Investigating the parenting style of parents of children with autism spectrum disorder: A systematic review article

Corresponding Author:

Ebrahim Pishyareh
Assistant Professor, Division of Cognitive Neuroscience, Department of Occupational Therapy, faculty of rehabilitation sciences, university of rehabilitation sciences and social health, Tehran, Iran
E-mail: [email protected]

Received date: 11-Apr-2025, Manuscript No. NPY-25-164408; Editor assigned: 14-Apr-2025, PreQC No. NPY-25-164408 [PQ]; Reviewed date: 28-Apr-2025, QC No. NPY -25-164408; Revised date: 05-May-2025, Manuscript No. NPY-25-164408 [R]; Published date: 12-May-2025, DOI: 10.37532/1758-2008.2025.15(4).774

Abstract

Objective: The growing body of research on the influence of parental behavior and parenting styles on children with Autism Spectrum Disorder [ASD] and its recognition as an influential factor in shaping the behaviors of such children has motivated this study to determine the predominant parenting style among parents of children with ASD. Method: ProQuest, Scopus, PubMed, and Web of Science databases were independently searched by two researchers using certain keywords, including “Autism Spectrum Disorder, Parenting Styles, Permissive Parenting Style, Authoritarian Parenting Style, Authoritative Parenting Style, Supportive Parenting Style, Child Rearing, and Stereotyped Behaviors,” from 2000 to March 2024. Results: Following the completion of the search process and the removal of duplicate articles, 23 articles meeting the inclusion and exclusion criteria were included in the study. The quality of the articles, assessed using the Critical Appraisal Skills Program [CASP] and the Centre for Evidence-Based Medicine [CEBM] tools, ranged from low to moderate. Based on the conducted reviews, 12 articles addressed authoritative parenting style, 5 articles addressed authoritarian parenting style, 3 articles addressed permissive parenting style, and 3 articles addressed supportive parenting style. Conclusion: Based on the analysis of available data, it can be concluded that the predominant parenting style among parents of children with ASD is the authoritative style. Adopting an authoritative parenting approach may contribute to positive outcomes, even for children with ASD, through practice and sound knowledge of its effectiveness

Keywords

Parenting style, Autism Spectrum Disorder, Authoritative, Autocratic, Permissive, Supportive

Introduction

The increasing prevalence and consequences of autism spectrum disorder (ASD) necessitate ongoing efforts to better understand the biological markers and behavioral symptoms of this disorder so that their findings can be utilized for timely diagnosis toward promoting simultaneous development of rehabilitation team members and raising awareness of the impact of parental behavior on the effectiveness of team interventions.

ASD is a general term for a group of neurodevelopmental disorders with clinical manifestations primarily related to deficits in “socio-communicative skills and impaired social interaction,” “restricted and repetitive behaviors,” as well as “sensory issues” [1]. The prevalence and incidence of this disorder have been increasing in recent years, such that the current prevalence rate is 1 in 54 children [2]. The economic burden associated with caring for children with ASD is substantial, encompassing costs, such as healthcare services, and education, health, and treatment related to autism for families [3].

Raising a child with developmental challenges, such as autism or intellectual disability, is often a more difficult and challenging process compared to raising a typically developing child [4]. Given that no definitive biological markers for ASD have been established and are not used in clinical practice, this issue can make it significantly more challenging for parents to accept their child’s condition. From the viewpoint of diagnosis, parents often struggle to comprehend and accept their child’s disorder and limitations [5]. Stressors associated with caring for a child with ASD become an integral concern of the family’s mind and behaviors, consistently presenting them with challenges in every situation.

Individuals with ASD, even in adulthood, experience numerous difficulties in life skills, quality of life, and adaptive functioning, such that if their difficulties are not ameliorated, they may exhibit impairments in daily living skills and adaptive functioning comparable to those with intellectual disabilities [9]. Additionally, parents of children with ASD consistently experience stress and tension stemming from various sources, including the daunting task of identifying and securing appropriate services and planning for a secure and reliable future, the ambiguity of the diagnosis and a prognosis fraught with uncertainty, lifelong grief, and diminished optimism toward their child’s future [6,7]. These tensions can influence a broad range of parental behaviors. Given their non-expert attitude toward parenting styles, many parents may employ various approaches when interacting with these children, which can be categorized into four general patterns. Parenting styles, generally defined as parental approaches, beliefs, and behaviors that determine the emotional tone of the parentchild relationship, include the authoritative, authoritarian, permissive, and supportive parenting styles [8].

