Exploring Parental Motivations for and Consequences of Having a Subsequent Child After an Autism Diagnosis in Türkiye.
Parents who plan a second child as a future caregiver often feel just as strained later.
01Research in Context
What this study did
Hüsna and colleagues asked 91 Turkish parents why they chose to have another child after learning their first child had autism.
The team used a written survey. Parents could pick more than one reason and later rated how the new baby affected daily life and stress.
What they found
Most parents said they wanted a brother or sister to keep the autistic child company. They also hoped the second child would help care for the sibling in the future.
Two-thirds of these families later felt the new baby disrupted the older child’s routines and added to caregiver load. Surprisingly, parents who planned the birth for caregiving reasons scored no lower on burden than other parents.
How this fits with other research
Kovačič et al. (2020) reviewed dozens of interviews with neurotypical siblings. Love and empathy showed up, but so did real distress. Hüsna’s data help explain why: parents expect a built-in helper, yet day-to-day life still feels chaotic.
Duerden et al. (2012) surveyed 486 typically developing siblings and found no jump in emotional problems. That null result may seem to clash with Hüsna’s report of added disruption. The difference is focus: G et al. measured sibling outcome, while Hüsna measured parent perception. Disruption felt by parents does not always translate into clinical problems for the child.
Stephens et al. (2018) also worked in Turkey and saw that parents who view autism as a heavy burden report more child behavior issues. Hüsna extends this thread by showing that even positive motives—wanting a companion—can still end in the same heavy feeling.
Why it matters
When families ask about “giving their autistic child a friend,” share these findings. A second child can enrich family life, but it rarely lightens the care load. Build realistic expectations, teach siblings self-care skills, and schedule one-to-one time with each child to lower stress for everyone.
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02At a glance
03Original abstract
An autism spectrum disorder (ASD) diagnosis in a child may be an important factor influencing parents in choosing whether to have or not to have a subsequent child. In this descriptive observational study, we aimed to investigate parental motivations for and consequences of having a subsequent child after an autism diagnosis. This study was conducted in a university hospital child and adolescent psychiatry department. A total of 91 subjects (male, n = 72) aged 3 to 22 (10.70 ± 4.60 years) diagnosed with ASD having at least one younger sibling were included in the study. Parents were explored for motivations for and consequences of having a subsequent child after autism diagnosis by using detailed interview form developed by the authors for this study. Parents were also asked to fill out Zarit Caregiver Burden Scale. Source of informants were mostly mothers (84.6%, n = 77). Most of the children with diagnosis of ASD were first born (82.4%, n = 75). A significant proportion of parents (79.1%, n = 72) reported that they were aware or suspected of a psychiatric condition in their child with ASD before the subsequent pregnancy. Definitive diagnosis of ASD had already been established or was in the process of being confirmed in 73.6% (n = 67) before the subsequent pregnancy. Of the respondents completed the survey (n = 58/91), 20.7 percent (12/58) reported their subsequent pregnancy as unintended. The most commonly reported motivations in intended pregnancies (n = 46) were: "to make friendship with the affected older sibling" (76.1%, n = 35), "to help care for the sibling with ASD" (54.3%, n = 25) and to have a healthy child (39.1%, n = 18). Among the parents with intended pregnancies, parents with ASD-related motivations (n = 40) were significantly more likely to have a first-born child diagnosed with ASD compared to those with non-ASD-related motivations (n = 18) (95.0% vs. 72.2%, p = 0.014). Parents with ASD-related motivations were more likely to believe their child would require lifelong support (62.5% vs. 33.3%, p = 0.039). Majority of the parents (67%; n = 61) reported perceiving at least some disruption in the overall care of their affected child after having another child. Caregiver burden scores, as measured by the Zarit Caregiver Burden Scale (ZCBS) did not differ significantly between the groups (mean = 38.05 ± 15.14 for ASD-related motivation vs. 42.38 ± 15.56 for non-ASD-related motivation, p = 0.443). Exploring parental motivations, awareness and consequences of having a subsequent child after autism diagnosis may be an important issue in clinical practice. This may have significant implications in decision making of the parents and clinical management of children with ASD and their families.
Journal of autism and developmental disorders, 2025 · doi:10.1080/24750573.2018.1457489