Cited by 404Family and Disability Support ResearchAutism Spectrum Disorder ResearchFamily Caregiving in Mental Illness

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Stress and Parents of Children with Autism: A Review of Literature

Bonis, Susan·2016·Issues in Mental Health Nursing

DOI 10.3109/01612840.2015.1116030

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Abstract

The purpose of this review is twofold. The first is to synthesize factors that impact parents' experiences of caring for a child with autism spectrum disorder (ASD); the second is to identify factors that impact parental stress and parental decision-making to use autism services or not. Parents of children with ASD score higher on levels of stress than other groups of parents. The daily challenges of caring for the child are endless and effect all aspects of the child's care as well as the parent's mental health and ability to manage the needs of the child and family. Understanding more about the challenges parents face will provide direction for research, intervention development, and practice. Accordingly, a search was conducted using CINAHL and Medline. Inclusion criteria included articles available in full text, published in English, and focused on children with ASD distinct from other diagnoses, as well as parental experiences of caring for a child with ASD. Articles (N = 132) that met the inclusion criteria were summarized. Challenging aspects of the child's diagnosis and care are discussed, as well as the factors that impact parental stress and decision-making to use autism services. Recommendations for research and practice include interventional development related to early diagnosis, disparity, access to care, parental decision-making to use autism services, and parental stress management.

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Items 101–200 of 401

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Carvalho, E., Santana, C. P., Rodrigues, I. D., Lacerda, L., & Bastos, G. S. (2020) · IEEE Access · doi:10.1109/access.2020.2997334 · Cited by 15
“An estimated increase in the ASD diagnosis, from 6% to 15% per year, makes ASD the fastest-growing developmental disability in the USA [8], although a global report [9] highlights that the prevalence increase may be affected by the changes in diagnostic concepts, service availability, and awareness about the disorder.”
BackgroundInfluential
Exploring the health of families with a child with autism
Smith, S. L., & McQuade, H. B. (2021) · Autism · doi:10.1177/1362361320986354 · Cited by 14
“The chronic and impactful stress of parents with a child with autism is clearly outlined in previous literature (Bonis, 2016; Mancil et al., 2009).”
Background
Problem gambling during Covid-19
Frisone, F., Alibrandi, A., & Settineri, S. (2020) · Mediterranean Journal of Clinical Psychology · doi:10.6092/2282-1619/mjcp-2457 · Cited by 30
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Harold Stanislaw, A., Howard, J. S., & Martin, C. (2019) · Journal of the American Association of Nurse Practitioners · doi:10.1097/jxx.0000000000000290 · Cited by 13
“However, health care decisions are not always made rationally (Courtney, Spivey, & Daniel, 2014), and families need help realizing the impact of their treatment choices (Bonis, 2016).”
Background
Effect of incredible years autism spectrum and language delays (IY-ASD) program on stress and behavioral management skills among parents of children with autism spectrum disorder in Palestine
Wahdan, M. M., Malak, M. Z., Al-Amer, R. M., Ayed, A., Russo, S., & Berte, D. Z. (2023) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2023.03.018 · Cited by 13
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“Furthermore, the daily challenges of caring for these children can significantly affect the parent's mental health and their capacity to address the demands of their child and family [3].”
Background
Context-Specific Resilience Through a Cultural Lens: Social-Ecological Factors Among Chinese Families of Children with Neurodevelopmental Disabilities
Dai, X., Cheung, Y. C. H., Zhuang, X., Ng, E. F. W., & Wong, D. F. K. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06605-x · Cited by 14
“It is not surprising that parents of children with NDDs report higher levels of parenting stress compared to parents of typically developing children (Bonis, 2016 ; Hassall et al., 2005 ).”
Dyadic coping and coparenting among couples after their child’s recent autism diagnosis
Downes, N., Geoffray, M., Isnard, P., Lemonnier, É., Orêve, M.-J., & Cappe, É. (2021) · Autism · doi:10.1177/13623613211020916 · Cited by 13
“…stress as parents raising a child on the spectrum are at an increased risk of experiencing high levels of parenting stress that can be detrimental to the couple and coparenting relationship (Bonis, 2016; Hartley et al., 2014; Hill-Chapman et al., 2013; May et al., 2015; Thullen & Bonsall, 2017).”
Background
Improving a Parent Coaching Model of Music Interventions for Young Autistic Children
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“This supports the consensus that the stress burden of parents with autism is a significant problem (Bonis, 2016; Ilias et al., 2018).”