So far, most previous research has focused on environmental variables such as family history of autism spectrum disorders, behavioral problems in children with autism, parental mental health problems, stressful life events, and the “Broader Autism Phenotype” (BAP), while variables such as Parenting style and family functioning have been neglected and neglected despite the knowledge of its impact on children’s behavioral and psychosocial adaptation. According to the review of the published documents, the presence of a very important and important indicator such as subthreshold symptoms of autism spectrum disorder in parents is a subject that has received less attention and research, this may greatly affect their parenting styles. and be related to it. It has been seen that the presence of one parent or sometimes both parents who show subthreshold symptoms [broader autism phenotype, BAP] or above the threshold of autism symptoms [9] that these symptoms may affect the acquisition and use of skills. These cases have been reported about parental personality [10] and psychopathology, such as depression [11] and anxiety disorder [12].

The main question of the review article is, what is the most common parenting style of parents of autistic children? What are the reasons for preferring this parenting style? And what are the effects of this parenting style on the child?

In recent years, attention has been paid to the effect of the behavior and parenting style of parents of children with autism spectrum disorder, so that the parenting style of parents is considered as an effective factor on autistic children, so the purpose of this study is to investigate the parenting style of parents of children with Autism spectrum disorder.

Literature Review

The key words of autism spectrum disorder, parenting style of parents, easy-going, autocratic, authoritative, supportive and raising children were searched in PubMed, Scopus, ProQuest, Web of Science databases. The search process was carried out by two occupational therapy experts separately and the search date is from 2000 to January 2024. The criteria for entering the article were cases in which the parenting style of children with autism spectrum disorder had been worked on, and the criteria for leaving were articles in which autistic children were accompanied by another disorder or interventions were made on the parenting style of parents. In order to review the article, after reviewing the title and summary of the article, the full text of the article has been reviewed, the CASP scale was used to measure the quality of the articles, based on which 11 criteria are used to review the articles, and the level of evidence is evaluated using the CEBM level of evidence scale. scale [Center for evidence-based medicine] was used (Table 1).

Table 1: Center for Evidence-Based Medicine (CEBM) level of evidence scale.

Eligibility Criteria

The criteria for inclusion in the article were cases in which parenting style in autistic children were investigated, cross-sectional research, control group exists, and the study is in English and Persian . The age of children wasn’t important.

Data Extraction

The exclusion criteria were articles in which parent style was carried out, the desired study did not state the results, and the sample was not a study of autistic children. To review the article, after reviewing the title and summary of the article, the full text of the article was reviewed in order to measure the quality of the articles from The CASP scale was used, based on which 11 grade are used to review the articles, CASP and the CEBM level of evidence scale was used to evaluate the evidence levels (Table 1). The three originally described philosophical dimensions of EBM were [a] the best research evidence, [b] clinical experience, and [c] patient values, this has been the fundamental basis of the EBM. These three dimensions help to cover the areas of research, clinical, and patient care and help us lead toward patient-centered care based on the best research and clinical expertise.

Results

After reviewing the articles and according to the inclusion and exclusion criteria, 23 articles were selected, which are shown in Figure 1 of the Process of Reviewing and Selecting Articles (PRISMA). The research process was done by the author and a colleague separately. 265 articles were initially reviewed and 92 articles were included in the study, of which 68 articles were fully available, and finally 23 articles were selected, during which all articles were scored according to the criteria of CASP et al. They got moderate and had average quality. Also, according to CEBM the articles had moderate to weak evidence level. The results of the evaluation of the quality of the articles based on the CASP criteria are reported in Table 2 and Table 3.

Table 2: The results of the evaluation of the quality of the articles based on the CASP criteria.

Table 3: CASP scale.

