Factors associated with resilience among parents of children with autism spectrum disorder: A systematic review

Clinical Snapshot

Key Findings

• P Value: Not reported at review level; individual study statistics not summarised in abstract

• Effect Size: Not reported — no meta-analysis conducted; findings are narrative and thematic only

• Primary Outcome: Five thematic domains of factors associated with parental resilience in ASD identified: (1) sociodemographic and economic factors; (2) child-related characteristics; (3) parenting well-being and distress; (4) psychological factors and coping styles; (5) social support and family relationships

• Nnt Or Sensitivity: Not applicable — this is an aetiological/associational systematic review without intervention arm; no NNT, sensitivity, specificity, or hazard ratio calculable from the reported data

• Confidence Interval: Not reported — no pooled quantitative estimates generated

Clinical Application

The identified resilience factors (social support, coping strategies, psychological well-being) are modifiable and amenable to intervention through existing service frameworks including psychology, social work, occupational therapy, and peer support programs. However, the absence of intervention studies within this review means that no specific evidence-based program can be directly recommended on the basis of these findings alone. Implementation would require integration with existing evidence on resilience-building interventions. In Australia, families of children with ASD are supported through the National Disability Insurance Scheme (NDIS), which funds therapeutic supports, early intervention, and carer capacity-building. The five thematic domains identified in this review align with NDIS goals around family well-being and informal support networks. The RACGP's role in coordinating care for ASD families, including mental health care plans (MBS Item 2715) for carers experiencing psychological distress, is directly relevant. TGA-approved pharmacological interventions for ASD-related behaviours (e.g., risperidone, aripiprazole) address child-related factors but do not directly target parental resilience. Culturally and linguistically diverse (CALD) communities in Australia, including families from Southeast Asian backgrounds, may particularly benefit from culturally sensitive resilience interventions as highlighted by this Malaysian-led review. The Raising Children Network and Autism Spectrum Australia (Aspect) provide existing platforms for delivering social support and psychoeducation to ASD families in Australia. Parents (particularly mothers, given predominance in ASD caregiving literature) of children with ASD aged under 18 years, particularly those experiencing high caregiving burden, psychological distress, or limited social support networks. Findings are most directly applicable to clinical and community settings where ASD family support services are delivered.

Abstract

Parents of children with autism spectrum disorder (ASD) experience ongoing caregiving demands and challenges that may contribute to their general well-being. Research has shown that resilience enables parents to adapt to these challenges; however, existing evidence on associated factors toward resilience among these parents remains fragmented. This systematic review aimed to identify factors associated with resilience among parents of children with ASD. We conducted a PRISMA 2020-guided systematic review on studies published between January 2019 and May 2025 using Web of Science, Scopus, and PubMed by applying predefined search terms and Boolean operators. Studies examining factors associated with resilience among parents of children with ASD aged under 18 years were included in this review. We also used the Mixed Methods Appraisal Tool 2018 to assess the quality of these studies. Findings were synthesised narratively using thematic analysis. From the 13 selected studies, five themes were identified as determinants of resilience among parents, i.e., sociodemographic and economic factors; child-related characteristics; parenting well-being and distress; psychological factors and coping styles; and social support and family relationships. Most included studies were cross-sectional and utilised different measurement tools, which may limit causal inference and comparability. As a conclusion, parental resilience was found to be influenced by psychological, social, and contextual factors. Strengthening coping resources and social support may enhance parental adaptation and family well-being. Along these lines, multi-level and culturally sensitive interventions are thus needed to inform strategies to foster resilience among parents of children with ASD. The review was registered with PROSPERO (CRD420251034348). The author(s) received no specific funding for this work.

References

1. 1.Md Salim, N. S., Idris, I. B., Nor, N. K., Roslan, S., Abdul Rashid, N., Ibrahim, R., & Abd Rahman, F. N. (2026). Factors associated with resilience among parents of children with autism spectrum disorder: A systematic review. PLOS ONE. https://doi.org/10.1371/journal.pone.0351969