Positive and challenging themes in parents’ perceptions of their relationships with their child with autism: Comparison between mothers and fathers

Abstract

Most studies of how parents of children with autism view the parent–child relationship used self-report questionnaires and focused on challenges. This study broadened the lens by interviewing parents using open-ended questions that provide an opportunity to raise challenging but also positive experiences. Seventy-five mother–father dyads were interviewed individually about their own and their spouses’ relationships with their preschooler, and content analyses of their responses revealed nine relationship themes. In descending order, the themes mentioned most frequently by mothers were “Security and Closeness,” “Love,” and “Tenderness and Sensitivity,” and by fathers were “Pleasure in Joint Activities,” “Security and Closeness,” and “Guidance.” Positive themes were more common than challenging themes. Finally, more mothers mentioned the themes “Love,” “Tenderness and Sensitivity,” “High Involvement and Care,” and “Difficulties” than did fathers, whereas more fathers mentioned the themes “Guidance,” “Pleasure in Joint Activities,” and “Limited Time with Child” than did mothers. The findings portray a nuanced view of the parenting experience of mothers and fathers of preschoolers with autism.

Lay Abstract

Most studies of how parents of children with autism see the parent–child relationship used questionnaires completed by the parents and focused on challenges. This study broadened the lens by interviewing parents using open-ended questions that provide an opportunity to raise challenging but also positive experiences. Seventy-five mother-father dyads were interviewed individually about their own and their spouses’ relationships with their preschooler, and we found nine relationship themes. In descending order, the themes mentioned most frequently by mothers were “Security and Closeness,” “Love,” and “Tenderness and Sensitivity,” and by fathers were “Pleasure in Joint Activities,” “Security and Closeness,” and “Guidance.” Positive themes were more common than challenging themes. Finally, more mothers mentioned the themes “Love,” “Tenderness and Sensitivity,” “High Involvement and Care,” and “Difficulties” than did fathers, whereas more fathers mentioned the themes “Guidance” and “Pleasure in Joint Activities” than did mothers. The findings portray a nuanced view of the parenting experience of mothers and fathers of preschoolers with autism.

Keywords

autism spectrum disorder autism fathers mothers parent–child relationship parents’ perspectives

Introduction

Most studies regarding parents’ perceptions of parenting young children with autism have focused on difficulties and challenges. In recent years, however, researchers have begun to adopt a wider angle and examine not only stressful aspects but also how parenting children with autism is similar to parenting neurotypical children and involves a wide range of positive, negative, and mixed experiences (Altiere & von Kluge, 2009; Cost et al., 2021). Adopting this wider lens is essential for achieving a full and comprehensive view of the experience of parenting children with autism. It is also consistent with the neurodiversity perspective (Dawson et al., 2022), according to which atypical neurological development such as in autism should be considered as an expression of the diversity of human neurological development rather than solely as a manifestation of an abnormal process.

Parents of children with autism experience significantly higher levels of parenting stress (e.g. Baker-Ericzen et al., 2005; Davis & Carter, 2008), depressive symptoms (Cohrs & Leslie, 2017; Lai et al., 2015), and other psychiatric conditions (Yirmiya & Shaked, 2005) than parents of neurotypical children. In addition, when examining differences between mothers and fathers of children with autism, studies mostly focused on the challenging aspects of parenting and report that mothers experience greater levels of stress (Dabrowska & Pisula, 2010; García-López et al., 2016; Little, 2002; Tehee et al., 2009), depression (Hastings et al., 2005; Olsson & Hwang, 2001; Ozturk et al., 2014) and caregiving burden (Foody et al., 2015; Tehee et al., 2009) than fathers.

Only a few studies examined the experience of parents of children with autism beyond their challenges and difficulties, however. For example, Altiere and von Kluge (2009) discovered that almost every parent in their study described significant positive experiences alongside the hardships. In another study, Cost et al. (2021) asked parents of children with autism to describe both their concerns regarding their child but also “the best things about their child.” In listing children’s best traits, the most common were love, kindness, happiness, and humor. Finally, Kayfitz et al. (2010) found that mothers reported more positive experiences in parenting their children with autism than did fathers, and Hall and Graff (2010) highlighted strategies parents use to manage the stress involved in parenting a child with autism. This emphasis on positive aspects alongside stressful ones is important for a more comprehensive view of parenting children with autism, and this study extended this research direction. Furthermore, similar to some of these studies (Altiere & von Kluge, 2009; Hall & Graff, 2010), open-ended questions were used so as not to define a priori the dimensions of parenting that parents are asked as is the case when self-report questionnaires are used.