Background
Parental Expressed Emotion, Parenting Stress, and Behavioral Problems of Young Children with 22q11.2 Deletion Syndrome and Idiopathic Autism Spectrum Disorder
Serur, Y., Sher‐Censor, E., Sofrin-Frumer, D., Daon, K., Sobol-Havia, D., Weinberger, R., Shulman, C., & Gothelf, D. (2022) · Child Psychiatry & Human Development · doi:10.1007/s10578-021-01310-7 · Cited by 13
“Yet, both our study and this former research are inconsistent with other studies that found parenting stress was higher among parents of children with 22q11DS [8, 18] and with iASD [15, 56] than among parents of TD children.”
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Content Analysis of Abstracts Published in Autism Journals in 2021: The year in Review
Memišević, H., & Djipa, A. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05751-4 · Cited by 12
“It is well-established that parents of children with ASD have more stress than parents of typically developing children (Bonis, 2016).”
Background
Collateral Damage: The Impacts of School Exclusion on the Mental Health of Parents Caring for Autistic Children
Cleary, M. L., West, S., Johnston‐Devin, C., Kornhaber, R. A., McLean, L., & Hungerford, C. L. (2024) · Issues in Mental Health Nursing · doi:10.1080/01612840.2023.2280718 · Cited by 12
“…mental health begins early, as parents learn to cope with stress related to their child’s emerging behavioral and communication challenges, followed by managing the many demands of finding, accessing and engaging with autism-related services and interventions (Bonis, 2016; Cleary et al., 2023).”
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Smith-Young, J., Pike, A. D., Swab, M., & Chafe, R. (2024) · JBI Evidence Synthesis · doi:10.11124/jbies-23-00332 · Cited by 14
[Effect of parental training based on Early Start Denver Model combined with intensive training on children with autism spectrum disorder and its impact on parenting stress].
Gao, D., Yu, T., Li, C.-L., Jia, F.-Y., & Li, H. H. (2020) · PubMed Central · doi:10.7499/j.issn.1008-8830.2020.02.014 · Cited by 12
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“For example, prior to or after diagnosis of ASD, some parents experience blame for their child’s behaviours and insinuations of ‘bad’ parenting and guilt (Bonis, 2016; Read & Schofield, 2010).”
Background
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Lobato-Ruiz, V., Ayuso, D. M. R., Toledano-González, A., & Triviño-Juárez, J. M. (2025) · PeerJ · doi:10.7717/peerj.19326 · Cited by 11
“QoL is essential to understanding how living conditions affect individuals’ mental and emotional health, and their ability to adapt and face everyday challenges ( Bonis, 2016 ; Vasilopoulou & Nisbet, 2016 ).”
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“Additionally, caregivers who utilized respite services reported lower stress levels (Bonis, 2016).”
BackgroundResultInfluential
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Denusik, L., Servais, M., Glista, D., Hatherly, K., Moodie, S., Cardy, J. O., Weitzman, E., & Cunningham, B. J. (2023) · American Journal of Speech-Language Pathology · doi:10.1044/2022_ajslp-22-00256 · Cited by 12
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“Studies focused on parents of CYP with special educational needs, including autism spectrum conditions or developmental language disorders, owing to likely additional needs for these parents, existing reviews 29 30 and our focus specifically on CYP with mental health conditions.”
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“For parents of children with Autism Spectrum Disorder (ASD), parenting stress is often very high (Barroso, Mendez, Graziano, & Bagner, 2018; Bonis, 2016; Dabrowska & Pisula, 2010; Hayes & Watson, 2013), and higher than for parents of children with almost any other disorder or health condition (Hayes & Watson, 2013; Pa…”
Background
Parental perception of stress and emotional-behavioural difficulties of children with autism spectrum disorder and specific language impairment
Renzo, M. D., di Castelbianco, F. B., Vanadia, E., Petrillo, M., Racinaro, L., & Rea, M. (2020) · Autism & Developmental Language Impairments · doi:10.1177/2396941520971502 · Cited by 11
“Some have found a higher incidence of psychopathological disorders in parents (Bonis, 2016), including depression, anxiety and stress-related symptoms, compared to parents of children with typical development (Ingersoll & Hambrick, 2011; Jones et al.”
Background
A Narrative Review about Autism Spectrum Disorders and Exclusion of Gluten and Casein from the Diet
González-Domenech, P., Díaz-Atienza, F., Gutiérrez-Rojas, L., Fernández‐Soto, M. L., & González-Domenech, C. M. (2022) · Nutrients · doi:10.3390/nu14091797 · Cited by 11
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Wallace-Watkin, C., Whitehouse, A., & Waddington, H. L. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04777-w · Cited by 11
“2016), and increased levels of parental stress (Bonis 2016).”
