Cited by 1,847Family and Disability Support ResearchAutism Spectrum Disorder ResearchChild Nutrition and Feeding Issues

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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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Exploring the clinical features of minimally verbal autistic children
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“Parents of autistic children typically encounter higher levels of parenting stress compared to parents of children with other disabilities (40).”
The Quality of the Parent–Child Relationship in the Context of Autism: The Role of Parental Resolution of the Child’s Diagnosis, Parenting Stress, and Caregiving Burden
Levante, A., Martis, C., & Lecciso, F. (2025) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe15070142 · Cited by 16
“…al., 2009)—report higher levels of stress compared to parents of typically developing children or children with other developmental delays or disorders (Catalano et al., 2018; Estes et al., 2014; Bitsika et al., 2013; Hayes & Watson, 2013; Pisula, 2007; Seymour et al., 2013; Tomanik et al., 2004).”
A virtuous circle: Stakeholder perspectives of a short-term intensive parent training programme delivered within the context of routine services for autism in China
Fang, Z., Lachman, J. M., Zhang, C., Qiao, D., & Barlow, J. (2022) · Autism · doi:10.1177/13623613211070869 · Cited by 12
Associations Between Parenting Stress and Quality Time in Families of Youth with Autism Spectrum Disorder
Bradley, R. S., Staples, G. L., Quetsch, L. B., Aloia, L. S., Brown, C. E., & Kanne, S. M. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05852-0 · Cited by 21
“…literature highlighting the significant levels of parenting stress many caregivers of youth with ASD experience (for reviews, see Enea & Rusu, 2020; Hayes & Watson, 2013) and its connection to negative family outcomes including caregiver depressive symptoms, child disruptive behavior, and…”
Background
A longitudinal study of the relationships between sleep problems in autistic children and maternal mental health
Baker, E. K., Giallo, R., Seymour, M., Hearps, S. J. C., & Wood, C. (2023) · Autism · doi:10.1177/13623613221147397 · Cited by 11
Parent reported barriers and facilitators to support services for autistic children in Aotearoa New Zealand
Wallace-Watkin, C., Sigafoos, J., Woods, L., & Waddington, H. L. (2023) · Autism · doi:10.1177/13623613231168240 · Cited by 12
“…children with other developmental differences, parents of autistic children comparatively appear to exhibit higher levels of parenting stress and/or decreased satisfaction with aspects of received support services (Amireh, 2019; Bitterman et al., 2008; Hayes & Watson, 2013; Picardi et al., 2018).”
Parent perspectives on treatment: A mixed methods analysis of PEERS® for Preschoolers
Tripathi, I., Moody, C. T., & Laugeson, E. A. (2023) · Autism · doi:10.1177/13623613231172314 · Cited by 12
“It is well documented that parents of autistic children have higher support needs and elevated levels of stress as compared to parents of typically developing children (Hayes & Watson, 2013; Kiami & Goodgold, 2017).”
Background
Impact of Child Behavior Problems on Parenting Stress and Depressive Symptoms Among Mothers of Children with Autism Spectrum Disorder: Mediation of Coping Strategies
Chen, K.-L., Iao, L., & Wu, C. (2023) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-023-09919-3 · Cited by 12
“…to parents of typically developing (TD) children (Giovagnoli et al., 2015; Kiani et al., 2014; Ueda et al., 2020), as well as parents of children with other developmental disorders (e.g., developmental delays) (Craig et al., 2016; Estes et al., 2013; Hayes & Watson, 2013; Hou et al., 2018).”
Social support and parenting self-efficacy in parents of children with ASD: The mediating role of post-traumatic growth and the moderating role of self-esteem
Zhang, J., Lin, X., Zhou, S., Ye, B., Zhang, Y., & Xiong, H. (2023) · Current Psychology · doi:10.1007/s12144-023-05031-z · Cited by 14
“Studies have found that parenting a child with autism spectrum disorder (ASD) is more demanding than parenting a normal child or a child with other developmental disorders (Hayes & Watson, 2013).”
Influential
Exploring mothers’ experiences of accessing an Education Health and Care Plan (EHCP) for an autistic child attending mainstream school in the United Kingdom
Keville, S., Mills, M., & Ludlow, A. (2024) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2023.2298606 · Cited by 12
“Given parents of autistic children already experience higher stress compared to parents who do not have an autistic child (Hayes and Watson 2013), struggling to access support can exacerbate their stressors and wellbeing (Brown et al. 2012).”
Leisure, community, workforce participation and quality of life in primary and secondary caregivers of autistic children
Davy, G., Barbaro, J., Unwin, K. L., Clark, M., Jellett, R., Date, P., Muniandy, M., & Dissanayake, C. (2024) · Autism Research · doi:10.1002/aur.3113 · Cited by 14
“Further, when compared to average levels of QoL and parenting stress in families of non-Autistic children reported in other studies using the same measures (Eapen et al., 2014; Hayes & Watson, 2013), the caregivers in the current study appear to experience poorer outcomes.”
