Burden on Family Caregivers of Children with Autism Spectrum Disorder: A Cross-Sectional Study
DOI:
https://doi.org/10.55489/njcm.161120255276Keywords:
ASD, Carers, AutismAbstract
Background: Children with Autism spectrum disorders need special care and understanding. This study aimed to assess burden and challenges faced by caregivers of children with ASD aged 2-10 years in Bhubaneswar, Odisha.
Materials and methods: A cross-sectional study conducted in Bhubaneswar, Odisha over two and half years. Data were collected from 12 autism therapy centres and schools. Caregiver Strain Questionnaire (CGSQ) with socio-demographic details of caregivers was used for assessment of challenges and experiences of caregivers.
Results: The mean age of mothers was 34.74 ± 3.40 years and the mean age of fathers was 40.02 ± 3.65 years. Highest level of strain as reported by caregivers was on subjective internalized subscale i.e. 3.07 ± 0.39 followed by objective strain subscale with mean score of 2.29 ± 0.46. Education, socio-economic status and family type were significantly associated with CGSQ score (P<0.05). Caregivers of children with autism spectrum disorder have significantly higher strain in low education levels, lower middle socio-economic status and nuclear families.
Conclusion: Caregivers experience a lot of challenges in parenting the child with ASD, so more educational and counselling sessions are needed to decrease their stress and improve the quality of life.
References
Hosozawa M, Sacker A, Mandy W, Midouhas E, Flouri E, Cable N. Determinants of an autism spectrum disorder diagnosis in childhood and adolescence: Evidence from the UK Millennium Cohort Study. Autism. 2020;24(6):1557-1565. DOI: https://doi.org/10.1177/1362361320913671 PMid:32367727 PMCid:PMC7645602
Alpert JS. Autism: a spectrum disorder. Am J Med. 2021;134(6):701-702. DOI: https://doi.org/10.1016/j.amjmed.2020.10.022 PMid:33181106
Van't Hof M, Tisseur C, van Berckelear-Onnes I, van Nieuwenhuyzen A, Daniels AM, Deen M, et al. Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019. Autism. 2021;25(4):862-873. DOI: https://doi.org/10.1177/1362361320971107 PMid:33213190
Srivastava M, Srivastava P, Dubey AK, Srivastava P. A narrative review of autism spectrum disorder in the Indian context. J Indian Assoc Child Adolesc Ment Health. 2024;19(4):336-343. DOI: https://doi.org/10.1177/09731342231223589
Lord C, Elsabbagh M, Baird G, Veenstra-Vanderweele J. Autism spectrum disorder. Lancet. 2018 Aug 11;392(10146):508-520. DOI: https://doi.org/10.1016/S0140-6736(18)31129-2 PMID: 30078460 PMCID: PMC7398158
Raina SK, Chander V, Bhardwaj AK, Kumar D, Sharma S, Kashyap V, et al. Prevalence of Autism Spectrum Disorder among rural, urban, and tribal children (1-10 years of age). J Neurosci Rural Pract. 2017;8(3):368-374. DOI: https://doi.org/10.4103/jnrp.jnrp_329_16 PMid:28694615 PMCid:PMC5488556
Rosen NE, Lord C, Volkmar FR. The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond. J Autism Dev Disord. 2021;51(12):4253-4270. DOI: https://doi.org/10.1007/s10803-021-04904-1 PMid:33624215 PMCid:PMC8531066
