Capability well-being in mothers and fathers of autistic children: a cross-sectional study from China

Abstract

Background: Parents of autistic children often experience reduced well-being, with most studies focusing on negative outcomes. However, fewer studies have applied capability approach to assess parental abilities to achieve positive functioning. This study aims to evaluate well-being in parents of autistic children, with a particular attention to differences between mothers and fathers. Methods: We conducted a cross-sectional study of 366 parents of children aged 1–17 years with a definitive diagnosis in China, including 318 mothers and 48 fathers. Parental well-being was assessed using the Investigating Choice Experiments Capability Measures for Adults (ICECAP-A), which captures key domains of well-being. We employed the United Kingdom tariffs to calculate index scores of the ICECAP-A. Stepwise multivariate linear regression models were performed to identify predictors of parental well-being. Results: The mean score of the ICECAP-A among parents was 0.672 (SD 0.214), with a significant gender disparity (p = 0.012, rank-biserial correction = 0.131, 95%CI [0.030, 0.227]). Mothers perceived a lower level of well-being than fathers in the domains of autonomy (β=-0.022, p < 0.01) and achievement (β=-0.021, p < 0.001). Risk factors for impaired parental well-being included more severe autistic symptoms, lower socioeconomic status of parents, and a considerably longer time spent on caretaking of the child. Conclusions: Professionals should prioritize gender-specific intervention programs tailored to the distinct needs of mothers and fathers, and actively promote and facilitate father involvement in the childcare. Evidence-based psychosocial support services need to be specifically designed for high-risk parent populations, especially those facing intensive caregiving burdens, socioeconomic disadvantages, or parenting autistic children with more severe symptoms.