Skip to main content

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.

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

Fig. 1
Fig. 2

References

  • References marked with an asterisk (*) indicate studies included in the meta-analysis.

  • Abbeduto, L., Seltzer, M. M., Shattuck, P., Krauss, M. W., Orsmond, G., & Murphy, M. M. (2004). Psychological well-being and coping in mothers of youths with autism, down syndrome, or fragile X syndrome. American Journal on Mental Retardation, 109(3), 237–254.

    PubMed  Article  Google Scholar 

  • Abidin, R. R. (1983). Parenting Stress Index-manual. Charlottesville, VA: Pediatric Psychology Press.

    Google Scholar 

  • Abidin, R. R. (1995). Parenting stress index third edition: Professional manual. Lutz, FL: Psychological Assessment Resources, Inc.

    Google Scholar 

  • Bayat, M. (2007). Evidence of resilience in families of children with autism. Journal of Intellectual Disability Research, 51, 702–714.

    PubMed  Article  Google Scholar 

  • Bebko, J. M., Konstantareas, M. M., & Springer, J. (1987). Parent and professional evaluations of family stress associated with characteristics of autism. Journal of Autism and Developmental Disorders, 17, 565–576.

    PubMed  Article  Google Scholar 

  • Benson, P. R., & Karlof, K. L. (2009). Anger, stress proliferation, and depressed mood among parents of children with ASD: A longitudinal replication. Journal of Autism Developmental Disorders, 39, 350–362.

    Article  Google Scholar 

  • Blacher, J., & Baker, B. L. (2007). Positive impact of intellectual disability on families. American Journal on Mental Retardation, 112(5), 330–348.

    PubMed  Article  Google Scholar 

  • *Blacher, J., & McIntyre, L. L. (2006). Syndrome specificity and behavioral disorders in young adults with intellectual disability: Cultural differences in family impact. Journal of Intellectual Disability Research, 50, 184–198.

    PubMed  Article  Google Scholar 

  • Borenstein, M., Hedges, L., & Rothstein, H. (2007). Introduction to meta-analysis. Retrieved from www.meta-analysis.com.

  • *Bouma, R., & Schweitzer, R. (1990). The impact of chronic childhood illness on family stress: A comparison between autism and cystic fibrosis. Journal of Clinical Psychology, 46, 722–730.

    PubMed  Article  Google Scholar 

  • *Brobst, J. B., Clopton, J. R., & Hendrick, S. S. (2009). Parenting children with autism spectrum disorders: The couple’s relationship. Focus on Autism and Other Developmental Disabilities, 24(1), 38–49.

    Article  Google Scholar 

  • Cameron, S. J., Dobson, L. A., & Day, D. M. (1991). Stress in parents of developmentally delayed and non-delayed preschool children. Canada’s Mental Health, 39(1), 13–17.

    Google Scholar 

  • Carpenter, B. N., & Steffen, P. R. (2004). Stress. In L. J. Haas (Ed.), Handbook of primary care psychology (pp. 563–577). New York, NY: Oxford University Press.

    Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155–159.

    PubMed  Article  Google Scholar 

  • Dabrowska, A., & Pisula, E. (2010). Parenting stress and coping styles in mothers and fathers of pre-school children with autism and Down syndrome. Journal of Intellectual Disability Research, 54, 266–280.

    PubMed  Article  Google Scholar 

  • Davis, N. O., & Carter, A. S. (2008). Parenting stress in mothers and fathers of toddlers with autism spectrum disorders: Associations with child characteristics. Journal of Autism Developmental Disorders, 38, 1278–1291.

    Article  Google Scholar 

  • Deater-Deckard, K. (1998). Parenting stress and child adjustment: Some old hypotheses and new questions. Clinical Psychology, Science and Practice, 5, 314–332.

    Article  Google Scholar 

  • Donenberg, G., & Baker, B. L. (1993). The impact of young children with externalizing behaviors on their families. Journal of Abnormal Child Psychology, 21(2), 178–198.

