Autistic Mothers of Autistic Children: A Preliminary Study in an Under-Researched Area

Abstract

Background:

Much research exists on the mental health and well-being of parents of autistic children; however, parents who are themselves autistic have received little attention in the literature. We aimed to compare parenting stress and family outcomes in mothers who do, and do not, identify as being autistic.

Methods:

We matched 20 mothers who identified as being autistic to 20 mothers who do not identify as being autistic on variables associated with parental well-being: child externalizing behaviors, score on the Social Communication Questionnaire, child adaptive functioning, family income, and child and maternal age. All mothers had at least one autistic child. Outcome variables were family outcomes (Family Outcome Survey-Revised) and parenting stress (Parent Stress Index 4-Short Form). Paired t-tests were used to compare scores between the two samples.

Results:

There were no statistical differences in achievement of family outcomes between the autistic and nonautistic mothers. The small effect size on Family Outcome 4 may suggest that autistic mothers develop stronger support networks, but as a statistical comparison for this item nonsignificant, this should be interpreted with caution. Autistic and nonautistic mothers reported equally high levels of parenting stress.

Conclusions:

Further research with larger samples is required to explore this under-researched area. Such research would be of value to understand any interaction between parental and child autism characteristics, well-being, and parenting. This could then inform development of supports, which can be tailored for each child's family.

Lay summary

Why was this research done?

Despite decades of research exploring the well-being and mental health of parents of autistic children, the experience of autistic adults with autistic children has not been researched in detail. In fact, we could find less than five research studies on the topic.

What was the purpose of the study?

We wanted to do some preliminary work in the area and look at whether parent well-being or family outcomes are similar or different between autistic and nonautistic mothers of autistic children.

What did the researchers do?

We are part of a team of researchers working on a larger study on a different topic. As part of this study, we asked parents about their own experiences and well-being, which included questions on whether or not the parents identify as autistic. This meant that within this larger study, there were the data to look at parent and family outcomes and see if they differ depending on whether or not the mothers themselves identified as being autistic.

To do this, we went to the large data set and first identified the mothers who identified as being autistic; this was 20 mothers. Then, one of the researchers (M.S.) carefully matched the 20 autistic mothers to 20 mothers who did not identify as autistic (nonautistic mothers) on a number of areas that previous research has linked with parent and family well-being and outcomes. Trying to make the two groups as similar as possible in the areas shown to impact parent and family outcomes means that we can be more confident that any differences between the two groups are due to the one thing that is purposeful: whether or not the mothers were autistic.

What were the results of the study?

We found that in general, parent well-being and family outcomes did not differ between the two groups.

What were the potential weaknesses of the study?

The small sample size and the lack of detailed knowledge around parental relationship status and ethnicity mean that it is not possible to assume that these results represent the wider population. We also cannot be sure that mothers who identified as nonautistic were definitely not autistic (i.e., they may have been autistic but as yet undiagnosed).

How will these findings help autistic adults now or in the future?

We hope that this study will be a platform to inspire future research in this area, using different research methods (interviews, questionnaires) to learn from the lived experience of autistic mothers. This can provide a way for nonautistic parents, researchers, and professionals to learn from the experience and skills of autistic mothers and potentially inform future practice.

Introduction

Despite autism being a lifelong condition, only 2% of research funding is allocated to life span research.¹ As recently as 1988, researchers questioned whether autistic adults could “…marry, have satisfactory sexual relations, have children, [and] hold regular jobs.”² (p139) With the realization that autistic children grow into autistic adults, an increasing number of adults are being diagnosed as autistic and having children of their own. However, little is known about the experiences of autistic parents. As autistic individuals are more likely to have autistic children,³ careful methodology is required to explore both positive and challenging experiences that parenting can bring and identify the relative contribution, if any, of parent, child, environmental, and systematic factors (and their interaction) to these experiences.⁴ This research aims to compare family outcomes and parenting stress in mothers of autistic children who themselves do and do not identify as being autistic.

