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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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Background
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Benson, P. R. (2023) · Research in Autism · doi:10.1016/j.rasd.2023.102133 · Cited by 14
Parenting stress, general distress, and coparenting quality: An Actor–Partner Interdependence Moderation Model
Turgeon, J., Lonergan, M. H., Bureau, J., Schoppe‐Sullivan, S. J., & Lafontaine, M. (2023) · Personal Relationships · doi:10.1111/pere.12498 · Cited by 9
Oral Healthcare Practices and Awareness among the Parents of Autism Spectrum Disorder Children: A Multi-Center Study
Alqahtani, A. S., Gufran, K., Alsakr, A., Alnufaiy, B., Ghwainem, A. A., BinKhames, Y. M., Althani, R. A., & Almuthaybiri, S. M. (2023) · Children · doi:10.3390/children10060978 · Cited by 9
Exploring the Potential Impact of Training on Short-Term Quality of Life and Stress of Parents of Children with Autism: The Integrative Parents’ Autism Training Module
Mavroeidi, N., Sifnaios, C., Ntinou, A., Iatrou, G., Konstantakopoulou, O., Martínez, M. M., Nucifora, M., Tanrıkulu, İ., & Vadolas, A. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21040474 · Cited by 11
“Parenting stress is characterized by distress that arises from the demands faced within the parental role [12].”
Background
The Impact of Self-Narratives of Motherhood for Mothers of Children with Autism
Trzebiński, J., Wołowicz, A., & Wójcik, A. D. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01899 · Cited by 11
“…with other disabilities or to parents of typically developing children, parents of children with ASD exhibit higher level of stress (Baker-Ericzén et al., 2005; Hayes and Watson, 2013; van Steijn et al., 2014), anxiety (Hastings et al., 2005), and depression (Singer, 2006; Feldman et al., 2007).”
Background
Effects of Parent Implemented Visual Schedule Routines for African American Children with ASD in Low-Income Home Settings
Goldman, S. E., Glover, C. A., Lloyd, B. P., Barton, E. E., & Mello, M. P. (2017) · Exceptionality · doi:10.1080/09362835.2017.1294984 · Cited by 11
“Further, research suggests that family members of children with ASD experience more stress than parents of typically developing children and parents of children with other disabilities (Hayes & Watson, 2013).”
Background
Family Factors and Communicative Skills in Children with Autism Without Intellectual Disability
Baixauli, I., Mira, Á., Berenguer, C., Roselló, B., & Miranda, A. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04216-5 · Cited by 13
Negative Controlling Parenting and Child Personality as Modifiers of Psychosocial Development in Youth with Autism Spectrum Disorder: A 9-Year Longitudinal Study at the Level of Within-Person Change
Clercq, L. D., Dieleman, L. M., van der Kaap‐Deeder, J., Soenens, B., Prinzie, P., & Pauw, S. S. W. D. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04761-4 · Cited by 9
Bedtime Routines of Young Children, Parenting Stress, and Bedtime Resistance: Mediation Models
Larsen, K. L., Erp, L. S., Jordan, M., & Jordan, S. S. (2021) · Child Psychiatry & Human Development · doi:10.1007/s10578-021-01275-7 · Cited by 11
The mediating role of parental playfulness on parent–child relationship and competence among parents of children with ASD
Roy, R. G., & Aneesh Kumar, P. (2021) · Advances in Autism · doi:10.1108/aia-02-2021-0010 · Cited by 9
Utilization of health services among adults with autism spectrum disorders: Stakeholders’ experiences
Ghanouni, P., Hood, G., Weisbrot, A., & McNeil, K. (2021) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2021.104120 · Cited by 9
What makes home environments favorable to independence: perspectives of autistic people and their parents
Marcotte, J., Grandisson, M., & Milot, É. (2022) · Disability and Rehabilitation · doi:10.1080/09638288.2022.2074153 · Cited by 11
Mental health impact of autism on families of children with intellectual and developmental disabilities of genetic origin
Wolstencroft, J., Srinivasan, R., Hall, J., van den Bree, M. B. M., Owen, M. J., Raymond, F. L., & Skuse, D. (2023) · JCPP Advances · doi:10.1002/jcv2.12128 · Cited by 8
“We aimed to assess whether speciﬁc domains are associated with a greater risk parental psychological distress, in order to identify meaningful targets for intervention (Hayes & Watson, 2013).”
