Family Processes and the Emotional and Behavioural Well-being of Autistic Children and Youth: A Systematic Review of Prospective Studies

Emotional and behavioural difficulties including depression, anxiety, and hyperactivity are elevated in autistic children (AC). Family processes of a psychological nature are associated with these difficulties, but the direction of influence is uncertain. We searched seven bibliographic databases for prospective, quantitative studies on the impact of family processes across the parent, dyad, and family system levels on the later well-being of AC without intellectual disability, across a minimum of six months. Eligible studies were extracted following PRISMA guidelines and narratively synthesised. Sixteen of the 17 studies included for review reported significant associations between at least one family process and later well-being. Parenting stress and aspects of the parent-child relationship yielded most robust associations. Weaker support was found for parent mental health problems. Clinical and research implications are discussed.