Relationship satisfaction in couples raising a child with autism spectrum disorder: A systematic review of the literature

https://doi.org/10.1016/j.rasd.2016.07.004Get rights and content

Highlights

  • Couples with a child with ASD often experience poor relationship satisfaction.

  • Risk factors include challenging behaviours, parental stress and poor mental health.

  • Protective factors include positive cognitive appraisal and social support.

  • Future research should investigate changes in relationships over time.

  • A theoretical framework is presented to scaffold future research.

Abstract

Background

Couples raising a child with autism spectrum disorder (ASD) face challenges that may impact on their relationship. The purpose of this review was to compare relationship satisfaction in couples raising children with and without ASD and to identify factors associated with satisfaction in couples with a child with ASD.

Methods

Thirteen databases were searched and studies were systematically screened against predetermined inclusion criteria. Twenty six articles, ranging from good to strong methodological quality, met the criteria for inclusion. Of these, seven were included in a meta-analysis comparing relationship satisfaction in couples raising a child with ASD with couples raising children without disabilities.

Results

The meta-analysis showed that couples raising a child with ASD were found to experience less relationship satisfaction than couples raising a child without a disability (Hedges’s g = 0.41, p < 0.001); however, evidence from the narrative synthesis was mixed when compared with couples raising children with other disabilities. The most consistent evidence implicated challenging child behaviours, parental stress and poor psychological wellbeing as risk factors, and positive cognitive appraisal and social support as protective factors.

Conclusion

Findings demonstrate that couples raising a child with ASD would benefit from support to assist them in maintaining satisfaction in their relationship with their partner. However, further studies are needed to gain a greater understanding of the risk and protective factors and how these co-vary with relationship satisfaction over time. A theoretical framework has been developed to scaffold future research.

Section snippets

Research questions

This review sought to answer two research questions:

  • Do couples raising a child with ASD experience lower relationship satisfaction when compared with couples raising children without ASD?

  • What are the factors associated with relationship satisfaction in couples raising a child with ASD?

Method

The PRISMA Statement was used to guide the methodology and reporting of this systematic review. It is comprised of a 27-item checklist developed for the purpose of improving the quality and consistency of systematic review reporting (Moher, Liberati, Tetzlaff, Altman, & The PRISMA Group, 2009).

Study selection

A total of 26 studies met the eligibility criteria for synthesis, of which 25 were quantitative and one was mixed method design. Of these, seven studies provided adequate data for inclusion in the meta-analysis. If the article was deemed suitable but provided insufficient data, attempts were made to contact the authors for further information. Fig. 1 outlines the study selection process.

Study characteristics

Articles spanned 32 years of research from 1983 to 2015. Fourteen (54%) were published in the preceding 5

Discussion

The overall finding of this systematic review and meta-analytic summary suggests that couples with a child with ASD are at risk of experiencing lower relationship satisfaction when compared with couples who have children without a disability. This finding was true for both mothers and fathers when analysed separately. However, care must be taken when drawing conclusions as the meta-analysis plots showed that seven out of ten studies displayed group differences with 95% confidence intervals

Conflicts of interest

The authors declare that they have no conflicts of interest.

Acknowledgment

No funding was received for this review.

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