Little research directly explores the parenting experiences of autistic parents. In a recent newspaper article that included interviews with autistic parents, Deweerdt⁵ summarized that being an autistic parent can provide helpful parenting skills, particularly when their child is also autistic, but that it can also be challenging at times, for example, when dealing with one's own sensory sensitivities or when one needs or wants to help their child understand a complex social situation. Lau and Peterson⁶ explored parental satisfaction in 22 autistic adults, whose children were also autistic. They found that being autistic or having a spouse who is autistic did not significantly decrease the satisfaction derived from parenting roles. However, parents of autistic children reported lower parental satisfaction than parents of nonautistic children. Lau et al.⁷ compared the self-reported parental efficacy among three groups: group 1: 109 parents and their children who were both autistic, group 2: 128 nonautistic parents of autistic children, and group 2: 109 nonautistic parents of nonautistic children. Autistic mothers reported comparable reported levels of parenting efficacy to nonautistic mothers in both groups. However, autistic fathers of autistic children (group 1) reported significantly lower parental efficacy than nonautistic fathers in groups 2 or 3. This suggests that the experience of parenting for autistic parents may differ, and that other factors, including whether or not the child is autistic, may interact with that experience.

Pohl et al.⁸ explored the experiences of 355 autistic mothers and 132 nonautistic mothers, all of whom had at least one autistic child. Autistic mothers were more likely than nonautistic mothers to report pre- or postnatal depression, difficulties in parenting (e.g., multitasking, coping with domestic responsibilities, creating social opportunities for their child), and feeling misunderstood by professionals. They were also more likely to find motherhood an isolating experience, to worry about others judging their parenting, or to feel unable to turn to others for parenting support. The authors conclude that motherhood in autistic women is a neglected area of research and more work is needed to further understand any unique challenges that autistic mothers may face.

Dissanayake et al.⁴ noted that higher autism traits within parents of autistic children were correlated with lower parenting satisfaction and higher reported parenting difficulties (accounting for 11% of variance) such as understanding their child's needs, regulating emotions related to their child, and dealing with sensory stimuli. However, parental autism traits did not contribute to parental psychological well-being. Such broad and mixed results around both strengths and challenges for autistic parents highlight a clear need for more work in this area to begin to understand the potential relationship (if any) between parent diagnosis, child diagnosis, and parental mental health and well-being.

In addition to exploring the relationship between child and parent characteristics and parenting well-being, research has begun to focus on the outcomes of families of individuals with additional needs. Bailey et al.⁹ define family outcomes as, “benefits experienced by families as a result of services received” (p228)—specifically, understanding the needs and abilities of their children, awareness of their rights, helping their children learn and develop, having support systems, and accessing the community,¹⁰ and several recent studies have reported on family outcomes for families of autistic children.^11,12 This is particularly important in mothers on the spectrum given that Pohl et al.⁸ reported that mothers on the spectrum had significantly more difficulty than nonautistic mothers in feeling able to communicate effectively with professionals about their child, and were more likely to feel misunderstood by professionals and to feel unable to turn to others for support in parenting. Given the mixed findings for well-being outcomes in autistic mothers of autistic children, it is critical that any approach to exploring differences in the achievement of family outcomes between autistic and nonautistic mothers is able to consider the benefits of being an autistic mother of an autistic child alongside any additional challenges that this may bring.

Summary and Research Questions

Autistic children grow up to be autistic adults, who may themselves become parents. The very limited research literature to date exploring the experience of autistic mothers of autistic children suggests that being an autistic parent of an autistic child may bring many benefits but maybe also some challenges that require further research. In this study, we aimed to explore family outcomes and parenting stress in autistic and nonautistic mothers of autistic children by asking the following research questions:

• 1.Are there differences in family outcomes in families of autistic children where the mother does and does not identify as being autistic?
• 2.Are there differences in levels of parenting stress between mothers of autistic children who do and do not identify as being autistic?

Given the limited literature in the area, we did not make any directional hypotheses.

Methods

Procedure and design

We utilized data from the Longitudinal study of Australian Students with Autism (LASA); an initiative of the Co-operative Research Centre for Living with Autism established and supported under the Australian Government's Cooperative Research Centres Program. The LASA is a cross-sequential, prospective longitudinal quantitative study, in which data regarding educational and participation outcomes were collected annually over 6 years (for detail, see published protocol¹³). Ethical approval was given for the LASA by the HREC at the lead university (Griffith University HREC Clearance Number EDN/76/14/HREC). Additional ethical approval was given from all the recruiting sites and universities (see list in published protocol¹³). Upon enrollment, we asked caregivers to provide documentation of their child's DSM-IV or DSM-V^14,15 autism diagnosis and then complete the Social Communication Questionnaire-Lifetime (SCQ).¹⁶

Participants and matching procedure

The data analyzed in the current study were those collected at the time of enrollment for a larger longitudinal study. At enrollment, parents were asked to respond yes or no to a question asking whether they themselves have a formal diagnosis of autism. Twenty mothers stated that they identified as being autistic. Author MS then matched these mothers to a sample of mothers from the remaining 200 complete data sets who did not identify as being autistic at the time of the questionnaire (hereafter referred to as nonautistic). For demographics of the sample, see Table 1.

