Coping strategies of parents of children with autism spectrum disorder: a systematic review


To deal with stress, parents of children with ASD use coping strategies that help to tackle the challenging situations of raising their child. This systematic review examines parental coping strategy’s questionnaires, factors which influence these coping strategies, interactions between these strategies and perceived stress and their impact on parental quality of life. According to PRISMA guidelines, an electronic search was conducted on Medline, PsycInfo and Eric: 156 articles were identified and 11 studies were selected. Many types of self-reported questionnaires were used to assess parental coping strategies. Studies highlighted that parents of a child with ASD used more avoidance strategies and less social support-seeking strategies than those of typical children. Furthermore, problem-focused coping protects parental stress and quality of life, that on the contrary, emotion-focused coping is a risk factor for alteration. Our systematic review illustrates the need to adapt psychoeducational interventions for parents of children with ASD.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. 1.

    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publication, Washington, D.C.

    Book  Google Scholar 

  2. 2.

    Dunn ME, Burbine T, Bowers CA, Tantleff-Dunn S (2001) Moderators of stress in parents of children with autism. Commun Ment Health J 37(1):39–52

    CAS  Article  Google Scholar 

  3. 3.

    Hayes SA, Watson SL (2013) 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. J Autism Dev Disord 43(3):629–642.

    Article  PubMed  Google Scholar 

  4. 4.

    Lee GK, Lopata C, Volker MA, Thomeer ML, Nida RE, Toomey JA, Chow SY, Smerbeck AM (2009) Health-related quality of life of parents of children with high-functioning autism spectrum disorders. Focus on Autism Other Dev Disabil 24(4):227–239.

    Article  Google Scholar 

  5. 5.

    Lyons AM, Leon SC, Phelps CER, Dunleavy AM (2010) The impact of child symptom severity on stress among parents of children with ASD: the moderating role of coping styles. J Child Fam Stud 19(4):516–524.

    Article  Google Scholar 

  6. 6.

    Cooper CE, McLanahan SS, Meadows SO, Brooks-Gunn J (2009) Family structure transitions and maternal parenting stress. J Marriage Fam 71(3):558–574.

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Lacharité C, Ethier L, Piché C (1992) Parental stress in mothers of preschool children: validation and Quebec norms for the Parental Stress Inventory. Sante Ment Que 17(2):183–203

    Article  Google Scholar 

  8. 8.

    Abidin RR (1992) The determinants of parenting behavior. J Clin Child Psychol 21(4):407–412.

    Article  Google Scholar 

  9. 9.

    Ekas NV, Whitman TL (2011) Adaptation to daily stress among mothers of children with an autism spectrum disorder: the role of daily positive affect. J Autism Dev Disord 41(9):1202–1213

    Article  Google Scholar 

  10. 10.

    Estes A, Munson J, Dawson G, Koehler E, Zhou X-H, Abbott R (2009) Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism 13(4):375–387.

    Article  PubMed  Google Scholar 

  11. 11.

    Higgins DJ, Bailey SR, Pearce JC (2005) Factors associated with functioning style and coping strategies of families with a child with an autism spectrum disorder. Autism 9(2):125–137.

    Article  PubMed  Google Scholar 

  12. 12.

    Pastor-Cerezuela G, Fernández-Andrés MI, Tárraga-Mínguez R, Navarro-Peña JM (2016) Parental stress and ASD: relationship with autism symptom severity, IQ, and resilience. Focus Autism Other Dev Disabil 31(4):300–311.

    Article  Google Scholar 

  13. 13.

    Pinto Costa A, Steffgen G, Ferring D (2017) Contributors to well-being and stress in parents of children with autism spectrum disorder. Res Autism Spectr Disord.

    Article  Google Scholar 

  14. 14.

    Mugno D, Ruta L, D’Arrigo VG, Mazzone L (2007) Impairment of quality of life in parents of children and adolescents with pervasive developmental disorder. Health Qual Life Outcomes 5:22.

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Parish SL, Seltzer MM, Greenberg JS, Floyd F (2004) Economic implications of caregiving at midlife: comparing parents with and without children who have developmental disabilities. Ment Retard 42(6):413–426.<413:eiocam>;2

  16. 16.