Background
Facilitators’ perspectives on a psychoeducational program for parents of an autistic child
Decroocq, C., Soulas, T., Lichtlé, J., Sankey, C., Engelberg, A., & Cappe, É. (2020) · Autism · doi:10.1177/1362361319899766 · Cited by 11
“Considering the prevalence of mental health issues among these parents (Bonis, 2016; Da Paz & Wallander, 2017), providing continuity with an intervention that responds specifically to their psychological distress is essential.”
Background
Routines as a Protective Factor for Emerging Mental Health and Behavioral Problems in Children with Neurodevelopmental Delays
Hatherly, K., Stienwandt, S., Salisbury, M. R., Roos, L. E., & Fisher, P. A. (2022) · Advances in Neurodevelopmental Disorders · doi:10.1007/s41252-022-00260-y · Cited by 10
“Research has demonstrated that parents who report higher stress levels also report lower use of family routines (Bonis, 2016; Hayes & Watson, 2013).”
Background
The relationship between perceived social support and rumination among parents of children with autism: moderating effect of the degree of intervention received by children
Xu, L., Li, S., Xiong, Z., & Chen, J. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1340046 · Cited by 10
“Compared to caregivers of typically developing children, parents of autistic children tend to face more psychological dif ﬁ culties, with a high risk of psychiatric disorders such as somatization, obsessive-compulsive states, repression, paranoia, and irritability (3).”
Background
Parental Mental Health: Addressing the Unmet Needs of Caregivers for Children With Autism Spectrum Disorders
Lushin, V., & O’Brien, K. H. (2016) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2016.09.507 · Cited by 10
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Brisini, K. S. C., & Solomon, D. H. (2020) · Southern Communication Journal · doi:10.1080/1041794x.2020.1816608 · Cited by 10
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“Elevated experiences of caregiver or parental stress are well documented among families with autistic children in comparison with families of nonautistic children and families of children with other developmental disabilities (Bonis, 2016; Hayes & Watson, 2013; Pastor-Cerezuela et al., 2021).”
The impact of having an autisTic child on parental mental health and wellbeing in pakistan
Nadeem, N., Afzal, S., Dogar, I., Smith, J., Shah, T., Noreen, M., & ALI, A. (2024) · Research in Autism · doi:10.1016/j.rasd.2024.102423 · Cited by 17
“Parents of children with ASD frequently present with higher stress levels than other groups of parents (Bonis, 2016).”
BackgroundResult
Parental experiences of raising an autistic child in Ireland: A qualitative thematic analysis
Whelan, S., Caulfield, N., O’Doherty, S., Mannion, A., & Leader, G. (2024) · Autism · doi:10.1177/13623613241277040 · Cited by 9
“The societal stigma that surrounds autism impacts parents through the criticism and judgement they receive regarding their child’s behaviour in public settings (Bonis, 2016; Lutz et al., 2012; Neely-Barnes et al., 2011; Swaab et al., 2021).”
Effectiveness of Interventions to Promote Physical, Psychological, and Socioeconomic Well-being Outcomes of Parents of Children With Neurodevelopmental Disabilities: Protocol for a Systematic Review
Novak‐Pavlic, M., Rosenbaum, P., Macedo, L. G., Rezze, B. D., Yong, J., Noori, A., & Hughes, D. (2022) · JMIR Research Protocols · doi:10.2196/38686 · Cited by 9
“In addition, parents of children with impairments have been found to experience more social marginalization, financial difficulties [18], under- or unemployment [7], and other disadvantages.”
BackgroundResultInfluential
Percepção parental sobre o filho com autismo: as repercussões na adaptação familiar
Portes, J. R. M., & Vieira, M. L. (2022) · Revista Psicologia em Pesquisa · doi:10.34019/1982-1247.2022.v16.32614 · Cited by 16
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Schwartzman, J. M., Williams, Z. J., Paterson, A. V., Jacobs, A. X., & Corbett, B. A. (2023) · Autism · doi:10.1177/13623613221143587 · Cited by 10
“A focus on caregiver well-being in the MBC-AUT system may be a critical benefit for autistic clients, particularly as caregivers of autistic youth frequently endorse higher stress (Bonis, 2016) and more psychiatric symptoms (e.”
Background
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
“It seems, however, that successful educational programs, whatever we call them, support parents both in understanding their children’s behaviors and managing them [41].”
