Background: Autism spectrum disorder (ASD) is a life-long neurodevelopmental condition often requiring substantial support from parents. Research has identified that parents of children with ASD tend to experience increased stress and lower quality of life (QoL) compared to parents of typically developing children. However, little research has investigated child factors related to ASD and the impact of these on parental stress and QoL in New Zealand.

Aim: The present study aims to explore how the severity of child core ASD symptoms, child comorbidities, and problem behaviours might impact upon parent stress and health-related QoL (HR-QoL).

Method: Using a quantitate approach and cross-sectional design, 494 parents of children with ASD were recruited for the study between August and September 2021 by voluntary sampling. Participants completed the Autism Impact Measure (AIM), Strengths and Difficulties Questionnaire (SDQ), a comorbidities checklist, Parental Stress Scale (PSS), and Short Form-36 Questionnaire (SF-36) to assess parent-rated child factors and obtain self- rated measures of stress and QoL.

Results: Pearons’s correlation analyses revealed all child factors and parent mental and physical HR-QoL were significantly associated with parent stress. The mental HR-QoL of parents declined significantly with increasing parental stress. Path analysis demonstrated that child problem behaviours significantly predicted mental HR-QoL directly, and indirectly with partial mediation via stress. Moreover, the only child factor significantly predicting parent physical HR-QoL was a positive direct effect observed from ASD symptom severity. Parental stress was a direct and significant predictor of QoL in both mental and physical health domains for parents of children with ASD.

Conclusion and implications: Findings of the present study add to the body of literature investigating the impact of child factors on parent stress and quality of life for parents caring for a child with ASD in New Zealand. It has been highlighted that child factors can impact both the mental and physical HR-QoL of these parents, with mental HR-QoL most affected. The exploration of environmental and personal factors acting to mediate child variables and parent outcomes could further develop our understanding of how best to support parents and guide development of mental health intervention.