    Pozo P, Sarriá E, Brioso A (2014) Family quality of life and psychological well-being in parents of children with autism spectrum disorders: a double ABCX model. J Intellect Disabil Res 58(5):442–458.

    CAS  Article  PubMed  Google Scholar 

  17. 17.

    Benson PR (2010) Coping, distress, and well-being in mothers of children with autism. Res Autism Spectr Disord 4(2):217–228.

    Article  Google Scholar 

  18. 18.

    Twoy R, Connolly PM, Novak JM (2007) Coping strategies used by parents of children with autism. J Am Acad Nurse Pract 19(5):251–260.

    Article  PubMed  Google Scholar 

  19. 19.

    Lazarus RS, Folkman S (1984) Stress, appraisal, and coping. Springer Publishing Company, New York

    Google Scholar 

  20. 20.

    Folkman S, Lazarus RS (1980) An analysis of coping in a middle-aged community sample. J Health Soc Behav 21(3):219–239.

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Folkman S, Moskowitz JT (2004) Coping: pitfalls and promise. Annu Rev Psychol 55:745–774.

    Article  PubMed  Google Scholar 

  22. 22.

    Bruchon-Schweitzer M (2002) Psychologie de la santé: modèles, concepts et méthodes. Dunod

  23. 23.

    Vasilopoulou E, Nisbet J (2016) The quality of life of parents of children with autism spectrum disorder: a systematic review. Res Autism Spectr Disord 23:36–49.

    Article  Google Scholar 

  24. 24.

    Lai WW, Oei TPS (2014) Coping in parents and caregivers of children with autism spectrum disorders (ASD): a review. Rev J Autism Dev Disord 1(3):207–224

    Article  Google Scholar 

  25. 25.

    von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, Initiative S (2014) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 12(12):1495–1499.

    Article  Google Scholar 

  26. 26.

    Law MC, MacDermid J (2008) Evidence-based rehabilitation: a guide to practice. SLACK Incorporated, Thorofare

    Google Scholar 

  27. 27.

    Luque Salas B, Yáñez Rodríguez V, Tabernero Urbieta C, Cuadrado E (2017) The role of coping strategies and self-efficacy as predictors of life satisfaction in a sample of parents of children with autism spectrum disorder. Psicothema 29(1):55–60

    PubMed  Google Scholar 

  28. 28.

    Benson PR (2014) Coping and psychological adjustment among mothers of children with ASD: an accelerated longitudinal study. J Autism Dev Disord 44(8):1793–1807.

    Article  PubMed  Google Scholar 

  29. 29.

    Carter AS, de Martínez-Pedraza FL, Gray SAO (2009) Stability and individual change in depressive symptoms among mothers raising young children with ASD: maternal and child correlates. J Clin Psychol 65(12):1270–1280.

    Article  PubMed  Google Scholar 

  30. 30.

    Dardas LA, Ahmad MM (2015) Coping strategies as mediators and moderators between stress and quality of life among parents of children with autistic disorder. Stress Health J Int Soc Invest Stress 31(1):5–12.

    Article  Google Scholar 

  31. 31.

    Rayan A, Ahmad M (2017) Psychological distress in Jordanian parents of children with autism spectrum disorder: the role of positive reappraisal coping. Arch Psychiatr Nurs 31(1):38–42.

    Article  PubMed  Google Scholar 

  32. 32.

    Wang J, Hu Y, Wang Y, Qin X, Xia W, Sun C, Wu L, Wang J (2013) Parenting stress in Chinese mothers of children with autism spectrum disorders. Soc Psychiatry Psychiatr Epidemiol 48(4):575–582.

    Article  PubMed  Google Scholar 

  33. 33.

    Cappe E, Wolff M, Bobet R, Adrien J-L (2011) Quality of life: a key variable to consider in the evaluation of adjustment in parents of children with autism spectrum disorders and in the development of relevant support and assistance programmes. Qual Life Res Int J Qual Life Asp Treat Care Rehabil 20(8):1279–1294.

    Article  Google Scholar 

  34. 34.

    Dabrowska A, Pisula E (2010) Parenting stress and coping styles in mothers and fathers of pre-school children with autism and Down syndrome. J Intellect Disabil Res 54(3):266–280.

    CAS  Article  PubMed  Google Scholar 

  35. 35.