    Article  Google Scholar 

  • Dumas, J. E., Wolf, L. C., Fisman, S. N., & Culligan, A. (1991). Parenting stress, child behavior problems, and dysphoria in parents of children with autism, Down syndrome, behavior disorders, and normal development. Exceptionality, 2(2), 97–110.

    Article  Google Scholar 

  • Dykens, E. M. (2006). Toward a positive psychology of mental retardation. American Journal of Orthopsychiatry, 76, 185–193.

    PubMed  Article  Google Scholar 

  • Dykens, E. M., & Hodapp, R. M. (2001). Research in mental retardation: Toward an etiologic approach. Journal of Child Psychology and Psychiatry, 42(1), 49–71.

    PubMed  Article  Google Scholar 

  • *Eisenhower, A. S., Baker, B. L., & Blacher, J. (2005). Preschool children with intellectual disability: Syndrome specificity, behaviour problems, and maternal well-being. Journal of Intellectual Disability Research, 49, 657–671.

    PubMed  Article  Google Scholar 

  • Ekas, N., & Whitman, T. L. (2010). Autism symptom topography and maternal socioemotional functioning. American Journal on Intellectual and Developmental Disabilities, 115(3), 234–249.

    PubMed  Article  Google Scholar 

  • Esbensen, A. J., & Seltzer, M. M. (2011). Accounting for the “Down syndrome advantage”. American Journal on Intellectual and Developmental Disabilities, 116(1), 3–15.

    PubMed  Article  Google Scholar 

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

    PubMed  Article  Google Scholar 

  • Fedele, D. A., Grant, D. M., Wolfe-Christensen, C., Mullins, L. L., & Ryan, J. L. (2010). An examination of the factor structure of parenting capacity measures in chronic illness populations. Journal of Pediatric Psychology, 35, 1083–1092.

    PubMed  Article  Google Scholar 

  • Field, A. P., & Gillett, R. (2009). How to do a meta-analysis. Retrieved from http://www.statisticshell.com/meta_analysis/How_To_Do_Meta-Analysis.html.

  • Field, A. P., & Gillett, R. (2010). How to do a meta-analysis. British Journal of Mathematical and Statistical Psychology, 63, 665–694.

    PubMed  Article  Google Scholar 

  • Folkman, S., & Lazarus, R. S. (1985). If it changes it must be a process: Study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology, 48(1), 150–170.

    PubMed  Article  Google Scholar 

  • Friedrich, W. N., Greenberg, M. T., & Crnic, K. (1983). A short form of the Questionnaire on Resources and Stress. American Journal of Mental Deficiency, 88, 41–48.

    PubMed  Google Scholar 

  • Gabriels, R. L., Cuccaro, M. L., Hill, D. E., Ivers, B. J., & Goldson, E. (2005). Repetitive behaviors in autism: Relationships with associated clinical features. Research in Developmental Disabilities, 26, 169–181.

    PubMed  Article  Google Scholar 

  • Gerstein, E. D., Crnic, K. A., Blacher, J., & Baker, B. L. (2009). Resilience and the course of daily parenting stress in families of young children with intellectual disabilities. Journal of Intellectual Disability Research, 53, 981–997.

    PubMed  Article  Google Scholar 

  • *Griffith, G. M., Hastings, R. P., Nash, S., & Hill, C. (2010). Using matched groups to explore child behavior problems and maternal well-being in children with Down syndrome and autism. Journal of Autism and Developmental Disorders, 40, 610–619.

    PubMed  Article  Google Scholar 

  • *Guess, P. E. (1996). Parental perceptions of stress and coping: Families of preschoolers with and without disabilities (Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (UMI No. 9823088).

  • Gupta, V. B. (2007). Comparison of parenting stress in different developmental disabilities. Journal of Developmental and Physical Disabilities, 19, 417–425.

    Article  Google Scholar 

  • *Hamlyn-Wright, S., Draghi-Lorenz, R., & Ellis, J. (2007). Locus of control fails to mediate between stress and anxiety and depression in parents of children with a developmental disorder. Autism, 11, 489–501.