Table 1.

Demographic Information for Mothers and Children (N = 40)

	Mothers identifying as autistic (n = 20)		Mothers not identifying as autistic (n = 20)		Group comparisons
Demographic area	n	%	n	%		p
Maternal age range					U = 160	0.21
21–30 years	0	0	1	5
31–40 years	14	70	10	50
41–50 years	6	30	9	45
Maternal highest education level					U = 190	0.28
Secondary school	5	25	6	30
Tertiary education	15	75	14	70
				Maternal co-occurring diagnoses
Speech or language disordera	2	10	0	0	—b	0.49
Learning disabilitya	1	5	0	0	—b	1.0
Mental health disorder	10	50	3	15	χ2 = 6.92	0.01
Intellectual disabilitya	0	0	0	0	—	—
Family income					U = 151.5	0.22
AUD$0–$37,000	2	10	1	5
AUD$37,001–$80,000	5	25	3	15
AUD$80,001–$180,000	12	60	12	60
AUD$180,001 and over	1	5	2	10
Do not wish to answer	0	0	2	10
Child gender					2.50b	0.114
Male	14	70	18	90
Female	6	30	2	10
Matching variables	M	SD	M	SD	t	p
Child DBC-P Disruptive Behaviorc	22.90	12.53	22.95	12.64	0.013	0.990
Child SCQ scorea	21.45	6.25	21.40	5.43	−0.027	0.979
Child VABS-II Receptive Communicationb	9.40	3.98	10.15	3.44	0.638	0.527

^a Not all participants provided an answer for this question.

^b Fisher exact used as expected cell count below 5.

^c Percentages for maternal co-occurring conditions were based on total number in each group (n = 20).

DBC-P, Developmental Behaviour Checklist-Parent/carer Form; SCQ, Social Communication Questionnaire-Lifetime; VABS-II, Vineland Adaptive Behavior Scale, 2nd edition.

As seen in Table 1, both groups of mothers were generally well educated, with 72.5% of the total sample having a tertiary education. The 2016 Australian census data (the year that these data were collected) reported the median annual household income as AUD$74,776, meaning that 65% of autistic mothers and 80% of nonautistic mothers were living in households with income above the national median. More than three times as many autistic mothers (50%) had received a diagnosis of a mental health disorder in their lifetime than nonautistic mothers (15%), a statistically significant difference. Most mothers in the autistic (70%) and nonautistic (90%) were enrolled into the LASA study for their male child. Although not statistically significant, 30% of autistic mothers had enrolled into the LASA study for their autistic daughters compared with only 10% of the nonautistic mothers.

To explore the family outcomes and parenting stress levels between the two groups, author MS employed a matching procedure as per Ambrose et al.¹⁷ This matching controlled for factors previously shown to be associated with family outcomes or parent well-being within the autism and intellectual disability literature and therefore reduced the possibility of any group differences being due to those factors. It is important to note that while these factors have been shown to be associated with parenting stress, this does not imply that they are the direct cause of increased levels of parental stress. MS first matched the participants on factors that have shown the strongest associations with parental stress; behavioral challenges^18–20 and adaptive behavior skills.^21,24 Levels of parental stress have also been shown to be higher in younger parents²² and in parents living in households with a lower income,²³ and so, MS then matched the participants on maternal age and family income. Following matching, no significant differences were found between autistic and nonautistic mothers in terms of matching variables, indicating these groups may be comparable (Table 1).

Measures

Matching variables

The Disruptive/Antisocial Behaviour scale of the Developmental Behaviour Checklist-Parent/carer Form (DBC-P)¹⁰ was used to match for behavioral challenges. Items are summed for a total score that shows excellent internal consistency, α = 0.94.²⁵

The SCQ¹⁶ was first used to verify children's autism diagnosis and then used as a matching variable between the two groups. The total score shows good internal consistency, α = 0.81.²⁶

The V-scale score (i.e., standardized score) of the Receptive Communication subdomain of the Vineland Adaptive Behavior Scale, 2nd edition (VABS-II),²⁷ was used to match groups on communication skills, as per Giovagnoli et al.¹⁹ This measure shows good psychometrics, including acceptable internal consistency α = 0.84–.93.²⁷

Outcome variables

Family outcomes

The Family Outcome Survey-Revised (FOS-R),¹⁰ Section A, has five subscales: (1) understanding their child's strengths, abilities, and needs; (2) knowing their rights and advocating for available services; (3) helping their child learn and develop; (4) having support systems; and (5) accessing the community. Items are rated on a 5-point Likert scale. For the current sample, all five subscales showed good internal consistency, α = 0.87 (Outcome 1), 0.91 (Outcome 2), 0.93 (Outcome 3), 0.88 (Outcome 4), and 0.79 (Outcome 5).

