Parental Stress among Family Caregivers of Children with Autism in a Teaching Hospital


  • Nur Ashida Hamidon Centre for Nursing Studies, Faculty of Health Sciences, University Technology Mara Selangor Branch, 42300 Kampus Puncak Alam, Malaysia
  • Nur Ily Shazwany Mohd Anuar Centre for Nursing Studies, Faculty of Health Sciences, University Technology Mara Selangor Branch, 42300 Kampus Puncak Alam, Malaysia ; University of Malaya Medical Center, Lembah Pantai, 59100 Kuala Lumpur, Malaysia
  • Siti Khuzaimah Ahmad Sharoni Centre for Nursing Studies, Faculty of Health Sciences, University Technology Mara Selangor Branch, 42300 Kampus Puncak Alam, Malaysia
  • Nur Azah Mohd Isa Hospital Al-Sultan Abdullah, University Technology Mara, 42300 Bandar Puncak Alam, Selangor, Malaysia



Background: Parenting is a journey that may bring joy, happiness, challenges, and frustration. However, raising children with autism with unpredictable behavior may elevate parental stress among parents and family caregivers. Objective: The study aims to assess parental stress among family caregivers of children with autism in a teaching hospital. Methods: This quantitative cross-sectional study was conducted at Hospital Al-Sultan Abdullah (HASA), University Technology Mara (UiTM), using a convenient sampling technique with a total sample size of 110 parents and family caregivers of children with autism (N = 110). An online questionnaire consisting of the Parental Stress Scale (PSS) and the Childhood Autism Spectrum Test (CAST) was used in this study to assess the level of parental stress and identify the severity of probable autistic behavior. Results: The finding shows that 75.5% of the participants were female and 94.5% were Malay. Most autistic children were male (63.6%), and most children (n = 81, 73.6%) had severe autistic behavior. However, 82.7% of participants reported low parental stress (mean = 34.41±13.06). Caregivers were found to have higher stress levels (t (108) = -2.16, p=0.033). Besides, there was no significant association between the level of parental stress and the severity of autism (r=0.035, p=0.715). Conclusion: Special intervention is needed for the caregiver to improve stress management strategies by involving health care professionals for counseling and assistance to address the effects of stress. A larger sample size is recommended for future research to enhance external validity.


Autism Spectrum Disorder, Autistic Behaviour(s), Caregiver(s), Parent(s), Stress


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Alibekova, R., Chan, C. K., Crape, B., Kadyrzhanuly, K., Gusmanov, A., An, S., ... & Rakhimova, M. (2022). Stress, anxiety and depression in parents of children with autism spectrum disorders in Kazakhstan: prevalence and associated factors. Global Mental Health, 9, 472-482.

Alothman, A. A., Ebrahim, M. T., & Gadelrab, H. F. (2024). Challenges, practices, and impact of COVID-19 among mothers of children with autism spectrum disorder in cities and remote areas in Saudi Arabia. Research in Developmental Disabilities, 148, 104718.

Alvarez, E. (2021). Stress and Coping among Parents or Caregivers Raising a Child with an Autism Spectrum Disorder (ASD). California State University, Fresno. origsite=gscholar&cbl=18750&diss=y. Accessed on 26th April, 2022.

Berry, J. O., & Jones, W. H. (1995). The parental stress scale: Initial psychometric evidence. Journal of Social and Personal Relationships, 12(3), 463- 472.

Coulacoglou, C., & Saklofske, D. H. (2017). Psychometrics and Psychological Assessment: Principles and Applications. Academic Press. Accessed on 28th April, 2022

Fante, C., De Luca Picione, R., Dioni, B., Manari, T., Raffin, C., Capelli, F., ... & Musetti, A. (2024). Parental Quality of Life and Impact of Multidisciplinary Intervention for Children with Autism Spectrum Disorders: A Qualitative Study. Journal of Autism and Developmental Disorders, 1-13.

Fithriyah, I., & Carrasco, M. E. (2021). Caregiver burden and psychosocial factors in mothers with autism spectrum disorder children. Biomol Health Sci J, 4(2), 103.

Hashmi, S. I., Gang, G. C. A., Sombuling, A., Nawi, N. H. M., & Ahmad, P. H. M. (2021). Psychometric Properties and Factor Structure of the Malay Autism Spectrum Quotient: Children’s Version. The Malaysian Journal of Medical Sciences: MJMS, 28(6), 108.