Background
Primary care of children with autism spectrum disorder
Kilmer, M. (2020) · The Nurse Practitioner · doi:10.1097/01.npr.0000666192.02590.ed · Cited by 9
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“As per the report, ASD is the fastest-growing developmental disorder in the USA with a 6% to 15% increase in rate per year (Bonis, 2016).”
Method
The mediating role of parental playfulness on parent–child relationship and competence among parents of children with ASD
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“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
“Nevertheless, caregivers of children with NDDs/NDPs are at an increased risk of psychological distress and caregiving stress (Barroso et al., 2018; Bonis, 2016; D’Arcy et al., 2023; Scherer et al., 2019).”
Influential
'Of course you crash' Parenting a young child with neurodevelopmental difficulties
Fäldt, A. E., & Fängström, K. (2024) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2024.104825 · Cited by 8
The Challenge Coping and Resilience of the Families of School-Aged Children with Autism Spectrum Disorder in China: A Qualitative Study
Han, F., & Gao, X. (2025) · Behavioral Sciences · doi:10.3390/bs15040409 · Cited by 8
“Several studies have demonstrated that the families of children with ASD experience stress from multiple sources, including psychological, physical, economic, familial relationships, social policies, and sociocultural factors, etc. (Bonis, 2016; Gülbetekin et al., 2024; Ha et al., 2014).”
Representations of adult attachment and shame in parents of children on the autism spectrum
Conrad, C. E., Lauritsen, M. B., Færk, E., Jakobsen, H. N., Thomsen, P. H., & George, C. C. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1519090 · Cited by 8
“Previous research shows that parents of children on the autism spectrum are already more stressed before the diagnosis compared to other parents, as they are dealing with the discovery of the disabilities and delayed development of their child (Bonis, 2016; Silva and Schalock, 2012).”
Factors Influencing Despair, Self-blame, and Acceptance Among Parents of Children with Autism Spectrum Disorder (ASD): A Malaysian Perspective
Latif, M., Ismail, W. S. W., Manaf, M. R. A., & Taib, N. I. A. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-023-06155-8 · Cited by 13
“While accepting the diagnosis of ASD could be difficult, some parents were more resilient in accepting the diagnosis (Bonis, 2016 ; Zhao & Fu, 2020).”
Communication Training Within Partners in School : Feasibility, Acceptability, and Usability
Azad, G. F., Taormina, I., Herrera, V., & Zhang, Y. (2024) · Journal of Educational and Psychological Consultation · doi:10.1080/10474412.2024.2341382 · Cited by 9
“It is likely that our community partners requested only one in-person consultation meeting given the time demands and stress experienced by parents of children with Autism and special education teachers (Bonis, 2016; Krakovich et al., 2016; Uzodinma et al., 2022).”
Background
Family-Centered Care Coordination in an Interdisciplinary Neurodevelopmental Evaluation Clinic: Outcomes From Care Coordinator and Caregiver Reports
Keehn, R. M., Enneking, B. A., Ramaker, M., Goings, M. J., Yang, Z., Carroll, A. E., & Ciccarelli, M. R. (2020) · Frontiers in Pediatrics · doi:10.3389/fped.2020.538633 · Cited by 8
“These findings are supported by an extensive literature regarding high levels of stress in caregivers of children with ASD and other neurodevelopmental disabilities [see (41) for review].”
Result
The Psychological Impact of the COVID-19 Lockdown: A Comparison between Caregivers of Autistic and Non-Autistic Individuals in Italy
Fusar‐Poli, L., Martinez, M., Surace, T., Meo, V., Patania, F., Avanzato, C., Signorelli, M. S., & Aguglia, E. (2022) · Brain Sciences · doi:10.3390/brainsci12010116 · Cited by 7
“Particularly, it has been reported that being the caregiver of an autistic person—typically one of the parents—can be stressful and impact family functioning [15].”
Background
Impacto en la familia del diagnóstico de Trastorno del espectro del autismo (TEA) en un hijo/a: una revisión sistemática
Lavado-Candelario, S., & Muñoz‐Silva, A. (2023) · Análisis y Modificación de Conducta · doi:10.33776/amc.v49i180.7652 · Cited by 21
Utilization of Chickpea Split (Cicer arietinum L.) in Preparing Some Gluten-Free Casein-Free Food Products for Autism Children
Ibrahim, R. M. (2022) · Food and Nutrition Sciences · doi:10.4236/fns.2022.133023 · Cited by 7
Exploring Collaborative Efforts Toward Promoting Better Eating Habits among Autistic Children in the United Arab Emirates
Opoku, M. P., Moustafa, A., Anwahi, N., Shah, H., Aldhaheri, S., Almeqbaali, A., Alkateri, T., & Belbase, S. (2023) · The Linacre Quarterly · doi:10.1177/00243639231156701 · Cited by 7
“Particularly, a large body of literature has con ﬁ rmed the dif ﬁ culties stakeholders face, such as parents and teachers, in supporting the development of autistic children (Bonis 2016; Hall and Graff 2010; Ilias et al. 2018).”
