Table 4.

Themes, subthemes, and categories.

Themes	Sub themes	Categories
Initial reaction to child’s ASD symptoms and diagnosis	Help seeking behavior	Proactive action Began the treatment prior to diagnosis. Delayed for further investigation and treatment
	Adjusting parents’ cognition, daily routines and life plans	Initial dismissal/Grief Redefine future dreams and hope Constant worries and anxious over future Positive self-thought and belief Busy daily living Redefine life priorities
	Stress due to the inadequate “system”	Limited awareness about autism Financial burden Difficulties in finding appropriate school, childcare, therapies and healthcare Shortage of qualified healthcare practitioners, teachers and caregivers Government policy and support on ASD Limited access due to logistic areas
Family life affected by a child with ASD	Parents’ emotional turmoil	Dealing with the symptomatic ASD condition Isolation due to child’s challenging behaviors Strain on family Job and career adjustments
	Impact on significant others	Siblings rivalry Burden on siblings and other family members
	Increase sense of connectedness	Family closeness Mutual relationship and understanding with others
Awareness of ASD in Malaysia	Lack of knowledge	Ignorance Inadequate understanding about ASD
	Judgemental environment	Bad parenting style and practices Stigma from others
	Pervasive cultural beliefs	Previous generations or parental sins Inadequate explanation and belief about the causes of ASD
Coping strategies, wellbeing and becoming resilient	From zero to hero	One little step at a time The power of knowledge Increase sense of competence
	Growing stronger together	Recognizing the joys Celebrating the little triumphs
	Stronger spiritual faith	Believe chosen by God Pure and innocent gift from God
	Social support	Immediate vs. extended family members Formal and informal support groups    • Professionals, therapists and government    • Community