After reviewing the articles and according to the entry and exit criteria, 23 articles were selected, which are shown in Figure 1 of the process of reviewing and selecting articles. All the articles scored 5-7 based on the CASP criteria and were of average quality. Also, according to CEBM level of evidence scale [Center for evidence-based medicine], the articles had moderate to weak evidence level. The results of evaluating the quality of articles based on the CASP criteria are reported in Table 3.

Discussion

Based on a study by Rahman and Jermadi, which examined parental stress and parenting style in the management of autistic children with behavioral problems, they concluded that the most common type of parenting style in these parents was authoritative. In this study, 79 parents of children aged 4 to 12 with autism spectrum disorder were included in the study. Based on this study, understanding the relationship between parenting style and parental stress in children with autism spectrum disorder can greatly help in the behavioral management of these children [13].

According to a study by Sinha and Dorshe, which compared parenting styles, stress, and parental resilience among parents of children with autism spectrum disorder and parents of children with specific learning disabilities, they found that 86 parents were authoritative, while 10 were permissive and only 2 were authoritarian. The average resilience score in authoritative parenting was significantly higher, followed by permissive and authoritarian parents with the lowest scores. The study sample included parents of 98 children, including 53 mothers and 45 fathers [4].

According to a study by Gutenberg et al. in 2015, 40 preschool children and their mothers were included in the study to find the relationship between self-regulation of fear and anger with parenting style and temperament. In this study, it was found that the most common parenting style of mothers was authoritative. Only in the autism group, authoritative maternal style predicted higher self-regulation and lower co-regulation of anger, and authoritative maternal style predicted higher self-regulation of fear. Maternal temperament did not predict the child’s ER. The findings emphasize the importance of the mother’s flexible parenting style in facilitating ER in children with autism [14].

In 2023, Zhijin Lin et al. examined the relationship between maternal parenting style and behavioral problems in children with autism spectrum disorder. In this study, 70 autistic children were assessed with 98 normal children. The most common parenting style among mothers was supportive. Among children with autism, hostile/coercive parenting styles can increase the risk of children’s externalizing problems, especially in the context of high levels of maternal attention switching problems. Therefore, the present study has important implications for the clinical practice of early family-level interventions for children with autism [15]. Ventola et al. in 2018 compared parenting styles between parents of autistic, anxious, and normal children. 151 autistic, 113 normal children participated in this study. The most common parenting style was permissive. Parents of anxious children had a distinct parenting style compared to parents of autism and TD. Unique relationships between child symptoms and parenting behaviors emerged across the three groups. Understanding the factors that influence parenting across and within clinical groups can guide the development of interventions designed to support the needs of parents, particularly parents of children with autism [16]. Greenlee et al. examined the relationship between marital satisfaction, parenting style, and outcomes in families of children with autism. The most prevalent parenting style in this study was authoritative. The study was conducted over three time points and found that lower levels of marital satisfaction at Time 1 predicted impaired child outcomes at Time 3 through its effect on parenting style at Time 2. Specifically, for both mothers and fathers, lower marital satisfaction predicted child externalizing symptoms through reports of greater authoritarianism. Lower parenting style and marital satisfaction in mothers at Time 1 were associated with higher levels of child internalizing symptoms at Time 3 through increased authoritarian parenting in mothers [17].

Lambridge et al. studied parental behavior with children with autism. In this study, 305 parents of autistic children were evaluated with 325 parents of normal children. The most common parenting style was authoritarian. The results show that there is not much difference in general parental behavior between parents of children with autism and parents of children without autism [18].

In 2009, Shurenfan Gao et al. studied behavioral problems and parenting styles among Taiwanese children and their siblings diagnosed with autism. 151 autistic children, 134 autistic siblings, and 113 normal children aged 3 to 12 years were included in the study. The most common parenting style was authoritative. In addition to children with autism, who have a wide range of behavioral problems and disruptions in parent-child interactions, their siblings may also be at risk for such problems [19].

In a 2007 study comparing the attachment and parenting styles of children with autism with children with intellectual disability, speech impairment, and normal children, Rogers et al. found that children with autism were less secure than other clinical and normal comparison groups. Parents of nonclinical children reported higher levels of authoritative parenting than parents in the autism group and the clinical group as a whole, and received less social support. Parents of children with autism coped well with the challenges of raising a child with autism, while parents of children with autism had a more authoritative parenting style [20].

