The relationship between parental stress and treatment adherence in parents of children with neurodevelopmental disorders: A cross-sectional study.
Parent stress and stigma drag down treatment adherence, but family resilience can push it back up.
01Research in Context
What this study did
Liao et al. (2025) asked 310 parents of children with neurodevelopmental disorders to fill out three short surveys.
One survey measured how stressed and stigmatized they felt.
Another asked how resilient their family felt.
The last one asked how well they followed through with therapy tasks at home.
What they found
Parents who scored high on stress and stigma were less likely to stick with treatment.
Parents who said their family was resilient were more likely to stick with treatment.
Stress hurt adherence, but resilience helped it.
How this fits with other research
Carr et al. (2016) saw the same stress-adherence link in an autism coaching study.
Panpan et al. (2025) and Zhao et al. (2021) also show that stigma raises stress, yet social support lowers it.
Fallahchai et al. (2022) adds that teaching couples to share stress and lean on friends protects their relationship.
Together these papers say: stress is a shared enemy, but support and resilience are shared shields.
Why it matters
You can’t erase every stressor, but you can build buffers.
Start sessions by asking one resilience question: “Who in your family helps you keep going?”
Add a social-support hand-off: a list of local parent groups or respite nights.
Two minutes of referral can save months of dropout.
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02At a glance
03Original abstract
BACKGROUND: Children with neurodevelopmental disorders (NDDs) require long-term medical care from clinicians and high-level daily support from their parents throughout the lifespan. Parents, as the primary caregivers, serve as major providers of daily care and important supporters of medical services. OBJECTIVE: This cross-sectional study aimed to investigate the relationship between parental stress and treatment adherence, while also examining the roles of family resilience and affiliate stigma in this dynamic among parents of children with NDDs. METHOD: Utilizing a convenience sampling approach, we recruited parents of children with NDDs to participate in an online survey. The survey included validated measures assessing parental stress, treatment compliance, family resilience, and affiliate stigma. Descriptive statistics were computed to summarize demographic characteristics and key study variables. Pearson correlation analyses were conducted to examine the bivariate relationships among the key study variables. Multiple linear regression analyses were conducted to identify predictive factors of treatment compliance. Mediation analysis was performed using the PROCESS macro for SPSS to explore the effect of affiliate stigma and family resilience on the relationship between parental stress and treatment compliance. RESULT: A total of 310 parents of children with NDDs participated in the online survey. Pearson correlation analysis revealed that treatment compliance was negatively correlated with parental stress (r = -0.385, p < 0.001) and affiliate stigma (r = -0.787, p < 0.001), while treatment compliance was positively correlated with family resilience (r = 0.856, p < 0.001). Multiple linear regression analysis indicated that parental stress (β = - 0.091, p < 0.001) and affiliate stigma (β = - 0.410, p < 0.001) were significant negative predictors of treatment compliance, while family resilience (β = 0.576, p < 0.001) was a significant positive predictor of treatment compliance. Moderated mediation analysis revealed that affiliate stigma mediated while family resilience moderated the relationship between parental stress and treatment compliance (all p < 0.001). CONCLUSION: This study underscores the complex interplay between parental stress, affiliate stigma, family resilience, and treatment adherence among parents of children with NDDs. The findings advocate for both clinical efforts and academic initiatives focused on developing targeted support programs and intervention strategies. These measures aim to alleviate parental stress, reduce affiliate stigma, and enhance family resilience, ultimately promoting treatment adherence and optimizing developmental outcomes for children.
Research in developmental disabilities, 2025 · doi:10.1016/j.ridd.2025.104941