Volume 29, Issue 165, November 2025

Parental Stress Among Caregivers of Children with Autism Spectrum Disorder: Systematic Review

Mohammed Ali Al-Medawi¹, Majed Mohammed Alshehri², Mohammed Saeed Almasodi³

¹Consultant Child and Adolescent Psychiatry, Head of Prince Mohammed Bin Salman Autism Center, Armed Forces Hospital Southern Region, Khamis Mushait, Saudi Arabia
²Psychiatry Resident, Armed Forces Hospital Southern Region, Khamis Mushait, Saudi Arabia
³Psychiatry Resident, Abha Mental Health Hospital, Aseer Region, Saudi Arabia

ABSTRACT

Background: Parents whose children are diagnosed with autism spectrum disorder (ASD) experience disproportionately high stress. We examined magnitude, predictors and interventions for parental stress while emphasising quantifiable determinants and evidence-based strategies for mitigation. Methods: Following PRISMA 2020 standards, twenty eligible studies (2000–2025) were reviewed across PubMed, Scopus and PsycINFO. Effect sizes, odds ratios and correlation coefficients were extracted and critically appraised for quality and heterogeneity. Results: Parents of children with autism spectrum disorder (ASD) exhibited significantly higher stress than parents of typically developing children (Hedges’ g = 1.58, 95% CI [1.16–2.00], p < .001) and moderately higher than those with other disabilities (g = 0.64, 95% CI [0.25–1.03]). Mean Parenting Stress Index scores exceeded clinical cut-offs (M = 91.4 ± 18.2 vs 72.1 ± 14.7, p < .001). Externalizing behaviours in children emerged as the strongest predictors (r = 0.52– 0.68, p < .01), and longitudinal analyses confirmed reciprocal associations (β = 0.12–0.18). Across assessments, mothers consistently reported higher levels of stress than fathers, with a difference of 8.6 PSI points (p < .001). Socioeconomic strain and unmet service needs increased odds of severe stress (OR = 2.8–3.4), whereas adaptive coping (β = −0.31) and social support (r = −0.39) were protective. Mindfulness and parent-training programs achieved moderate stress reduction (SMD = −0.47 to −0.82, I² = 67%), though follow-up rarely exceeded three months. Conclusion: Parental stress in ASD caregiving is profound and multifactorial, primarily behaviour-driven but socially moderated. Routine screening, structured psychosocial support and sustainable intervention frameworks are crucial for long-term caregiver well-being.

Keywords: autism spectrum disorder; parental stress; caregivers; mindfulness; coping; social support.

Medical Science, 2025, 29, e220ms3751

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DOI: https://doi.org/10.54905/disssi.v29i165.e220ms3751

Published: 30 November 2025