Background
How effective are group-based psychoeducation programs for parents of children with ASD in Turkey? A systematic review and meta-analysis
AĞIRKAN, M., Koç, M., & Avcı, Ö. H. (2023) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2023.104554 · Cited by 10
Using Secondary Datasets in Disability Research
Hodapp, R. M., Goldman, S. E., & Urbano, R. C. (2013) · International review of research in developmental disabilities · doi:10.1016/b978-0-12-407760-7.00001-3 · Cited by 9
Comorbilidad de TEA y TDAH: revisión sistemática de los avances en investigación
Rico-Moreno, J., & Mínguez, R. T. (2016) · Anales de Psicología · doi:10.6018/analesps.32.3.217031 · Cited by 18
Reliability and validity of the COPE Index among caregivers of disabled people
Juntunen, K., Nikander, R., Törmäkangas, T., Tillman, P., & Salminen, A. (2016) · Applied Nursing Research · doi:10.1016/j.apnr.2016.11.002 · Cited by 9
Mindfulness and parenting stress among parents of autistic children: The mediation of resilience and psychological flexibility
Feng, Y., Lu, D., Ng, T. Y. C., Chau, P. H., Chan, L. M. L., & Kwok, J. Y. Y. (2025) · Autism · doi:10.1177/13623613251328465 · Cited by 8
“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).”
Predictors of family burden in families caring for children with special needs
Rakap, S., Batık, M. V., & Coleman, H. (2023) · Journal of Childhood Education & Society · doi:10.37291/2717638x.202341245 · Cited by 15
Do Naturalistic Developmental Behavioral Interventions improve family quality of life? A systematic review and meta-analysis
Duncan, A. L., Keene, H., & Shepley, C. (2024) · Autism · doi:10.1177/13623613241227516 · Cited by 11
“…of autistic children report greater emotional distress than parents raising a child with any other condition or disability (Al-Farsi et al., 2016; Hayes & Watson, 2013), for which such stress has been associated with detrimental impacts on child development and well-being (Crnic et al., 2017).”
Application of the Community-based Participatory Research in Autism Spectrum Disorder: A Scoping Review
Chen, J., Yao, D., Lin, S., Yuan, S., Wang, M., Wu, H., & Zhang, Q. (2024) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-024-00446-1 · Cited by 8
“Raising an autistic child presents ongoing challenges and multiple demands for parents, compared to parents of typically developing children or children with other developmental disabilities (Hayes & Watson, 2013).”
Characterising Insistence on Sameness and Circumscribed Interests: A Qualitative Study of Parent Perspectives
Spackman, E. K., Geng, A., Smillie, L. D., Frazier, T. W., Hardan, A. Y., Alvarez, G. A., Whitehouse, A., Schuck, R. K., Leekam, S. R., & Uljarević, M. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06404-4 · Cited by 8
“Many parents described impacts on their own mental health affirming, in specific cases, the need for intervention and support services aimed at parents and caregivers as well as autistic individuals themselves (Da Paz & Wallander, 2017; Hayes & Watson, 2013; Grahame et al., 2015).”
“Bottom of My Own List:” Barriers and Facilitators to Mental Health Support Use in Caregivers of Children with Neurodevelopmental Support Needs
Penner, K. E., Roy, R., Hanlon‐Dearman, A., Cheung, K., Katz, C., Schleider, J. L., Roos, L. E., & Cameron, E. E. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06409-z · Cited by 9
“…given the differences in child behaviour and caregiving stress for families of children with NDDs/NDPs compared to the general population (Hayes & Watson, 2013; Miranda et al., 2019; Roubinov et al., 2022), and given that these caregivers are seeking support at low rates (D’Arcy et al.,…”
The Efficacy of a Culturally-Adapted Group-based Parent Coaching Program for Autistic Children in China via Telehealth: A Randomized Controlled Trial
Qu, L., Colombi, C., Chen, W., Miller, A. L., Miller, H. L., & Ulrich, D. A. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06543-8 · Cited by 12
“…children experience higher levels of stress (Barroso et al., 2018 ) and other negative affects compared to parents of typically developing children, and even higher than parents of children with other disabilities (Estes et al., 2009 ; Hayes & Watson, 2013; Phetrasuwan & Shandor Miles, 2009).”