Background
Virtual Mindfulness Workshops for Parents of Children on the Autism Spectrum
Curl, E. L., & Hampton, L. H. (2023) · Journal of Early Intervention · doi:10.1177/10538151231169950 · Cited by 7
“…scores, both pre-and post-intervention, fall above the 95th percentile, compared with parents of typically developing children, indicating that all of the parents in the study experienced high levels of parenting stress, which is expected when parenting a child on the autism spectrum (Bonis, 2016).”
How to build resiliency in autistic individuals: an implication to advance mental health
Ghanouni, P., Raphael, R., Seaker, L., & Casey, A. (2024) · BMC Psychology · doi:10.1186/s40359-024-01916-1 · Cited by 9
“It has been indicated that using social groups to help with problem-solving, cognitive coping and stress management strategies can be considered by parents [14, 21].”
Background
Exposure to the earthquake with a child with autism: A qualitative study on parenting experiences
Aslan, S. D. (2024) · International Journal of Disaster Risk Reduction · doi:10.1016/j.ijdrr.2024.104850 · Cited by 7
EXPERIENCES OF MOTHERS IN DEALING WITH STIGMA RELATED TO THEIR CHILDREN WITH AUTISM SPECTRUM DISORDER IN THE SAUDI CONTEXT
Sulaimani, M. F., & Mursi, N. B. (2022) · Problems of Education in the 21st Century · doi:10.33225/pec/22.80.851 · Cited by 7
‘I can’t say that anything has changed’: parents of autistic young people (16–25 years) discuss the impact of the Children and Families Act in England and Wales
Crane, L., Davies, J., Fritz, A., Portman, K., O’Brien, S., Worsley, A., & Remington, A. (2023) · Frontiers in Education · doi:10.3389/feduc.2023.1250018 · Cited by 7
HUBUNGAN ANTARA HARAPAN DAN STRES ORANG TUA YANG MEMILIKI ANAK DENGAN AUTISME
Kurniadi, G., Atmodiwirjo, E. T., & Soetikno, N. (2019) · Jurnal Muara Ilmu Sosial Humaniora dan Seni · doi:10.24912/jmishumsen.v3i2.3860 · Cited by 6
Pilot randomized controlled trial of MINDful TIME, a novel telehealth mindfulness-based intervention for autistic adolescents and their caregivers.
Matthews, N. L., Mitchell, M. M., Honda, H., Malligo, A., Boyd, S., Pagni, B. A., & Blair Braden, B. (2025) · Autism · doi:10.1177/13623613251328484 · Cited by 9
“Nonetheless, improvements in parent well-being are a meaningful benefit of this telehealth program and may help to address heightened stress among parents of autistic children (Bonis, 2016).”
Psychological Stress in Parents of Children with Autism Spectrum Disorder
Ha, C. T. M., Nguyen, H. T., Nguyen, V. H. A., & Tran-Thien, G.-P. (2024) · National Journal of Community Medicine · doi:10.55489/njcm.150620243909 · Cited by 6
“24 Moreover, the mutual experiences and obligations among siblings can help to mitigate the caring load on parents, so indirectly diminishing their levels of stress.”
Background
Deregulated Nrf2-Keap1-BACH1 axis in autism spectrum disorder
Vallese, A., Melija, S., Hayek, J., Pecorelli, A., & Valacchi, G. (2025) · Redox Biology · doi:10.1016/j.redox.2025.103837 · Cited by 6
“The disorder typically develops into a lifelong condition, making it a source of chronic stress for affected families due to the persistence of symptoms, the presence of comorbidities, and limited access to appropriate health care support [6,7].”
Interdisciplinary Competencies for Implementing NDBIs With Young Children With Autism and Other Social Communication Challenges
Ingersoll, B. R., Douglas, S. N., Brodhead, M. T., Barber, A. B., & Kaczmarek, L. A. (2023) · Journal of Early Intervention · doi:10.1177/10538151231218928 · Cited by 6
“Seeking diagnosis and services for their child, interacting with numerous providers from a variety of disciplines, and scheduling therapy sessions can further increase family stress as they juggle the needs and priorities of their child with autism with those of other family members (Bonis, 2016).”
