Background: Parents of children with Autistic Spectrum Disorder (ASD) are at an increased risk for stress and other mental health problems. While treatment is mainly focused on the child, somehow parents’ stress is exacerbated. Accordingly, the purpose of this study was to identify the sources of stress in the parents of children with ASD. Methods: The 52 parents of children with ASD who participated in the study completed the child domain (CD) and parent domain (PD) subscales of the Parenting Stress Index Fourth Edition (PSI-4). Subsequently, the scores of the PSI-4 subscales were analyzed and compared. Results: The respondents scored the highest for the distractibility/hyperactivity subscale in the child domain and highest for the depression subscale in the parent domain. Conclusion: The results of this study may help to determine suitable treatment for parents of children with ASD. Child and parent characteristics contribute equally to parental stress, distractibility/hyperactivity and depression were most prevalent in the CD and PD respectively.


  1. Baker-Ericzén MJ, Brookman-Frazee L, Stahmer A. Stress levels and adaptability ın parents of toddlers with and without autism spectrum disorders. Res Pract Persons Severe Disabil. 2005;30:194-204.
  2. Hayes SA, Watson SL. The ımpact 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. 2013;43:629-42.
  3. Estes A, Munson J, Dawson G, Koehler E, Zhou XH, Abbott R. Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism. 2009;13:375-87.
  4. Lewis JD, Evans AC, Pruett Jr JR, Botteron KN, McKinstry RC, Zwaigenbaum L, et al. The emergence of network ınefficiencies in ınfants with autism spectrum disorder. Biol Psychiatr. 2017;82:176-85.
  5. van Santen JP, Sproat RW, Hill AP. Quantifying repetitive speech in autism spectrum disorders and language ımpairment. Autism Res. 2013;6:372-83.
  6. Lee JX, Ong SI, Lee VY, Fairuz Nazri AR. Parenting stress among Malaysian parents of children with autism spectrum disorder (ASD). Med Health. 2017;12:42-55.
  7. Nikmat AW, Ahmad M, Oon NL, Razali S. Stress and psychological wellbeing among parents of children with autism spectrum disorder. ASEAN J Psychiatr. 2008;9:65-72.
  8. Kaur J, Engakasa JP, Sivanesom RS, Bahar N. Technical report autism spectrum disorder research in Malaysia. Kuala Lumpur: Institute for Public Health, Family Health Development Division, Ministry of Health, 2015.
  9. Dabrowska A, Pisula E. Parenting stress and coping styles in mothers and fathers of pre‐school children with autism and down syndrome. J Intellect Disabil Res. 2010;54:266-80.
  10. Pisula, E. 2011. Parenting stress in mothers and fathers of children with autism spectrum disorders. In Mohammadi, MR. Ed. A Comprehensive Book on Autism Spectrum Disorders. Croatia: InTech Publishers, 2011, p. 87–106.
  11. Baker BL, Blacher J, Crnic KA, Edelbrock C. Behavior problems and parenting stress in families of three-year-old children with and without developmental delays. Am J Ment Retard. 2002;107:433-44.
  12. Ludlow A, Skelly C, Rohleder P. Challenges faced by parents of children diagnosed with autism spectrum disorder. J Health Psy. 2012;17:702-11.
  13. Weiss JA, Cappadocia MC, MacMullin JA, Viecili M, Lunsky Y. The impact of child problem behaviors of children with ASD on parent mental health: The mediating role of acceptance and empowerment. Autism. 2012;16:261-74.
  14. Estes A, Olson E, Sullivan K, Greenson J, Winter J, Dawson G, et al. Parenting-Related stress and psychological distress in mothers of toddlers with autism spectrum disorders. Brain Dev. 2013;35:133–
  15. Pastor-Cerezuela G, Fernández-Andrés MI, Tárraga-Mínguez R, Navarro-Peña JM. Parental stress and ASD: Relationship with autism symptom severity, IQ, and resilience. Focus Autism Other Dev Disabil. 2016;31:300-11.
  16. Dunn ME, Burbine T, Bowers CA, Tantleff-Dunn S. Moderators of stress in parents of children with autism. Community Mental Health J. 2001;37:39-52.
  17. Blacher J. A dynamic perspective on the impact of a severely handicapped child on the family. Severely handicapped children and their families. New York: Academic Press Orlando; 1984. p.3-50.
  18. Zaidman-Zait A, Mirenda P, Duku E, Vaillancourt T, Smith IM, Szatmari P, et al. Impact of personal and social resources on parenting stress in mothers of children with autism spectrum disorder. Autism. 2017;21:155-66.
  19. Horowitz A, The mediating effects of perceptions and coping strategies between personal resources and emotional well-being: A study of mothers of children with autism [dissertation]. U.S.A.: Rutgers The State University of New Jersey-New Brunswick; 2004.
  20. Abidin RR. Parenting stress index. 4th. ed. Florida: PAR Odessa; 2012.
  21. Cabanillas PP, Sarriá E. A global model of stress in parents of ındividuals with autism spectrum disorders (ASD). Anales de Psicología. 2014;30:180-91.
  22. Van Steijn DJ, Oerlemans AM, Van Aken MA, Buitelaar JK, Rommelse NN. The reciprocal relationship of ASD, ADHD, depressive symptoms and stress in parents of children with ASD and/or ADHD. J Autism Dev Disord. 2014;44:1064-76.
  23. Leitner Y. The co-occurrence of autism and attention deficit hyperactivity disorder in children–what do we know? Front Human Neurosci. 2014;8:268.
  24. Miranda A, Tárraga R, Fernández MI, Colomer C, Pastor G. Parenting stress in families of children with autism spectrum disorder and ADHD. Except Child. 2015;82:81–95.
  25. Miranda A, Mira A, Berenguer C, Rosello B, Baixauli I. Parenting stress in mothers of children with autism without ıntellectual disability. Mediation of behavioral problems and coping strategies. Front Psy. 2019;10:464.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.