Volkmar FR, Reichow B. Autism in DSM-5: progress and challenges. Mol Autism. 2013 May 15;4(1):13. DOI: https://doi.org/10.1186/2040-2392-4-13 PMid:23675688 PMCid:PMC3716827
Bölte S, Girdler S, Marschik PB. The contribution of environmental exposure to the etiology of autism spectrum disorder. Cell Mol Life Sci. 2019 Apr;76(7):1275-1297. DOI: https://doi.org/10.1007/s00018-018-2988-4 PMid:30570672 PMCid:PMC6420889
Ousley O, Cermak T. Autism Spectrum Disorder: Defining Dimensions and Subgroups. Curr Dev Disord Rep. 2014 Mar 1;1(1):20-28. DOI: https://doi.org/10.1007/s40474-013-0003-1 PMid:25072016 PMCid:PMC4111262
Watt N, Wetherby AM, Barber A, Morgan L. Repetitive and stereotyped behaviors in children with autism spectrum disorders in the second year of life. J Autism Dev Disord. 2008;38(8):1518-1533. DOI: https://doi.org/10.1007/s10803-007-0532-8 PMid:18266099 PMCid:PMC2637365
Gangi DN, Hill MM, Maqbool S, Young GS, Ozonoff S. Measuring social-communication difficulties in school-age siblings of children with autism spectrum disorder: Standardized versus naturalistic assessment. Autism Res. 2021;14(9):1913-1922. DOI: https://doi.org/10.1002/aur.2531 PMid:34008921 PMCid:PMC8434950
Dückert S, Gewohn P, König H, Schöttle D, Konnopka A, Rahlff P, et al. Multidimensional burden on family caregivers of adults with autism spectrum disorder: a scoping review. Rev J Autism Dev Disord. 2023. DOI: https://doi.org/10.1007/s40489-023-00414-1
Yıldız M, Demir Y, Kırcalı A, Incedere A. Caregiver Burden in Schizophrenia and Autism Spectrum Disorders: A Comparative Study. Psychiatry Investig. 2021;18(12):1180-1187. DOI: https://doi.org/10.30773/pi.2021.0165 PMid:34872240 PMCid:PMC8721291
Sánchez Amate JJ, Luque de la Rosa A. The Effect of Autism Spectrum Disorder on Family Mental Health: Challenges, Emotional Impact, and Coping Strategies. Brain Sci. 2024;14(11):1116. DOI: https://doi.org/10.3390/brainsci14111116 PMid:39595879 PMCid:PMC11592025
Masi A, DeMayo MM, Glozier N, Guastella AJ. An Overview of Autism Spectrum Disorder, Heterogeneity and Treatment Options. Neurosci Bull. 2017;33(2):183-193. DOI: https://doi.org/10.1007/s12264-017-0100-y PMid:28213805 PMCid:PMC5360849
Talha A, Ram Gopal CN. Caregiver Strain and Coping Strategies Among Caregivers of Children with Autism Spectrum Disorder (ASD). J Indian Acad Appl Psychol. 2024 Apr;50(Special Issue):113-121.
Yang R, Zhou H, Liu J, Wang Y, Zhang Y, Wang Y, Liu R, Cao X, Han D, Yang S, Yang J, Kang C. Psychometric properties of the Caregiver Strain Questionnaire among Chinese parents of children with ADHD or ASD. Gen Psychiatry. 2021;34:e100246. DOI: https://doi.org/10.1136/gpsych-2020-100246 PMid:33782658 PMCid:PMC7944967
Asahar SF, Malek KA, Isa MR. Quality of Life and Child's Autism-Specific Difficulties among Malaysian Main Caregivers: A Cross-Sectional Study. Int J Environ Res Public Health. 2021;18(18):9861. DOI: https://doi.org/10.3390/ijerph18189861 PMid:34574788 PMCid:PMC8469129
Renford NG Robert, Arulappan J, Thomas KDE, Karuppiah KM, Chinnathambi K, Thangaswamy GC. Quality of Life of Caregivers of Children with Autism Spectrum Disorder in Tamil Nadu, South India. Int J Nutr Pharmacol Neurol Dis. 2020 Apr-Jun;10(2):57-64.