Ren et al. examined parenting style and awareness in Chinese families of children with autism spectrum disorder. 167 autistic and 167 normal children were included in the study. Compared with parents of children who were developing, parents of children with autism spectrum disorder showed less attentive listening, less active parenting, less support, more permissive control, and more physical control toward their children. In families of children with autism spectrum disorder [but not in families of developing children], fathers showed more supportive and active parenting toward their children than mothers. We also found that parental attentive listening and awareness of children’s emotions were significantly associated with positive and negative parenting styles in families of children with autism spectrum disorder [21].

Sharon Etzelfield-Etzion et al. examined selfregulatory adaptation in preschool children with autism spectrum disorder: the role of temperament and parental disciplinary style. In this study, 40 autistic and 40 normal preschool children were included. Children with autism spectrum disorder showed greater non-compliance and less compliance with parental demands and prohibitions and more temperament problems in several domains. No group differences were observed in parental disciplinary style. Child self-regulatory adaptation was associated with parental supportive disciplinary style and child-focused parenting style was more supportive [22].

Bailey examined attachment styles, parenting styles, and theory of mind: examining their relationships with social deficits in autism spectrum disorder. In this study, 46 autistic children aged 4 to 14 years were selected. The most prevalent parenting style was authoritative. This study suggests that authoritative parenting and ToM skills in particular may be the underlying mechanisms for better social abilities in autism [23].

Alcantara Lucero examined parenting styles and techniques in parents of children with autism spectrum disorder. Based on this study, it was found that parents display three main parenting themes, including corrective parenting, progressive parenting, and warm parenting. Four effective techniques were also found in these parents: autonomy, conscientiousness, improved sociability, and aggression. Therefore, parents of children with autism use a variety of techniques in raising their children. It seems that corrective parenting is the most important practical technique for mothers. Therefore, researchers concluded that this technique greatly helps mothers in raising and shaping the behavior of their children [24].

In an article, Klosser et al. examined parenting style, parental stress, and behavioral outcomes in children with autism spectrum disorder. Based on the results of this study, it was found that autism severity and parenting style played a role in externalizing symptoms, but did not have a significant effect on internalizing symptoms. Parenting stress was the main predictor of the child’s externalizing and internalizing symptoms. Parenting style was not associated with the level of stress of parents of children with autism and did not moderate the relationship between autism severity and internalizing and externalizing symptoms. This study highlights the importance of reducing parental stress and providing parent education to promote positive parenting styles for children with autism. Parenting style was correlated [25].

Yin O et al. conducted an article in 2020 titled Factors Associated with the Severity of Autism Symptoms, Including Parenting Style. In this study, 224 children with ASD were included in the study. Their mothers completed a self-administered questionnaire on demographic characteristics, autism severity, parenting styles, parental feeding styles, parental stress, child sleep habits, and eating behaviors. Children with ASD showed higher levels of autism severity. Multiple linear regression showed that father’s occupational status and child’s perceived weight predicted autism severity. Authoritative parenting style was the most important predictor [26].

In a 2014 paper, Zhou and Yi used a grounded theory method to analyze the parenting styles used by caregivers to raise children with Autism Spectrum Disorders (ASD) and to explore parents’ experiences of how to help their children overcome symptoms. Thirtytwo parents from 28 families of children with ASD in China were interviewed. Based on the results, four patterns of parenting styles were found that differed in relation to caregiver and educator roles. Based on their experience, a significant group of parents found that their emotions affect the child’s emotions and symptoms. The authoritative parenting style was [27].

Shojaei et al. conducted a study titled “Comparison of Parenting Styles of Parents of Children with and without ASD” in 2016 on 99 parents (49 parents without the disorder and 50 parents with ASD). In this article, the Robinson, Mandelko, Elsen, and Hart Parenting Style Questionnaire was used. Based on the results of this study, it was determined that the authoritarian parenting style of parents of children with ASD was significantly higher than that of parents of children without ASD, and the authoritative parenting style of parents of children without ASD was significantly higher than that of parents of children with ASD, but no difference was observed between the permissive parenting style among parents [28].