Stress among caregivers of autistic children: Conceptual analysis and verification using two qualitative datasets
Gentles, S. J., McLaughlin, J., & Schneider, M. A. (2024) · PLoS ONE · doi:10.1371/journal.pone.0312391 · Cited by 11
Parental psychopathology before and after the child's diagnosis of a mental disorder: a population‐based matched cohort study
Chatwin, H., Holde, K. E. V., Wimberley, T., Dalsgaard, S., & Petersen, L. V. (2025) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.14113 · Cited by 8
Parent Outcomes Following Participation in Cognitive Behavior Therapy for Autistic Children in a Community Setting: Parent Mental Health, Mindful Parenting, and Parenting Practices
Ibrahim, A. T., Lee, V., Vashi, N., Roudbarani, F., Modica, P. T., Pouyandeh, A., Sellitto, T., Ameis, S. H., Elkader, A. K., Gray, K. M., et al. (2025) · Autism Research · doi:10.1002/aur.70001 · Cited by 8
Chinese caregivers’ experiences parenting children with autism spectrum disorder: a descriptive qualitative study
Fan, X., & Ko, K. S. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1514948 · Cited by 8
Effects of Cannabidiol on Social Relating, Anxiety, and Parental Stress in Autistic Children: A Randomized Controlled Crossover Trial
Parrella, N.-F., Hill, A. T., Enticott, P. G., Botha, T., Catchlove, S. J., Downey, L. A., & Ford, T. C. (2025) · Autism Research · doi:10.1002/aur.70159 · Cited by 9
“Parenting an autistic child has been associated with greater parenting stress compared with parenting a neurotypical child, and improvements in parental well-being have been linked to enhanced outcomes for autistic children, including reduced behavioral difficulties (Hayes and Watson 2013).”
Pivotal response treatment for autism: A brief report on training for rural communities
Dahiya, A. V., Openden, D., Ostmeyer, K. F., Anderson, R. M., & Scarpa, A. (2021) · Journal of Community Psychology · doi:10.1002/jcop.22558 · Cited by 9
Relations among co-occurring psychopathology in youth with autism spectrum disorder, family resilience, and caregiver coping
Menezes, M., Robinson, M. F., Simmons, S. C., Smith, K. R., Zhong, N., & Mazurek, M. O. (2021) · Research in Autism · doi:10.1016/j.rasd.2021.101803 · Cited by 9
The association of adverse life events and parental mental health with emotional and behavioral outcomes in young adults with autism spectrum disorder
Hollocks, M., Meiser-Stedman, R., Kent, R., Lukito, S., Briskman, J., Stringer, D., Lord, C., Pickles, A., Baird, G., Charman, T., et al. (2021) · Autism Research · doi:10.1002/aur.2548 · Cited by 9
“…those with ASD experience more stress than parents of typically developing children or even parents of those with other developmental difficulties (Hayes & Watson, 2013), and that the stress resulting from caring for an adult with ASD and no intellectual difficulties is comparable to that…”
Exploring Effects of Sensory Garments on Participation of Children on the Autism Spectrum: A Pretest-Posttest Repeated Measure Design
Lawson, L. M., Foster, L. H., Hamner, K., & Wright, L. (2022) · Occupational Therapy International · doi:10.1155/2022/3540271 · Cited by 11
“Evidence shows parents of autistic children experience more stress than parents of typically developing children or children with another disability [11, 12].”
Background
L’animal de compagnie dans la vie des enfants au développement typique et atypique et de leur famille
Dollion, N., & Grandgeorge, M. (2022) · La revue internationale de l éducation familiale · doi:10.3917/rief.050.0157 · Cited by 8

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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