Service Delivery

Exploring the health of families with a child with autism.

Smith et al. (2021) · Autism : the international journal of research and practice 2021
★ The Verdict

Autism services must target whole-family health—schedule flexibility, support networks, and financial help matter as much as child-focused therapy.

✓ Read this if BCBAs running clinic, home, or school programs with kids under 18
✗ Skip if Clinicians who only serve autistic adults without family contact

01Research in Context

01

What this study did

Hamama et al. (2021) talked to the families who have a child with autism. They asked moms, dads, and sometimes grandparents to describe what "being healthy" feels like for the whole family.

The team held long, open chats. They recorded the talks and looked for common words and stories.

02

What they found

Families said health is a moving target. Good days happen when everyone eats together, sleep is steady, and money stress is low.

Support from friends, flexible work hours, and quick access to therapy mattered just as much as the therapy itself.

03

How this fits with other research

McKenzie et al. (2015) and Klein et al. (2024) show Black families often face provider bias and long waits. Hamama et al. (2021) widen the lens, saying every family—no matter race—needs schedule help and cash aid to stay healthy.

Mammarella et al. (2022) found dads feel stress differently than moms. Hamama et al. (2021) agree: services must ask both parents what they need, not just mom.

Ledbetter-Cho et al. (2023) argue family-centered care can clash with strict treatment rules. Hamama et al. (2021) give real quotes showing why bending the rules for family life boosts overall health.

04

Why it matters

If you only track the child's goals, you miss the bigger picture. Ask about dinner time, dad's work shift, or grandma's ride to therapy. When these pieces wobble, therapy gains slip. Build small flexes into plans: swap a 9 a.m. slot for 6 p.m., split parent training into two shorter calls, or add a 15-minute buffer for traffic. Healthy families do the work—help them show up.

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Add one question about the family's weekly schedule stress at the start of your next session.

02At a glance

Intervention
not applicable
Design
qualitative
Sample size
48
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Families are important for the overall growth and development of a child. The health of a family is foundational to the everyday life in which a child and family can blossom. Families with a child with autism have a family life that has challenges for many reasons including that parents can be stressed from trying to figure out how to be a good parent for their child with autism. We wanted to know two things: (1) what is family health for families of a child with autism and (2) what affects families trying to be their healthiest. We wanted to know the answers to these questions from families themselves, including parents (not just moms), children, and children with autism, because they are the best experts. We talked to 16 families including 16 mothers, 8 fathers, and 32 children (18 with autism). Families shared that being a healthy family was a journey with ups and downs and that families were not always perfect. It helped when families knew about themselves as a family such as knowing what they liked and did not like to do, and knowing what the different people in the family needed. Families said that what helped and influenced their family's health was being together, keeping their days not too busy, stress, autism itself, having helpers like friends, grandparents, therapists, and having money to pay for services. We hope that knowing these answers will guide service providers of people with autism to think about healthy families from a holistic perspective.

Autism : the international journal of research and practice, 2021 · doi:10.1177/1362361320986354