Background
The physical and psychosocial benefits of a family judo program for parents of children with Autism Spectrum Disorder: A pilot study
Garcia, J. M., Hahs‐Vaughn, D. L., Murray, M., Perry, C., Brazendale, K., Rice, D. J., & Fukuda, D. H. (2024) · Disability and health journal · doi:10.1016/j.dhjo.2024.101631 · Cited by 6
The Impact of COVID-19 Pandemic Containment Measures on Families and Children with Moderate and High-Functioning ASD (Autism Spectrum Disorder)
Saliverou, M., Georgiadi, M., Tomprou, D. M., Ieridou, N. L., & Plexousakis, S. (2021) · Education Sciences · doi:10.3390/educsci11120783 · Cited by 10
Uplifts, Respite, Stress, and Marital Quality for Parents Raising Children With Down Syndrome or Autism
Easler, J. K., Dyches, T. T., Roper, S. O., Yorgason, J. B., & Harper, J. M. (2022) · Intellectual and developmental disabilities · doi:10.1352/1934-9556-60.2.145 · Cited by 12
Spring is not yet here: raising a child with ASD in rural southwest China
Wang, L., Xie, Z., & Zhao, D. (2022) · Disability and Rehabilitation · doi:10.1080/09638288.2022.2161642 · Cited by 6
“In response, parents of children with ASD often require a significant amount of time and physical effort to complete their responsibilities [10].”
Background
Dietary Assessment Methods Applied in Clinical and Epidemiological Studies in Children and Adolescents with Autism Spectrum Disorder: a Systematic Review
Silva, E. D. S., Castro, K., Valle, S. C., & Vaz, J. D. S. (2023) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-022-00353-3 · Cited by 6
“Only seven studies (Bicer & Alsaffar, 2013; Hyman et al., 2012; Lockner et al., 2008; Marí-Bauset et al., 2014a, 2015a, b, 2016) reported adjustments for energy intake (Nut 12.2), one study (Eow et al., 2021) addressed dietary or nutritional assessment bias (Nut 9), and six studies (Hyman et al.,…”
Influential
Knowledge and belongingness: experiences of a programme for parents of children with autism
Gillberg, N., Miniscalco, C., & Andersson, G. W. (2023) · Educational Research · doi:10.1080/00131881.2023.2276956 · Cited by 9
“At the same time, having a child with autism has been shown to be challenging for parents and siblings (Bonis 2016; Carlsson et al. 2016; Leedham, Thompson, and Freeth 2020), with multiple studies reporting increased stress in parents of children with autism (Hayes and Watson 2013; Krakovich et al.…”
Background
Impacts of Caregiving for Individuals with Autism in Low-Resource Settings, a Report from the Kurdistan Region of Iraq
Samadi, S. A., & Rashid, H. M. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-023-06165-6 · Cited by 6
“These results indicate that caregiving for a child with autism was associated with greater impaired general health, increased levels of parental stress, lower levels of satisfaction with caregiving, and lower levels of functioning in the family in general (Cachia et al., 2016; Bonis, 2016).”
Psycho-social consequences associated with COVID-19 in people with ASD and their families: A literature review
Aarabi, M. A., Abdi, K., & Khanjani, M. S. (2021) · Medical Journal of the Islamic Republic of Iran · doi:10.47176/mjiri.35.131 · Cited by 7
“Parenting an ASD child can be stressful (9).”
Background
Parental experiences of adopting healthy lifestyles for children with disabilities living with overweight and obesity
Peña, C. M., & Payne, A. (2021) · Disability and health journal · doi:10.1016/j.dhjo.2021.101215 · Cited by 6
The Effect of Aerobic Exercise on Motor Skills and Body Composition of Children with Autism
Shahrasfenghar, A., Arabameri, E., Daneshfar, A., Ghasemi, A., & Kashi, A. (2019) · Journal of Health and Care · doi:10.29252/jhc.20.4.332 · Cited by 6
Does hope mediate the relationship between parent’s resolution of their child’s autism diagnosis and parental stress
Naicker, V. V., Hedley, D., & Bury, S. M. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1443707 · Cited by 5
“…such as managing behaviors that challenge, changes in the parent’s life (e.g., routines, relationships with friends and family), as well as difficulties finding and organizing autism services, or overcoming barriers or challenges with the education systems (Bonis, 2016, Hayes and Watson, 2013).”