Parenting stress

The Parent Stress Index 4-Short Form (PSI-SF).²⁸ The Parent Distress (PD) subscale, Parent-Child Dysfunctional Interaction (PCDI) subscale, and total stress score were calculated. For the current sample, the PSI-SF had good internal consistency, α = 0.87 (PD), α = 0.85 (PCDI), and α = 0.93 (total stress).

Data screening and analysis

Data from one participant were missing for one FOS-R item (<5% missing data); the recommended²⁹ method of mean value substitution was used to calculate the overall mean for Outcome 2. Exploration of skew and kurtosis suggested a distribution within the normal range. Given the high degree of matching between the samples (Table 1), the two samples were not considered independent of each other, and so, paired samples t-tests were used to compare scores on each subscale.

Effect sizes are calculated and presented so as to quantify the size of any difference between the two groups without being confounded by sample size. Within a study with a limited sample size such as this, there is an elevated probability that the p-value may be “not significant” due to the sample size and low power of the study rather than there being no difference between the two groups. Therefore, by reporting on and interpreting the results based on effect size, it is possible to quantify the magnitude of any difference between the groups and therefore reducing the risk if a type II error (i.e., a false negative). For effect size, Cohen's d was considered to be small (0.2–0.49), medium (0.5–0.79), or large (>0.8).³⁰ Anything below 0.2 is considered to reflect a “trivial” difference between groups.³⁰ A small effect size suggests that there is a real effect (i.e., something differs between the two groups) but one that can only be identified through careful study and one that will only be identified as “statistically significant” with large sample sizes.³⁰ However, a small effect size may mean that the difference may not be clinically noticeable in the real world at an individual level (i.e., it may only be noticeable at a group level with greater intragroup than intergroup differences).

Results

Family outcomes

As shown in Table 2, there were no significant differences between groups on Outcome 1 (understanding child's strengths, abilities, and needs), Outcome 2 (knowing rights and advocating for services), Outcome 3 (helping child learn and develop), and Outcome 5 (accessing the community). For these outcomes, the effect size was below the cutoff for a small effect size (i.e., only indicates a “trivial” difference between groups).

Table 2.

Family Outcome Survey-Revised Mean Scores and % Meeting Outcome and Parental Stress Index–Short Form (Version 4) Mean Scores and Percentage over the Clinically Significant Cutoff for Mothers Who Do and Do Not Identify as Autistic (Cohen's d Effect Size: Small 0.2, Medium 0.5, Large 0.8)

FOS-R subscalea	Mothers identifying as autistic (n = 20)		Mothers not identifying as autistic (n = 20)		Group comparisons (df = 19)
	M (SD)	n (%) meeting outcome	M (SD)	n (%) meeting outcome	t	d	p
Outcome 1: Understanding your child's strengths, needs, and abilities	3.99 (0.74)	18 (90%)	3.90 (0.71)	15 (75%)	−0.41	0.09	0.69
Outcome 2: Knowing your rights and advocating for your child	3.53 (1.04)	11 (55%)	3.44 (1.01)	11 (55%)	−0.27	0.06	0.79
Outcome 3: Helping your child develop and learn	3.99 (0.79)	15 (75%)	4.01 (0.88)	17 (85%)	0.10	0.03	0.93
Outcome 4: Having support systems	3.60 (1.13)	14 (70%)	3.28 (1.15)	9 (45%)	−1.38	0.31	0.18
Outcome 5: Accessing the community	3.90 (0.78)	16 (80%)	3.95 (0.78)	16 (80%)	0.29	0.08	0.77

PSI-SF subscale	M (SD)	n (%) above clinical cutoff	M (SD)	n (%) above clinical cutoff	t	d	p
Total scoreb	108.50 (25.47)	9 (45%)	106.55 (21.84)	7 (35%)	0.008	0.002	0.99
PDb	37.20 (10.55)	10 (50%)	36.45 (9.87)	8 (40%)	0.19	0.09	0.85
PCDIc	32 (9.32)	6 (30%)	32.05 (8.91)	6 (30%)	0.41	0.04	0.85

^a A mean score of over 4 out of 5 constitutes achievement of FOS-R Outcome.

