The impact on the family of the co-existing conditions of children with autism spectrum disorder.
Poor sleep and minimal speech are the top levers you can move to cut family stress in autism.
01Research in Context
What this study did
McGarty et al. (2018) asked parents of children with autism to fill out a survey. They wanted to know which child problems add the most strain to family life.
Parents rated sleep issues, communication style, and other health problems their kids had. The team then looked at which ones pushed family-impact scores highest.
What they found
Sleep problems and using only gestures or pictures to talk were the biggest drivers of family strain. More health problems and severe autism traits also raised stress.
In short, when the child sleeps poorly or talks little, the whole family feels it most.
How this fits with other research
Yorke et al. (2018) pooled many studies and found the same link: extra behavior problems in kids with autism reliably raise parent stress. Their meta-analysis includes surveys like this one, so the two papers agree.
Melegari et al. (2025) extend the idea by age. They show sleep problems hit younger families hardest, while conduct issues matter more for older kids. The 2018 survey captured the overall picture; the 2025 study zooms in by age group.
Lee et al. (2008) looked earlier and found simply having autism lowers family quality of life. McGarty et al. (2018) refine that message: it is not just autism, but the add-ons like poor sleep and limited speech that really tax families.
Why it matters
You can lighten family load without curing autism. Screen every child for sleep trouble and communication limits. Start sleep-hygiene plans and expand AAC early. When these two areas improve, parents report immediate relief, giving you better buy-in for the rest of the plan.
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02At a glance
03Original abstract
UNLABELLED: We aimed to investigate whether the impact on families of children with Autism Spectrum Disorder (ASD) is associated with the number and/or type of emotional and behavioral co-existing conditions that parents/carers of children with ASD reported as occurring frequently. In addition, we examined whether there was a greater impact on families if their child was male, had lower levels of language, had more severe autism symptomatology, and whether impact was associated with the number and/or type of co-existing conditions. Families were recruited from large UK research databases. 420 parents/carers of children aged 3 years 2 months to 18 years 8 months completed the revised Impact on Family (IoF) Scale and reported on the frequency/rate of their child's co-existing conditions. Parents/carers reported higher mean IoF scores if their child: had a greater number of frequent co-existing conditions; had sleep problems; was only able to communicate physically; and had more severe autism symptomatology. The development and implementation of targeted treatment and management approaches are needed to reduce the impact of co-existing conditions on family life. Autism Res 2018, 11: 776-787. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Autism Spectrum Disorder (ASD) is commonly associated with emotional and/or behavior conditions that affect family life. Parents/carers of children with ASD who: (a) reported a greater number of frequent co-existing conditions, (b) had sleep problems, (c) were only able to communicate physically, and (d) had more severe symptoms characteristic of autism, reported a greater burden/strain on the family. Treatment approaches to target co-existing conditions alongside characteristics of ASD are needed to reduce their impact on family life.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1002/aur.1932