Background
Living-loss: A narrative synthesis review of the grief process in parents of children with autism spectrum disorder
Alimohamadi, A., Ghasemzadeh, M., Fooladi, F., Abdolmohamadi, K., Killikelly, C., & Janghorbanian, Z. (2024) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2024.03.036 · Cited by 5
The perceived benefits of Dance Movement Therapy for parents of a child on the autism spectrum: A pilot study
Champagne, E. R., & MacDonald, S. E. (2021) · The Arts in Psychotherapy · doi:10.1016/j.aip.2021.101875 · Cited by 5
Raising a Child with Autism Spectrum Disorder: Examining Parental Factors
Barklı, A., & Doğan, A. (2024) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.1455122 · Cited by 4
Sexual education for adolescent autism spectrum disorders: an interpretative phenomenological analysis
Lestari, L., & Aunurrahman, A. (2021) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20211210 · Cited by 4
“children, discrimination in society, and an increased burden on the nation's future generation of people diagnosed with ASD.(7-9) The stage of sexual development is a stage of development that adolescents must go through, as well as adolescents with ASD.”
Background
Parental Stress and Effective Parent Training for Parents of Individuals Diagnosed with ASD
Sato, S. K., Plattner, C., Leaf, J. B., Oppenheim‐Leaf, M. L., Cihon, J. H., Driscoll, M., Leaf, R. B., Unumb, L. S., & Weiss, M. J. (2022) · Autism and child psychopathology series · doi:10.1007/978-3-030-88538-0_8 · Cited by 5
Aggression in Autism Spectrum Disorder: Supporting the Entire Family
Sabapathy, T., Vanderbilt, D. L., Zamora, I., & Augustyn, M. C. (2016) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000347 · Cited by 5
Parents’ Experiences after Their Child’s Autism Diagnosis: A Reflexive Thematic Analysis
Hughes, R., Curley, K., & Kotera, Y. (2024) · Psychiatry International · doi:10.3390/psychiatryint5030026 · Cited by 8
“This theme reflects that self-care was considered essential in this sample of parents, however, a struggle to prioritise this was a consistent finding in the data and consistent with previous research [102,158,159].”
Result
Contextualizing Resilience: A Theoretical Integration of Social Determinants of Health and Family Functioning in Neurodiverse Families
McDowell, C. N. (2025) · Journal of Family Theory & Review · doi:10.1111/jftr.70031 · Cited by 4
Validation of the safety, empathy and utility of a large language model conversation agent for parents of autistic and neurodivergent children
Brown, F. J., Muscat, I. S., Quinn, L., Best, L., & Cooper, P. (2026) · Scientific Reports · doi:10.1038/s41598-026-44254-5 · Cited by 4
Effect of the Early Start Denver Model on Children With Autism Spectrum Disorder Syndrome of Different Traditional Chinese Medicine Types in Northeast China
Wang, L., Feng, J., Zhang, Y., & Wang, T. (2022) · Frontiers in Pediatrics · doi:10.3389/fped.2022.851109 · Cited by 4
Resilience Within Families of Young Children with ASD
Neijs, L. D.-D., Swaab, H., van Berckelaer‐Onnes, I. A., & Ester, W. A. (2025) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-025-06773-4 · Cited by 8
“Similarities in parenting stress may be related to factors associated to the child and/or family relationships like the influence of the partners on each other in coping with stress (Bonis, 2016; Enea & Rusu, 2020; Ooi et al., 2016; Walsh, 2016).”
The levels of stress, anxiety, and depression in parents of children with autism spectrum disorder: A review of literature
Alicka, Y., Gjeta, A., Kotherja, O., Topi, B., Osmanaj, E., Shyti, M., Zace, E., & Agolli, D. (2025) · Multidisciplinary Reviews · doi:10.31893/multirev.2025350 · Cited by 4
The Relationship Among Problem-Solving, Coping Styles and Stress Levels of Parents of Children with Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder and Typical Development
Gül, H., & Gür, Ç. (2022) · European Journal of Educational Research · doi:10.12973/eu-jer.11.3.1231 · Cited by 7
“Bonis (2016) focused on children with ASD distinct from other diagnoses, as well as parental experiences of caring for a child with ASD.”