    PubMed  Article  Google Scholar 

  • Hastings, R. P., Allen, R., McDermott, K., & Still, D. (2002). Factors related to positive perceptions in mothers of children with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 15, 269–275.

    Article  Google Scholar 

  • Hastings, R. P., Daley, D., Burns, C., & Beck, A. (2006). Maternal distress and expressed emotion: Cross-sectional and longitudinal relationships with behavior problems of children with intellectual disabilities. American Journal on Mental Retardation, 111(1), 48–61.

    PubMed  Article  Google Scholar 

  • Hastings, R. P., Kovshoff, H., Ward, N. J., Espinosa, F. D., Brown, T., & Remington, B. (2005). Systems analysis of stress and positive perceptions in mothers and fathers of pre-school children with autism. Journal of Autism and Developmental Disorders, 35, 635–644.

    PubMed  Article  Google Scholar 

  • Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. Orlando, FL: Academic Press, Inc.

    Google Scholar 

  • Hedges, L. V., & Vevea, J. L. (1998). Fixed- and random-effects models in meta-analysis. Psychological Methods, 3, 486–504.

    Article  Google Scholar 

  • Higgins, J. P. T., & Thompson, S. G. (2002). Quantifying heterogeneity in a meta-analysis. Statistics in Medicine, 21, 1539–1558.

    PubMed  Article  Google Scholar 

  • Hodapp, R. M., Fidler, D. J., & Smith, A. C. (1998). Stress and coping in families of children with Smith-Magenis Syndrome. Journal of Intellectual Disability Research, 42, 331–340.

    PubMed  Article  Google Scholar 

  • *Hoffman, C. D., Sweeney, D. P., Hodge, D., Lopez-Wagner, M. C., & Looney, L. (2009). Parenting stress and closeness: Mothers of typically developing children and mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 24(3), 178–787.

    Article  Google Scholar 

  • Holroyd, J. (1974). The Questionnaire on Resources and Stress: An instrument to measure family response to a handicapped family member. Journal of Community Psychology, 2, 92–94.

    Article  Google Scholar 

  • Holroyd, J. (1987). Questionnaire on Resources and Stress for families with chronically ill or handicapped members. Brandon, VT: Clinical Psychology Publishing Company, Inc.

    Google Scholar 

  • Holroyd, J. (1988). A review of criterion validation research on the Questionnaire on Resources and Stress for families with chronically ill or handicapped members. Journal of Clinical Psychology, 44, 335–354.

    PubMed  Article  Google Scholar 

  • Honey, E., Hastings, R. P., & McConachie, H. (2005). Use of the Questionnaire on Resources and Stress (QRS-F) with parents of young children with autism. Autism, 9, 246–255.

    PubMed  Article  Google Scholar 

  • Huedo-Medina, T., Sanchez-Meca, J., Marin-Martinez, F., & Botella, J. (2006). Assessing heterogeneity in metaanalysis: Q statistic or I2 index? Center for Health, Intervention, and Prevention Documents. Paper 19. Retrieved from http://digitalcommons.uconn.edu/chip_docs/19.

  • Kasari, C., & Sigman, M. (1997). Linking parental perceptions to interactions in young children with autism. Journal of Autism and Developmental Disorders, 27(1), 39–57.

    PubMed  Article  Google Scholar 

  • Kayfitz, A. D., Gragg, M. N., & Orr, R. R. (2010). Positive experiences of mothers and fathers of children with autism. Journal of Applied Research in Intellectual Disabilities, 23, 337–343.

    Article  Google Scholar 

  • Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism, 4(2), 117–132.

    Article  Google Scholar 

  • Koegel, R. L., Schreibman, L., Loos, L. M., Dirlich-Wilhelm, H., Dunalp, G., Robbins, F. R., et al. (1992). Consistent stress profiles in mothers of children with autism. Journal of Autism and Developmental Disorders, 22, 205–216.

    PubMed  Article  Google Scholar 

  • Konstantareas, M. M., Homatidis, S., & Plowright, C. M. S. (1992). Assessing resources and stress in parents of severely dysfunctional children through the Clarke modification of Holroyd’s Questionnaire on Resources and Stress. Journal of Autism and Developmental Disorders, 22, 217–234.