The current investigation addressed several limitations of prior studies. First is the exclusion of fathers. Although fathers are increasingly involved in parenting young children (Pleck, 2010), and their involvement can be of particular significance in the case of families with children with autism (Rankin et al., 2019), most studies of parenting children with autism focused on mothers. The few studies which included both parents mostly focused on the differences between mothers and fathers in the level of challenge they experience (e.g. Dabrowska & Pisula, 2010; Foody et al., 2015; Hastings et al., 2005). Second, in past studies, children’s diagnoses were not independently confirmed, and children’s cognitive functioning and severity of diagnosis, which may impact the parenting experience, were not examined. Finally, the samples used in these studies were small (26 families in the Altiere & von Kluge, 2009 study and 10 families in the Hall & Graff, 2010 study).

The present study

The goal of the study was to provide an opportunity for parents of preschoolers with autism to describe their relationships with their children using open-ended, non-directive questions, without guiding parents to stress positive or challenging experiences. The study addressed the limitations mentioned above: first, it included both mothers and fathers. This was important not only because fathers have a central role in parenting but also because it offered an opportunity to compare the experiences of fathers and mothers. Also, each parent was asked about their relationship with the child but also about the other parent’s relationship with the child, and this provided an opportunity to “validate” each parent’s self-perception with the perception of the other parent. Second, children’s cognitive functioning and severity of diagnosis were assessed so it was possible to examine the association between these child characteristics and parent’s perceptions of the children. Third, the sample was relatively large and therefore offered an opportunity for quantitative analyses.

The study focused on three questions: first, what are the themes raised by parents in their descriptions of their relationships with their children? Second, what is the relative frequency of positive versus challenging themes? And finally, what are the similarities and differences in themes mentioned by mothers and fathers?

Method

Participants

The study was part of a larger investigation (Oppenheim et al., 2023) which included 80 Israeli mother–father dyads with preschoolers with an ASD (Autism Spectrum Disorder) diagnosis. Because autism is more prevalent among boys than girls (American Psychiatric Association, 2013), only parents of boys were included in the study. Children’s ages ranged between 29 and 68 months (M = 49.65, SD = 11.04). Mothers’ mean age was 36.41 years (SD = 5.20) and fathers’ mean age was 39.54 years (SD = 5.96). Parents’ mean number of years of education was 15.39 (SD = 3.10) for mothers and 15.13 (SD = 2.74) for fathers. The number of children in the families ranged between 1 and 5 (M = 2.34, SD = 1.07). Forty-five percent of the participating children were first born, and the remainder were later-born. Five mother–father dyads were excluded because one of the parents (three fathers and two unrelated mothers) did not provide full responses. Thus, 75 dyads were included in subsequent analyses.

Families were recruited through treatment and assessment centers in Israel and via social media. Inclusion criteria were as follows: children had received the ASD diagnosis at least 6 months prior to the study, did not have any other known medical conditions, and were living at home. Parents were married, spoke fluent Hebrew, and completed at least 12 years of education. Parents received gift vouchers for their participation.

Procedure

The study included two laboratory visits. During the first visit, the Autism Diagnostic Observation Schedule (ADOS; Lord et al., 2000) which was used to confirm children’s diagnosis was administered and parents also signed informed consent forms. During the second visit, a cognitive assessment was carried out as well as the parental interviews which provided the data for this report. The interviews were conducted simultaneously by two interviewers to assure independence of parental responses. The study was approved by the University of Haifa Institutional Review Board (IRB) (permit no. 400/16). Members of the autism community were not involved in planning or designing the study.

Measures

Assessments of children’s diagnosis

ADOS

The ADOS (Lord et al., 2000) is a semi-structured, standardized assessment used for diagnosing individuals with autism. The ADOS assesses the child’s social interaction, communication, play and imaginative use of materials, through interactions with a trained professional. One of the four modules is administered based on the individual’s developmental and language level. A revised algorithm for the ADOS (Gotham et al., 2009) was used to assign a calibrated severity score (CSS) ranging from 1 to 10 (1 being the lowest level of severity, 10 being the highest). Assessors were blind to all other variables in the study. The ASD diagnosis was confirmed for all participating children, and the CSS scores ranged from 4 to 10 (M = 7.08, SD = 1.52).