Background
The Healthcare Experience of Autistic Patients in Orthopaedic Surgery and Closely Related Fields: A Scoping Review
Criss, S. D., Kakulamarri, S., Xu, R. F., Fajardo, M., Keeney, T., Tolchin, D. W., & May, C. J. (2023) · Children · doi:10.3390/children10050906 · Cited by 4
“Furthermore, the stress of the various manifestations of autism and its associated comorbidities reaches beyond the patients themselves and plays a role in the well-being of their caregivers [27].”
Background
Traducción y Adaptación en Español del Manual de Emociones Expresadas para Trastorno del Espectro Autista y otros Trastornos Relacionados
Marín, E., Navas-Domenech, I., Otero, I. H., Ramírez‐Martín, A., Mayoral, F., Barbancho, M. Á., Lara, J. P., & Romero-González, M. (2023) · Revista de Psiquiatría Infanto-Juvenil · doi:10.31766/revpsij.v40n2a5 · Cited by 4
Perceived Stigma in Community-Based Leisure Activity Participation of Children With Autism: Perspective from Turkish Parents
Koçak, F., Sarol, H., & Gürkan, R. K. (2023) · The Online Journal of Recreation and Sport · doi:10.22282/tojras.1311038 · Cited by 4
“Breaking the news”–post-autism spectrum disorder diagnosis group intervention for parents to 6–18-year-old children
Gindi, S., Shabbat-Seri, M. B., Shimoni, H. N., Gilat, I., & Leitner, Y. (2024) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045241263365 · Cited by 4
“Children with ASD have a pervasive impairment in reciprocal communication and in the ability to display emotions, engage and initiate social interaction, and are therefore dependent on high levels of caregiver support and mediation (Bonis, 2016).”
Background
Explicit and Systematic Scripted Instructional Programs for Students with Autism Spectrum Disorder: An Updated and Extended Review
Sulu, M. D., Martella, R. C., TOPER, Ö., Marchand‐Martella, N. E., & KIYAK, Ü. E. (2021) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-021-00284-5 · Cited by 4
“Unfortunately, parents and school/clinic personnel working with individuals with ASD are not confident on implementing evidence-based practices and lack sufficient training and support to implement them (Bonis, 2016; Brock et al., , 2014, 2020).”
Background
Physical Fitness and Maternal Psychosocial Status in Children With Autism Attending a Regular Physical Activity Program
ŞAHAN, A. K., Öztürk, N., Kutukcu, E. C., Aksu, H., Tunagür, M. T., & Arıkan, H. (2022) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/10883576221108110 · Cited by 4
“Therefore, our results are consistent with those of previous research indicating that multiple factors can affect the anxiety level of parents of children with developmental disabilities (Bonis, 2016; Bujnowska et al., 2019).”
Result
Holes, Patches and Multiple Hats: The Experiences of Parents of Students with Special Education Needs Navigating At-Home Learning During COVID-19
Whitley, J., Specht, J., Matheson, I. A., & MacCormack, J. W. H. (2022) · Springer eBooks · doi:10.1007/978-3-031-02469-6_3 · Cited by 4
Caregiver Perceptions of Social Communication and Interaction: Development and Validation of the SCIPS
McClain, M. B., Golson, M. E., Haverkamp, C. R., Harris, B., Ficklin, E., Schwartz, S., & Wynn, C. J. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05840-4 · Cited by 5
“Family relations, including parent and sibling relationships, can also be stressful or strained for individuals with autism (Bonis, 2016; Hastings & Petalas, 2014 ).”

Authors: Bonis, S.
Affiliations: University of Wisconsin–Milwaukee (US)
Corresponding author: Bonis, Susan
ORCID: Bonis, Susan
Venue: Issues in Mental Health Nursing
Publisher: Informa UK Limited
Published: 2016-03-03
Volume: 37
Issue: 3
Pages: 153-163
ISSN: 0161-2840 (ISSN-L)
1096-4673
DOI: 10.3109/01612840.2015.1116030
OpenAlex: W2319420461
Cited by: 404
References: 132
Citations by year: 2026: 45 · 2025: 58 · 2024: 65 · 2023: 50 · 2022: 53 · 2021: 56 · 2020: 35 · 2019: 25 · 2018: 10 · 2017: 4 · 2016: 2
FWCI: 2.03
Type: journal article
Language: en
Open access: closed
Locations: Issues in Mental Health Nursing (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
Keywords: autism spectrum disorder, parental stress, parents of autistic children, parental decision-making, autism services, health care access, early diagnosis, parental mental health, stress management
MeSH terms: Autism Spectrum Disorder, Adult, Child, Humans, Parents, Stress, Psychological

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Stress and Parents of Children with Autism: A Review of Literature

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