    PubMed  Article  Google Scholar 

  • Lecavalier, L., Leone, S., & Wiltz, J. (2006). The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders. Journal of Intellectual Disability Research, 50, 172–183.

    PubMed  Article  Google Scholar 

  • *Lee, G. K., Lopata, C., Volker, M. A., Thomeer, M. L., Nida, R. E., Toomey, J. A., et al. (2009). Health-related quality of life of parents of children with high-functioning autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 24(4), 227–239.

    Article  Google Scholar 

  • Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., et al. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36, 849–861.

    PubMed  Article  Google Scholar 

  • Loyd, B. H., & Abidin, R. R. (1985). Revision of the parenting stress index. Journal of Pediatric Psychology, 10(2), 169–177.

    PubMed  Article  Google Scholar 

  • *Markham, E. V. (2000). Parenting stress in a clinical sample: Assessment and implications (Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (UMI No. 3000484).

  • Mayes, S. D., Calhoun, S. L., Murray, M. J., Ahuja, M., & Smith, L. A. (2011). Anxiety, depression, and irritability in children with autism relative to other neuropsychiatric disorders and typical development. Research in Autism Spectrum Disorders, 5, 474–485.

    Article  Google Scholar 

  • Minnes, P. (1988). Family stress associated with a developmentally handicapped child. International Review of Research in Mental Retardation, 15, 195–226.

    Article  Google Scholar 

  • Pisula, E. (2003). Parents of children with autism—review of current research. Archives of Psychiatry and Psychotherapy, 5(4), 51–63.

    Google Scholar 

  • Pisula, E. (2007). A comparative study of stress profiles in mothers of children with autism and those of children with Down’s syndrome. Journal of Applied Research in Intellectual Disabilities, 20, 274–278.

    Article  Google Scholar 

  • Quintero, N., & McIntyre, L. L. (2010). Sibling adjustment and maternal well-being: An examination of families with and without an autism spectrum disorder. Focus on Autism and Other Developmental Disabilities, 25(1), 37–46.

    PubMed  Google Scholar 

  • *Rao, P. A., & Beidel, D. C. (2009). The impact of children with high-functioning autism on parental stress, sibling adjustment, and family functioning. Behavior Modification, 33(4), 437–451.

    PubMed  Article  Google Scholar 

  • *Richardson, L. L. (2010). The relationship of repetitive behavior and sensory behavior to parenting stress in mothers of boys with autism and mothers of boys with fragile X syndrome. (Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (UMI No. 3402825).

  • Rosenthal, R. (1991). Meta-analysis: A review. Psychosomatic Medicine, 53, 247–271.

    PubMed  Google Scholar 

  • Rosenthal, R. (1995). Writing meta-analytic reviews. Psychological Bulletin, 118(2), 183–192.

    Article  Google Scholar 

  • Sanders, J. L., & Morgan, S. B. (1997). Family stress and adjustment as perceived by parents of children with autism or Down syndrome: Implications for intervention. Child and Family Behavior Therapy, 19(4), 15–32.

    Article  Google Scholar 

  • Scorgie, K., & Sobsey, D. (2000). Transformational outcomes associated with parenting children who have disabilities. Mental Retardation, 38(3), 195–206.

    PubMed  Article  Google Scholar 

  • Scott, R. L., Thompson, B., & Sexton, D. (1989). Structure of a short form of the Questionnaire on Resources and Stress: A bootstrap factor analysis. Educational and Psychological Measurement, 49, 409–419.

    Article  Google Scholar 

  • Seligman, M., & Darling, R. B. (2007). Ordinary families, special children: A systems approach to childhood disability (3rd ed.). New York, NY: The Guilford Press.

    Google Scholar 

  • Seltzer, M. M., Abbeduto, L., Krauss, M. W., Greenberg, J., & Swe, A. (2004). Comparison groups in autism family research: Down syndrome, fragile X syndrome, and schizophrenia. Journal of Autism and Developmental Disorders, 34(1), 41–48.