    Ji B, Zhao I, Turner C, Sun M, Yi R, Tang S (2014) Predictors of health-related quality of life in Chinese caregivers of children with autism spectrum disorders: a cross-sectional study. Arch Psychiatr Nurs 28(5):327–332.

    Article  PubMed  Google Scholar 

  36. 36.

    Lai WW, Goh TJ, Oei TPS, Sung M (2015) Coping and well-being in parents of children with autism spectrum disorders (ASD). J Autism Dev Disord 45(8):2582–2593.

    Article  PubMed  Google Scholar 

  37. 37.

    Pisula E, Kossakowska Z (2010) Sense of coherence and coping with stress among mothers and fathers of children with autism. J Autism Dev Disord 40(12):1485–1494.

    Article  PubMed  Google Scholar 

  38. 38.

    Folkman S, Lazarus RS (1988) Coping as a mediator of emotion. J Pers Soc Psychol 54(3):466

    CAS  Article  Google Scholar 

  39. 39.

    Cousson F, Bruchon-Schweitzer M, Quintard B, Nuissier J (1996) Analyse multidimensionnelle d’une échelle de coping: validation française de la W.C.C. (Ways of Coping Checklist). = Multidimensional analysis of a coping scale: the French validation of the Ways of Coping Checklist. Psychol Française 41(2):155–164

    Google Scholar 

  40. 40.

    Vitaliano PP, Russo J, Carr JE, Maiuro RD, Becker J (1985) The Ways of coping checklist: revision and psychometric properties. Multivar Behav Res 20(1):3–26.

    CAS  Article  Google Scholar 

  41. 41.

    Carver CS, Scheier MF, Weintraub JK (1989) Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 56(2):267–283.

    CAS  Article  PubMed  Google Scholar 

  42. 42.

    Carver CS (1997) You want to measure coping but your protocol’s too long: consider the Brief COPE. Int J Behav Med 4(1):92–100.

    CAS  Article  PubMed  Google Scholar 

  43. 43.

    Hastings RP, Kovshoff H, Brown T, Ward NJ, Espinosa FD, Remington B (2005) Coping strategies in mothers and fathers of preschool and school-age children with autism. Autism 9(4):377–391.

    Article  PubMed  Google Scholar 

  44. 44.

    Xie Y (1998) Reliability and validity of the simplified Coping Style Questionnaire. Chin J Clin Psychol 6(2):114–115

    Google Scholar 

  45. 45.

    Endler NS, Parker JDA (1990) Coping Inventory for Stressful Situations: CISS. Multi-Health Systems Inc, Toronto

    Google Scholar 

  46. 46.

    Tobin DL, Holroyd KA, Reynolds RV, Wigal JK (1989) The hierarchical factor structure of the Coping Strategies Inventory. Cognit Ther Res 13(4):343–361

    Article  Google Scholar 

  47. 47.

    Cano García FJ, Rodríguez Franco L, García Martínez J (2007) Adaptación española del Inventario de Estrategias de Afrontamiento. Span Vers Coping Strat Invent 35(1):29–39

    Google Scholar 

  48. 48.

    Garnefski N, Kraaij V, Spinhoven P (2002) Manual for the use of the Cognitive Emotion Regulation Questionnaire. DATEC, Leiderdorp

    Google Scholar 

  49. 49.

    Antonovsky A (1987) Unraveling the mystery of health: how people manage stress and stay well. Jossey-Bass, New York

    Google Scholar 

  50. 50.

    Antonovsky A (1998) The sense of coherence. Stress Coping Health Fam Sense Coherence Resil 1:1

    Google Scholar 

  51. 51.

    Yatchmenoff DK, Koren PE, Friesen BJ, Gordon LJ, Kinney RF (1998) Enrichment and stress in families caring for a child with a serious emotional disorder. J Child Fam Stud 7(2):129–145.

    Article  Google Scholar 

  52. 52.

    Ferguson E, Matthews G, Cox T (1999) The Appraisal of Life Events (ALE) scale: reliability and validity. Br J Health Psychol 4(Part 2):97–116.

    CAS  Article  Google Scholar 

  53. 53.

    Holroyd J (1987) Questionnaire on Resources and stress: for families with chronically ill or handicapped members: [QRS]. Clinical Psychology Publishing Company, Los Angeles

    Google Scholar 

  54. 54.