Kirby AV, White TJ, Baranek GT. Caregiver Strain and Sensory Features in Children with Autism Spectrum Disorder and other Developmental Disabilities. Am J Intellect Dev Disabil. 2015 Jan;120(1):32-45. DOI: https://doi.org/10.1352/1944-7558-120.1.32 PMid:25551265 PMCid:PMC4562396
Hosseinpour A, Younesi SJ, Azkhosh M, Safi MH, Biglarian A. Exploring Challenges and Needs of Parents Providing Care to Children with Autism Spectrum Disorders: A Qualitative Study. Iran J Psychiatry Behav Sci. 2022 Sep;16(3):e127300. DOI: https://doi.org/10.5812/ijpbs-127300
Cetinbakis G, Bastug G, Ozel-Kizil ET. Factors contributing to higher caregiving burden in Turkish mothers of children with autism spectrum disorders. Int J Dev Disabil. 2018;66(1):46-53. DOI: https://doi.org/10.1080/20473869.2018.1478630 PMid:34141366 PMCid:PMC8115497
Durán-Pacheco G, Silkey M, Johnson M, Liu C, Clinch S, Law K, et al. Effect of children's autism spectrum disorder severity on family strain and sleep quality: a cross-sectional online survey in the U.S. J Autism Dev Disord. 2023;53(5):1795-1808. DOI: https://doi.org/10.1007/s10803-022-05457-7 PMid:35118575 PMCid:PMC10123033
Hand BN, Lane AE, De Boeck P, Basso DM, Nichols-Larsen DS, Darragh AR. Caregiver Burden Varies by Sensory Subtypes and Sensory Dimension Scores of Children with Autism. J Autism Dev Disord. 2018;48(4):1133-1146. DOI: https://doi.org/10.1007/s10803-017-3348-1 PMid:29076036 PMCid:PMC8042612
Purpura G, Tagliabue L, Petri S, Cerroni F, Mazzarini A, Nacinovich R. Caregivers' Burden of School-Aged Children with Neurodevelopmental Disorders: Implications for Family-Centred Care. Brain Sci. 2021;11(7):875. DOI: https://doi.org/10.3390/brainsci11070875 PMid:34208983 PMCid:PMC8301981
Crump C, Sundquist J, Sundquist K. Preterm or Early Term Birth and Risk of Autism. Pediatrics. 2021 Sep;148(3):e2020032300. DOI: https://doi.org/10.1542/peds.2020-032300 PMid:34380775 PMCid:PMC9809198
Yang B, Zaks N, Kajantie E, Persson MSM, Reichenberg A, Gissler M, et al. Risk Factors for Autism Spectrum Disorder in Individuals Born Preterm: A Systematic Review and Meta-Analysis of Population-Based Studies. Biol Psychiatry Glob Open Sci. 2025;5:100535. DOI: https://doi.org/10.1016/j.bpsgos.2025.100535 PMid:40678694 PMCid:PMC12268552
Stuart M, McGrew JH. Caregiver burden after receiving a diagnosis of an autism spectrum disorder. Res Autism Spectr Disord. 2009;3(1):86-97. DOI: https://doi.org/10.1016/j.rasd.2008.04.006
Kavitharam TR. Indian mothers and autism: A psychological examination of caregiving burdens and supports. Int J Food Nutr Sci. 2022 Dec;11(10):6786-6803.
Desai C, Prajapati M. Quality of life of caregivers of children with autism spectrum disorder. Int J Indian Psychol. 2024;12(1):425-428. doi:10.25215/1201.040.
Regy MM, Lakshmi V, Shanbhag DN. The resilience and lived experiences of the parents of children with autism in India: a mixed-method study. Func Disabil J. 2024;7(1):E310.1. DOI: https://doi.org/10.32598/fdj.7.310.1
Bhatia S, Ahsan A. Exploring coping strategies and cultural influences among parents of children with autism spectrum disorder: implications for intervention. Int J Indian Psychol. 2024;12(1):2066-2081.
Lockwood Estrin G, Bhavnani S, Arora R, Gulati S, Divan G. Caregiver perceptions of autism and neurodevelopmental disabilities in New Delhi. Int J Environ Res Public Health. 2023;20(7):5291. DOI: https://doi.org/10.3390/ijerph20075291 PMid:37047907 PMCid:PMC10094583
Bradshaw J, Gillespie S, McCracken C, King BH, McCracken JT, Johnson CR, et al. Predictors of Caregiver Strain for Parents of Children with Autism Spectrum Disorder. J Autism Dev Disord. 2021;51(9):3039-3049. DOI: https://doi.org/10.1007/s10803-020-04625-x PMid:33151499 PMCid:PMC10860166
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Smitabh Barik, Sumitra Pattanaik, Lipilekha Patnaik, Rachita Sarangi

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.