    PubMed  Article  Google Scholar 

  • Sexton, D., Burrell, B., Thompson, B., & Sharpton, W. R. (1992). Measuring stress in families of children with disabilities. Early Education and Development, 3(1), 60–66.

    Article  Google Scholar 

  • Sheras, P. R., Abidin, R. R., & Konaold, T. R. (1998). Stress index for parents of adolescents. Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  • Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 921–929.

    PubMed  Article  Google Scholar 

  • Singer, G. H. S. (2006). Meta-analysis of comparative studies of depression in mothers of children with and without developmental disabilities. American Journal on Mental Retardation, 111(3), 155–169.

    PubMed  Article  Google Scholar 

  • Sloman, L., & Konstantareas, M. M. (1990). Why families of children with biological deficits require a systems approach. Family Processes, 29, 417–429.

    Article  Google Scholar 

  • Stainton, T., & Besser, H. (1998). The positive impact of children with an intellectual disability on the family. Journal of Intellectual & Developmental Disability, 23(1), 57–70.

    Article  Google Scholar 

  • Sutton, A. J., & Higgins, J. P. T. (2008). Recent developments in meta-analysis. Statistics in Medicine, 27, 625–650.

    PubMed  Article  Google Scholar 

  • Taunt, H. M., & Hastings, R. P. (2002). Positive impact of children with developmental disabilities on their families: A preliminary study. Education and Training in Mental Retardation and Developmental Disabilities, 37, 410–420.

    Google Scholar 

  • Tomanik, S., Harris, G. E., & Hawkins, J. (2004). The relationship between behaviours exhibited by children with autism and maternal stress. Journal of Intellectual and Developmental Disability, 29(1), 16–26.

    Article  Google Scholar 

  • Totsika, V., Hastings, R. P., Emerson, E., Lancaster, G. A., & Berridge, D. M. (2011). A population-based investigation of behavioural and emotional problems and maternal mental health: Associations with autism spectrum disorder and intellectual disability. Journal of Child Psychology and Psychiatry, 52(1), 91–99.

    PubMed  Article  Google Scholar 

  • *Watson, S. L., Coons, K., & Hayes, S. A. (2012). Autism and Fetal Alcohol Spectrum Disorder Part I: A comparison of parenting stress. (Manuscript submitted for publication).

  • Watson, S. L., Hayes, S. A., & Radford-Paz, E. (2011). ‘Diagnose me please!’: A review of research about the journey and initial impact of parents seeking a diagnosis of developmental disability for their child. International Review of Research in Developmental Disabilities, 41, 31–72.

    Article  Google Scholar 

  • Webster-Stratton, C. (1990). Stress: A potential disruptor of parent perceptions and family interactions. Journal of Clinical Child Psychology, 19, 302–312.

    Article  Google Scholar 

  • *Wolf, L. C., Noh, S., Fisman, S. N., & Speechley, M. (1989). Psychological effects of parenting stress on parents of autistic children. Journal of Autism and Developmental Disorders, 19(1), 157–166.

    PubMed  Article  Google Scholar 

  • Ylvén, R., Björck-Åkesson, E., & Granlund, M. (2006). Literature review of positive functioning with children with a disability. Journal of Policy and Practice in Intellectual Disabilities, 3(4), 253–270.

    Article  Google Scholar 

  • Zaidman-Zait, A., Mirenda, P., Zumbo, B. D., Wellington, S., Dua, V., & Kalynchuk, K. (2010). An item response theory analysis of the parenting stress index-short form with parents of children with autism spectrum disorders. The Journal of Child Psychology and Psychiatry, 51, 1269–1277.

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge funding received from the Social Sciences and Humanities Research Council. This paper was submitted as partial requirement for the first author’s Master’s degree. The first author would also like to thank Dr. Andy Field for his fantastic statistics website and resources.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephanie A. Hayes.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hayes, S.A., Watson, S.L. 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, 629–642 (2013). https://doi.org/10.1007/s10803-012-1604-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-012-1604-y

Keywords

  • Autism spectrum disorder
  • Parenting stress
  • Family
  • Meta-analysis