^b Percentile scores over 90 are considered clinically significant.

^c Percentile scores over 85 are considered clinically significant.

FOS-R, Family Outcome Survey-Revised; PCDI, Parent-Child Dysfunctional Interaction; PD, Parent Distress; PSI-SF, Parent Stress Index 4-Short Form.

The comparisons for Outcome 4 (having support systems) did not reach statistical significance but had a small effect size. A small effect size indicates that there may potentially be difference between the two groups, but most likely due to sample size, the paired t-test comparisons did not identify a statistical significance between the two groups.

Parenting stress scores

As noted in Table 2, there was no significant difference and below small effect sizes (i.e., trivial differences) between PSI-SF total score, PD, and PCDI scores between the two groups.

Discussion

In this study, we aimed to explore whether there was a difference in the levels of family outcomes and parenting stress between mothers who do and do not identify as autistic. Mothers of autistic children were matched on factors that have previously been identified as being associated with parental well-being (child challenging behaviors, score on the SCQ, adaptive functioning, family income, and child and maternal age). Control groups are critical to furthering the understanding of the similarities and differing experiences of women on the spectrum.³¹ There were no significant differences and only “trivial” effect sizes in mean scores on measures of family outcomes and levels of parenting stress between mothers who did and those who did not identify as being autistic. One exception to this is Family Outcome 4, having support systems, which had a nonsignificant comparison but small effect size; this is discussed further into the discussion. These findings are a clear example of where nonsignificant results (along with trivial effect sizes suggesting a lack of meaningful differences between groups) provide clinically important information; when controlling for factors associated with maternal well-being (e.g., child challenging behaviors), the additional factor of maternal autism diagnosis status did not significantly increase or decrease the levels of parenting stress or (with potentially one exception) change family outcomes. Therefore, negative parental outcomes should not be assumed based on parental diagnosis.

The results of the current study are consistent with previous research that found autistic mothers reported similar levels of parental satisfaction⁶ and parental efficacy⁷ as nonautistic mothers. Pohl et al.⁸ conclude that autistic motherhood may be a different experience, although the factors that Pohl et al. identify as the main differences between mothers who are and who are not on the spectrum (difficulties in parenting, finding parenthood isolating, experiencing pre- or postnatal depression, and feeling misunderstood by professionals) are unlikely to be captured on the measures of parenting stress or family outcomes. This highlights the importance of careful consideration of the factor being measured and not assuming that because some aspects of motherhood are reported to be challenging, that this will be reflected in all measures explored. Of course, it may be that some of the variables controlled in the current study (e.g., child challenging behavior) also controlled for some of the factors that are associated with experiences such as parenting difficulties and social isolation.

As noted in a recent editorial,³⁰ statistical group comparisons do not tell the whole story, qualitative methods are needed to complement this work and share the voices and experiences of autistic mothers. Knowing, accepting, and celebrating that you have the same diagnosis as your child (and therefore share a number of characteristics) may allow autistic mothers to feel that they have a greater understanding of themselves and how they can relate to their children⁵ and ensure a greater support system. This may be one factor that contributes to the small effect size noted for Family Outcome 4, Having Support Systems. On this Family Outcome subscale, a (nonstatistically significant) higher percentage of autistic mothers (70%) reported that they had good support systems than nonautistic mothers (45%). These questions ask about having family and friends who understand their child's needs and who have children with similar needs, and about those who care. A small effect size coupled with a nonsignificant p-value within a study with a small sample size, such as this, suggests that the difference may be present, but larger samples are required for detection.³⁰ A post-hoc power analysis with the effect size of FOS-R Outcome 4 (d = 0.31) suggests that a sample size of at least 90 mothers in each sample would be needed for future work using a quantitative approach to explore Family Outcomes or similar constructs. This highlights the work for more research with larger samples to further understand this area and explore how autistic mothers develop these support networks and what may make them more useful or powerful for them. However, it should be noted, an effect of this magnitude may represent a small difference detected at a group level only, so clinically it may have limited value on an individual basis. This highlights the importance of understanding each individual to inform clinical support or needs, rather than making assumptions based on diagnosis or nondiagnosis.

