke, A. V. V. (2020) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-020-00332-2 · Cited by 26
Mindfulness and Stress Among Parents of Children with Autism Spectrum Disorder in China
Wang, H., Wang, Q.-D., Hu, X.-Y., & Han, Z. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05011-x · Cited by 17
Metadata
- 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
- Published
- 2012-07-13
- Volume
- 43
- Issue
- 3
- Pages
- 629-642
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- 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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