BackgroundResult
Parents’ and guardians’ experiences of barriers and facilitators in accessing autism spectrum disorder diagnostic services for their children: a qualitative systematic review
Smith-Young, J., Pike, A. D., Swab, M., & Chafe, R. (2024) · JBI Evidence Synthesis · doi:10.11124/jbies-23-00332 · Cited by 14
The correlates of psychological distress among parents of children with psychiatric disorders
O'leimat, A. S., Al-Hussami, M. O., & Rayan, A. (2019) · Journal of Child and Adolescent Psychiatric Nursing · doi:10.1111/jcap.12223 · Cited by 12
FMR1 Low Zone CGG Repeats: Phenotypic Associations in the Context of Parenting Stress
Seltzer, M. M., Hong, J., DaWalt, L. S., Greenberg, J. S., Movaghar, A., Baker, M. W., Rathouz, P. J., & Brilliant, M. H. (2020) · Frontiers in Pediatrics · doi:10.3389/fped.2020.00223 · Cited by 13
A validation study of the Chinese version of the Autism Parenting Stress Index (C-APSI) in Hong Kong
Cheung, T. C. K., & Yeung, C. K. (2021) · Research in Autism · doi:10.1016/j.rasd.2021.101762 · Cited by 13
Understanding perceptions underlying the self-reported stress among parents of adolescents with autism spectrum disorder: Considerations for supporting families
Raff, N. S., Mire, S. S., Frankel, L. A., McQuillin, S. D., Loveland, K. A., Daire, A. P., Grebe, S. C., & Rosenbrock, G. J. (2021) · Research in Autism · doi:10.1016/j.rasd.2021.101770 · Cited by 12
Psychological Flexibility Is Associated with Parental Stress in Relatives of People with Intellectual Disabilities
Lobato, D., Montesinos, F., & Flujas-Contreras, J. M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19106118 · Cited by 14
“Multiples studies consistently show a significant higher risk of suffering psychological stress in parents of children with disabilities [2,3].”
Background
Analysis of Spanish Parents’ Knowledge about ASD and Their Attitudes towards Inclusive Education
Gómez‐Marí, I., Mínguez, R. T., & Cerezuela, G. P. (2022) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe12070063 · Cited by 16
“Moreover, having a child with ASD is related to high levels of stress [6,32] and stigma [9].”
Background
Parents' pandemic stress, parental involvement, and family quality of life for children with autism
Cheng, S., Cheng, S., Liu, S., & Li, Y. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1061796 · Cited by 14
Brief online surveys to monitor and evaluate facilitated peer support groups for caregivers of children with special needs
Wynter, K. H., Hammarberg, K., Sartore, G., Cann, W. G., & Fisher, J. (2014) · Evaluation and Program Planning · doi:10.1016/j.evalprogplan.2014.12.019 · Cited by 12
“Sartore et al. (personal communication with the PRC), it is worth noting that parents’ experiences of caring for children with ASD have been found to be quite different to those caring for children with other special needs (Hayes & Watson, 2013).”
Background
Families of Adolescents and Adults With Intellectual and Developmental Disabilities
Taylor, J. L., Burke, M. M., DaWalt, L. S., & Hartley, S. L. (2016) · International review of research in developmental disabilities · doi:10.1016/bs.irrdd.2016.04.001 · Cited by 13
Parental attributions for positive behaviours in children with autism spectrum disorder
Bussanich, P. M., Hartley, S. L., & Bolt, D. M. (2017) · Journal of Intellectual Disability Research · doi:10.1111/jir.12373 · Cited by 12
Chronic Stress and Impulsive Risk‐Taking Predict Increases in Visceral Fat over 18 Months
Mason, A. E., Schleicher, S., Coccia, M., Epel, E. S., & Aschbacher, K. (2018) · Obesity · doi:10.1002/oby.22150 · Cited by 12
“We operationalized chronic stress (group status) by using the objective criteria of providing care for a child with ASD versus caring for a neurotypical child (group status defined as a caregiver versus control, respectively) (21).”
Method
Dyadic Coping, Respiratory Sinus Arrhythmia, and Depressive Symptoms Among Parents of Preschool Children
Switzer, A., Caldwell, W., da Estrela, C., Barker, E. T., & Gouin, J. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.01959 · Cited by 14
“…cerebral palsy) were oversampled (21.3% of dyads), because these parents tend to experience more parenting stress and greater psychological distress than parents of typically developing children (Hayes and Watson, 2013), thereby increasing the range of parenting challenges within the sample.”