Although not an aim of this study, the finding that more than three times as many autistic mothers than nonautistic mothers had received a diagnosis of a mental health disorder in their lifetime is worthy of note and discussion. Elevated levels of mental health diagnoses are reported in autistic adults,³² with recent work³³ highlighting that autistic women and nonbinary people in particular experienced mental health issues at higher rates than autistic men. Participants were not asked to disclose when or how they were diagnosed as autistic, nor at what point they received their mental health diagnosis (i.e., if this was before, after, or at the same time as their autism diagnosis). Such findings highlight the importance of further understanding the multiple and intersecting journeys that many autistic mothers may have been on and how they have come together now in their role as an autistic mother of an autistic child.

Limitations and future directions

We conducted one of the first studies examining family outcomes and parenting stress of autistic mothers within the same study. There is very little existing research exploring the parenting experiences of autistic parents. As we extracted data from an existing data set, rather than specifically recruited for a study on parenting stress or family outcomes, this sample may be more representative. Conversely, mothers who felt able to commit to completing an annual questionnaire as part of the larger longitudinal study may be less stressed overall. Mothers in the sample were generally well educated and 72.5% were living in households with income above the national median, potentially limiting the representativeness of this sample and the generalizability of findings. As data on ethnicity or marital status were not collected, it is also not possible to comment on how generalizable the sample was in relation to these variables. As such, future research should seek to gather a more diverse sample and collect these data and report them in future research.

While this study makes an important and novel contribution to understanding family outcomes in autistic mothers, a number of limitations exist. First, the sample size was small and limited due to the use of preexisting data. Effect sizes (which indicate the magnitude or size of difference between the groups without being impacted by sample size) suggest minimal meaningful group differences, with a small effect only detected for Family Outcome 4 (although this comparison did not reach statistical significance, this finding should be interpreted with caution). Future research could build on this study using a larger sample size to reaffirm the null findings of this study. Larger samples could also allow for investigation of whether the predictors of parenting stress or family outcomes differ between the two groups, even if absolute values of parenting stress are similar. Such research could inform future support for parents and families of autistic children.

Mother participants in the current study were not required to verify their autism diagnosis or nondiagnosis. It is possible that some mothers who did not identify as autistic at the time of this questionnaire may be autistic. Furthermore, all of the participants in the study were mothers and results cannot be generalized to fathers, who may show different results as some research shows that the parenting experiences of autistic mothers and fathers can differ.⁷ Future research with autistic mothers and autistic fathers could elucidate both similarities and differences between diagnosis groups as well as the impact of gender to ensure that both mothers and fathers can receive appropriate support or intervention if needed. There is a clear need to combine qualitative and quantitative methods to further our knowledge of the experience of being an autistic parent of an autistic child, not only in relation to maternal outcomes (such as those explored in this study) but also in relation to other broader systemic factors such as accessing and benefiting from formal or informal supports across the child's lifetime. These combined qualitative and quantitative approaches could also be used to explore whether there are parenting skills or practices that autistic mothers use more, less, or differently and whether such approaches may support or promote positive maternal and/or child outcomes. Such an approach would then enable nonautistic parents and professionals to learn from the experience and skills of autistic mothers and potentially inform future practice.

Conclusion

This is one of the first studies to explore the experiences of autistic mothers and is particularly novel in addressing family outcomes and parental well-being. There were no significant differences in the achievement of family outcomes or levels of parenting stress between autistic and nonautistic mothers on parenting autistic children after close matching on a number of variables. Furthermore, effect sizes were trivial with the exception of the Family Outcome around support systems that showed a small, although nonsignificant, effect size. This area may benefit from further exploration as the small effect size suggests that potentially at a group level, autistic mothers may have slightly stronger or more beneficial networks who understand their child's needs and who have children with similar needs. Our results highlight the importance of not assuming greater parenting challenges for autistic mothers and the need for accessible and effective support for all parents.

Authorship Confirmation Statement

D.A. has been involved in the management and supervision of data collection for the larger study from which these data are drawn since 2016. D.A. also codesigned this study, carried out the analyses, reviewed and revised the first draft of the article, and finalized the article for submission.

M.S. conceptualized and codesigned the study, conducted the literature review and interpretation of the results, drafted the first draft of the article, critically reviewed the article, and approved the final article as submitted.

J.P. was involved in the development and ongoing management of the larger study from which these data are drawn. J.P. also codesigned the study, critically reviewed the article, and approved the final article as submitted.

All authors have approved the article and agree to its submission to your journal. This article has been submitted solely to this journal and is not published, in press, or submitted elsewhere.

Author Disclosure Statement

No competing financial interests exist.

Funding Information

The author acknowledges the financial support of the Cooperative Research Centre for Living with Autism (Autism CRC), established and supported under the Australian Government's Cooperative Research Centres Program (2.007).