Joshi, A., Kale, S., Chandel, S., & Pal, D. K. (2015). Likert scale: Explored and explained. British Journal of Applied Science & Technology, 7(4), 396-403.

Jx, L., Si, O., Vy, L., & Ar, F. N. (2017). Parenting stress among Malaysian parents of children with Autism Spectrum Disorder (ASD). Journal of Medicine and HealthCare, 12(1), 42-55.

Kishimoto, T., Liu, S., Zhang, L., & Li, S. (2023). How do autistic severity and family functioning influence parental stress in caregivers of children with autism spectrum disorder in China? The important role of parental self-efficacy. Frontiers in Psychology, 14, 956637.

Lindor, E., Sivaratnam, C., May, T., Stefanac, N., Howells, K., & Rinehart, N. (2019). Problem behavior in autism spectrum disorder: considering core symptom severity and accompanying sleep disturbance. Frontiers in Psychiatry, 10, 487.

Ministry of Health Malaysia. (2018). Clinical Practive Guidelines Management of Autism Spectrum Disorder in Children and Adolescents. Malaysian Health Technology Assessment Section (MaHTAS). https://efaidnbmnnnibpcajpcglclefindmkaj/ dren%20and%20Adolescents.pdf

Mohamad, S. P., Yusoff, M. Y., Mohd, Z., Adli, D. S. H., & Golden, K. J. (2019). Mental Health Studies on The Coping Strategies of Muslim Parents of Children with Autism Spectrum Disorder in Malaysia (A Narrative Review). Malaysian Journal of Medicine & Health Sciences, 15. pdf

Padden, C., & James, J. E. (2017). Stress among parents of children with and without autism spectrum disorder: a comparison involving physiological indicators and parent self- reports. Journal of Developmental and Physical Disabilities, 29(4), 567-586.

Prata, J., Lawson, W., & Coelho, R. (2019). Stress factors in parents of children on the autism spectrum: An integrative model approach. International Journal of Clinical Neurosciences and Mental Health, 6(2), 1-9.

Rahman, P. A., & Jermadi, S. H. (2021). Parental Stress and Parenting Styles in Managing Autistic Children With Behaviour Problems. Malaysian Journal of Medicine & HealthSciences, 17(3).

https://efaidnbmnnnibpcajpcglclefindmkaj/ 60913532012_2020_1168.pdf

Rollè, L., Prino, L. E., Sechi, C., Vismara, L., Neri, E., Polizzi, C., ... & Brustia, P. (2017). Parenting stress, mental health, dyadic adjustment: A structural equation model. Frontiers in Psychology, 8, 256995.

Shehu, S. N., Tahir, S., Dahiru, A., & Lawan, A. A. (2021). Examining the differences in autism quotient scores based on ethnicity. Malaysian Journal of Medical Research (MJMR), 5(1), 13-18.

Wang, L. (2022, December). Social Dilemmas Faced by Parents of Children Diagnosed with Autism in China. In 2022 6th International Seminar on Education, Management and Social Sciences (ISEMSS 2022) (pp. 1377-1382). Atlantis Press. 494069-31-2_163

Williams, J., Allison, C., Scott, F., Stott, C., Bolton, P., Baron-Cohen, S., & Brayne, C. (2006). The Childhood Asperger Syndrome Test (CAST) Test–retest reliability. Autism, 10(4), 415- 427.

Williams, J., Scott, F., Stott, C., Allison, C., Bolton, P., Baron-Cohen, S., & Brayne, C. (2005). The CAST (childhood asperger syndrome test) test accuracy. Autism, 9(1), 45-68.

Zelman, J. J., & Ferro, M. A. (2018). The parental stress scale: psychometric properties in families of children with chronic health conditions. Family Relations, 67(2), 240-252.

Zulkipli, A. E., Mansor, M., & Ismail, Z. (2020). Parental Attitude, Social Support, and Parental Stress Among Parents of Children With Autism in Selangor, Malaysia. International Journal of Education, Psychology and Counseling, 5(34), 160–175.



How to Cite

Hamidon, N. A. ., Mohd Anuar, N. I. S. ., Ahmad Sharoni, S. K., & Mohd Isa , N. A. . (2024). Parental Stress among Family Caregivers of Children with Autism in a Teaching Hospital. The Malaysian Journal of Nursing (MJN), 15(4), 139-149.