    Abidin RR (1995) Manual for the parenting stress index. Psychological Assessment Resources, Odessa

    Google Scholar 

  55. 55.

    Lovibond PF, Lovibond SH (1995) The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther 33(3):335–343

    CAS  Article  Google Scholar 

  56. 56.

    Whoqol G (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 28(3):551–558

    Article  Google Scholar 

  57. 57.

    Cronbach LJ (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16(3):297–334

    Article  Google Scholar 

  58. 58.

    Myers BJ, Mackintosh VH, Goin-Kochel RP (2009) “My greatest joy and my greatest heart ache:” Parents’ own words on how having a child in the autism spectrum has affected their lives and their families’ lives. Res Autism Spectr Disord 3(3):670–684.

    Article  Google Scholar 

  59. 59.

    Wang P, Michaels CA, Day MS (2011) Stresses and coping strategies of Chinese families with children with autism and other developmental disabilities. J Autism Dev Disord 41(6):783–795

    CAS  Article  Google Scholar 

  60. 60.

    Matud MP (2004) Gender differences in stress and coping styles. Pers Individ Differ 37(7):1401–1415

    Article  Google Scholar 

  61. 61.

    Ptacek JT, Smith RE, Dodge KL (1994) Gender differences in coping with stress: when stressor and appraisals do not differ. Pers Soc Psychol Bull 20(4):421–430

    Article  Google Scholar 

  62. 62.

    Meléndez JC, Mayordomo T, Sancho P, Tomás JM (2012) Coping strategies: gender differences and development throughout life span. Span J Psychol 15(3):1089–1098

    Article  Google Scholar 

  63. 63.

    Allik H, Larsson J-O, Smedje H (2006) Health-related quality of life in parents of school-age children with Asperger syndrome or high-functioning autism. Health Qual Life Outcomes 4(1):1

    Article  Google Scholar 

  64. 64.

    Mak WW, Ho AH, Law RW (2007) Sense of coherence, parenting attitudes and stress among mothers of children with autism in Hong Kong. J Appl Res Intellect Disabil 20(2):157–167

    Article  Google Scholar 

  65. 65.

    Pottie CG, Ingram KM (2008) Daily stress, coping, and well-being in parents of children with autism: a multilevel modeling approach. J Fam Psychol 22(6):855

    Article  Google Scholar 

  66. 66.

    Smith LE, Seltzer MM, Tager-Flusberg H, Greenberg JS, Carter AS (2008) A comparative analysis of well-being and coping among mothers of toddlers and mothers of adolescents with ASD. J Autism Dev Disord 38(5):876–889.

    Article  PubMed  PubMed Central  Google Scholar 

  67. 67.

    Abbeduto L, Seltzer MM, Shattuck P, Krauss MW, Orsmond G, Murphy MM (2004) Psychological well-being and coping in mothers of youths with autism, Down syndrome, or fragile X syndrome. Am J Ment Retard 109(3):237–254.<237:pwacim>;2

  68. 68.

    Baghdadli A, Pry R, Michelon C, Rattaz C (2014) Impact of autism in adolescents on parental quality of life. Qual Life Res Int J Qual Life Asp Treat Care Rehabil 23(6):1859–1868.

    Article  Google Scholar 

  69. 69.

    Hall HR, Graff JC (2011) The relationships among adaptive behaviors of children with autism, family support, parenting stress, and coping. Issues Compr Pediatr Nurs 34(1):4–25

    Article  Google Scholar 

  70. 70.

    Kuhlthau K, Payakachat N, Delahaye J, Hurson J, Pyne JM, Kovacs E, Tilford JM (2014) Quality of life for parents of children with autism spectrum disorders. Res Autism Spectr Disord 8(10):1339–1350

    Article  Google Scholar 

Download references


The authors would like to thank Cécile Michelon for participating in the data analyses and helping in the article submission

Author information



Corresponding author

Correspondence to Christelle Vernhet.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Vernhet, C., Dellapiazza, F., Blanc, N. et al. Coping strategies of parents of children with autism spectrum disorder: a systematic review. Eur Child Adolesc Psychiatry 28, 747–758 (2019).

Download citation


  • Autism
  • Parents
  • Children
  • Coping
  • Systematic review