Mohammadi and Zarafshan studied the effects of parenting style, family functioning, and the BAP broad autism phenotype on the psychological adjustment of siblings of autistic children. The results of the study showed that siblings of autistic children are at higher risk of psychological maladjustment due to genetic influences. In addition, environmental factors such as parenting styles and family functioning also have a significant impact on psychological maladjustment. With permissive parenting styles, behavioral problems increased and social behavior decreased among siblings of autistic children. In addition, both authoritative and authoritarian parenting styles reduced behavioral problems and increased prosocial behaviors [29]. Van Steen et al. studied the effect of subthreshold symptoms in parents of children with autism and hyperactivity to determine whether the diagnosis of the child [autism or hyperactivity] along with the parents’ autism or hyperactivity had an effect on the parenting style of these parents. The results indicated that the father’s ADHD symptoms had a negative impact on parenting styles in families with autism and hyperactivity. Authoritative parenting style was more prevalent in parents of autism [30].

Hodgson et al. conducted a paper titled The Relationship between Parental Stress, Parenting Style, and Executive Functioning in Children with ADHD and Autism. Overall, increased parental stress was associated with greater use of authoritarian and permissive parenting styles, as well as greater difficulties in regulating behavior for children. Authoritative and permissive parenting styles were associated with poorer child executive function. Permissive parenting style was the most prevalent parenting style [31].

Riani et al. conducted a study titled Parenting Style and Child-Parent Relationship in Parents of Autistic Children in Indonesia. Parents of children with ASD reported that they were more authoritative and authoritarian in raising their children than parents of normal children. In addition, parents of children with ASD reported higher levels of assertiveness and fewer positive qualities in their parent-child relationship than parents of normal children. Parents of children with ASD also received less support than the comparison group. This study provides an initial snapshot of parenting, parent-child relationships, and perceptions of social support for parents of children with and without ASD in Indonesia [32].

Odo et al. conducted a paper in Japan titled Maternal Parenting Style in Relation to Parental Stress and Behavioral Outcomes of Autistic Children in 2020. Parenting styles did not differ significantly between groups. Parenting stress predicted externalizing behaviors in children with autism. In addition, authoritarian parenting style predicted externalizing behaviors in children without autism. Parenting stress was also associated with authoritarian and permissive parenting in both groups. These findings indicate the need for interventions and mental health services that reduce parental stress and improve maternal well-being, thereby increasing parent-child interactions [33].

In a study conducted in 2017, Ershad, Hashemi, and Abdollahi compared parenting stress, parenting styles, and social problem solving in mothers of children with autism spectrum disorder, attention deficit/hyperactivity disorder, and normal children. In this study, 75 mothers of autistic, hyperactive, and normal children were selected into three groups. Mothers of autistic children showed more authoritarian parenting styles. The results showed that authoritarian parenting was significantly different in mothers of autistic, hyperactive, and normal children in terms of parenting stress. There was a significant difference between problem solving. Finally, other results of this study showed that authoritarian parenting styles were more common in the two groups of mothers of children with autism spectrum disorder and hyperactive children than in the normal group [34-37].

Conclusion

Based on studies conducted by Rahman and Jermadi, Sinha and Dorche, Gutenberg et al., Zhiozhin Lin et al., Ventola et al., Greenly et al., Lumbriget et al., and Schurfeng Gau et al., the most prevalent parenting style is the authoritative style. This study identified the parenting styles employed by parents of children with ASD. There are three primary types of parenting styles: Authoritative, authoritarian, and permissive. Among the three parenting styles, the authoritative style is the likely preference of most parents of children with ASD. Parents may have rated the authoritative parenting style highly compared to other parenting styles because they may feel they have been more effective in their parenting when using a warmer approach with their child with ASD, and thus reflect this issue. A greater reliance on the authoritative parenting style is associated with increased parental effectiveness. Children whose parents adopt an authoritative parenting style are recognized as having greater social competence compared to those raised with an authoritarian style. Similarly, in a population of children with developmental disabilities, positive parenting approaches, including authoritative parenting style, have been found to be associated with improved child behavioral outcomes on average. Hence, adopting an authoritative parenting approach may contribute to positive outcomes, even for children with ASD, through practice and a sound knowledge of its effectiveness.

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