BackgroundInfluential
Sense of Competence as Mediator on Parenting Stress
Daulay, N., Ramdhani, N., & Hadjam, N. R. (2018) · The Open Psychology Journal · doi:10.2174/1874350101811010198 · Cited by 15
“The result of this study confirms the results of meta-analysis study done by Hayes and Watson [48]that parents of children with autism spectrum disorder experience parenting stress higher than parents of developmentally disorder children and parents of developmentally normal children.”
BackgroundResult
Caregiver Involvement in Communication Skills for Individuals with ASD and IDD: a Meta-analytic Review of Single-Case Research on the English, Chinese, and Japanese Literature
Liao, C.-Y., Ganz, J. B., Vannest, K. J., Wattanawongwan, S., Pierson, L. M., Yllades, V. A., & Li, Y. (2020) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-020-00223-w · Cited by 13
The Relationship between the Presence of Depression and Attachment Styles of Mothers with Autistic Children
Ayhan, F., Teze, S., & Türkmen, A. S. (2021) · American Journal of Family Therapy · doi:10.1080/01926187.2021.1872044 · Cited by 12
“Parents of children with autism experience greater stress than parents of children with other medical and developmental disabilities or neurotypical children (Hayes & Watson, 2013).”
Background
Quality of Life among Mothers of High Functioning Autism Spectrum Disorder (HFASD)Adolescents
Aun, N. S. M., Zakaria, S. M., Badayai, A. R. A., Idris, I. B., Daud, T. I. M., & Fazree, S. D. M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19116663 · Cited by 13
“has demonstrated that parenting autistic children is a demanding situation, thus increasing the risk of parental stress and significantly reducing their well-being [10,11].”
Background
Strength-Based Approaches to Working with Families of Children with ASD
Steiner, A. M., & Gengoux, G. W. (2018) · Autism and child psychopathology series · doi:10.1007/978-3-319-90994-3_10 · Cited by 13
Understanding and Addressing Restricted and Repetitive Behaviors in Children with Autism
Turner-Brown, L., & Frisch, M. (2020) · Best Practices in Child and Adolescent Behavioral Health Care · doi:10.1007/978-3-030-41160-2_4 · Cited by 14
The estimation of the functioning of families with ASD children
Kostiukow, A., Strzelecki, W., Poniewierski, P., & Samborski, W. (2019) · AIMS Public Health · doi:10.3934/publichealth.2019.4.587 · Cited by 13
Emotional Availability and Play in Mother–Child Dyads with ASD: Changes during a Parental Based Intervention
Perzolli, S., Bertamini, G., de Falco, S., Venuti, P., & Bentenuto, A. (2020) · Brain Sciences · doi:10.3390/brainsci10120904 · Cited by 15
“In general, mother–child interactions may be influenced by the fact that mothers of children with ASD tend to have higher levels of stress compared to mothers of children with typical development [28,48].”
Background
Acceptance and Commitment Training Focused on Psychological Flexibility for Family Members of Children with Intellectual Disabilities
Lobato, D., Montesinos, F., Polín, E., & Cáliz, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192113943 · Cited by 16
“A significant and more immediate effect of the programme was observed on the variables related to psychological flexibility and suppression of unpleasant private events than on the variables related to stress and psychological health, which reached moderate effectiveness during the follow-up phase, in congruence with…”
BackgroundResult
Associations Between Caregiver Stress and Language Outcomes in Infants With Autistic and Non-Autistic Siblings: An Exploratory Study
Markfeld, J. E., Feldman, J. I., Bordman, S. L., Daly, C., Santapuram, P., Humphreys, K. L., Keçeli-Kaysılı, B., & Woynaroski, T. G. (2022) · Journal of Speech Language and Hearing Research · doi:10.1044/2022_jslhr-22-00154 · Cited by 15
“We hypothesized that associations of interest to this study may be stronger in Sibs-autism due to the potential for increased heterogeneity in caregiver stress and child language outcomes in this population (e.g., S. A. Hayes & Watson, 2013; Messinger et al., 2013).”
BackgroundResultInfluential
Parental Resources in Parents of Children with Special Needs (SNs) at the Time of COVID-19
Gentile, A., Polizzi, C., Giordano, G., Burgio, S., & Alesi, M. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12020475 · Cited by 11
Perceived Social Support and Quality of Life of Children with and without Developmental Disabilities and Their Caregivers during the COVID-19 Pandemic in Brazil: A Cross-Sectional Study
da Costa, I. G. R., Brugnaro, B. H., Lima, C. R. G., de Camargo, O. K., Fumincelli, L., Pavão, S. L., & Rocha, N. A. C. F. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20054449 · Cited by 15
“We highlight the loss of support of people and social stigma [4], changes in the routine of daily life with social restrictions [5], stress [6] and concerns about the health and development of the child [7].”
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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