Assessments of children’s cognitive functioning

Children’s cognitive functioning was assessed using one of two tests: the Wechsler Preschool and Primary Scale of Intelligence–Third Edition (WPPSI-III; Wechsler, 2002) for verbal children or the Mullen Scale of Early Learning (MSEL; Mullen, 1995) for non-verbal children. The WPPSI-III is a widely used, standardized, and norm-based test for measuring cognitive abilities of children aged 2:06–7:07 years. The MSEL is also a widely used, standardized, and norm-based developmental test for children from age of birth to 5:08 years, and it yields an overall Early Learning Composite score. Both the WPPSI-III and the MSEL total score, representing the child’s intelligence quotient (IQ) score, have a mean of 100 and a standard deviation of 15.

Themes in parents’ descriptions of their relationship with the child

As mentioned above, two open-ended questions were presented to the parents: (1) “What most characterizes your relationship with your child?” and (2) “What most characterizes your spouse’s relationship with your child?” The questions were presented following an interview about the child unrelated to this study. No time limit was set for the response nor were parents directed to specific topics. If needed, the interviewer clarified the questions and encouraged the parent to respond. Parents’ responses were recorded and transcribed verbatim. Pauses and vocalizations (such as coughs, cry, or laughter) were indicated. All names of persons and locations were removed. Fathers’ and mothers’ interviews were transcribed using female grammatical gender so that coders remained blind to gender. When the interview included reference to one of the parents as “mother” or “father,” these words were replaced by “the speaking parent” and “the other parent.” Transcribers were graduate students in developmental psychology, and quality control of the transcriptions was performed by the project coordinator.

Coding themes in parental responses

A coding system for the themes in parental responses was developed on a randomly selected set of 20 interviews (10 mother-father pairs). The number of interviews reviewed for developing the coding system (20) was determined a priori based on a working hypothesis that this number was sufficient for capturing the variability in parental responses. As the review of the interviews progressed, it became apparent that a saturation point was reached and gradually no new themes emerged. Later, when the bulk of transcripts were coded a few new examples for the themes were identified, but no new themes emerged. The identification of the themes proceeded as follows. First, all of the themes mentioned by parents in their description of the parent–child relationship were identified by the first author (e.g. parent’s love, child’s love, stress, anxiety, communication difficulties, joy, warmth and touch, tenderness, joint play, joint activities, rigidity, limits setting, promoting the child’s progress, limited time with the child because of the parent’s work, sense of security) and reviewed by the second author. Next, the topics were grouped by the first and second authors according to nine higher-order themes characterizing parents’ relationships with their children. Final fine-tuning of the coding system (e.g. relabeling some categories) occurred while training an additional coder. The nine themes were as follows: (1) Love; (2) Tenderness and Sensitivity; (3) Security and Closeness; (4) Guidance; (5) Worry; (6) Difficulties; (7) Pleasure in Joint Activities; (8) High Involvement and Care; and (9) Limited Time with Child. More than one theme could be assigned to a parent’s response. The coding system included examples for each theme (see Table 1). Coding of the transcripts included two steps. First, the portions of the text relevant for coding themes were marked. Next, the marked segments were coded into one of the nine themes described above. A score of 1 was given when a theme was mentioned (once or more) and a score of 0 was given if the theme was not mentioned. The transcripts of the 10 pairs of parents on which the coding system was developed were mixed within the remaining transcripts and subsequently recoded. Coders were blind to all other information about the parents or children. Twenty percent of the transcripts (n = 32) were double coded and inter-rater reliability for each theme was assessed using the intra-class correlation and ranged from 0.83 to 0.96 (all p’s < 0.001). In cases of discrepancies between the coders, consensus was reached by discussion.

Table 1.

Parent–child relationship themes.

Theme	Examples
(1) Love	“He is everything for me” “He knows that he is my son, that I will do anything for him, that I love him” “I know he loves me, and I of course love him. He doesn’t always show it but . . . we feel it . . . we don’t need to say anything”
(2) Tenderness and Sensitivity	“Sometimes I feel I understand him without words” “For me, it can be kisses and hugs all day long” “I think we have a very warm connection, warm relationship”
(3) Security and Closeness	“I feel that he needs me, that he feels safe when I am near him” “I feel that we are very connected. When he comes back home from preschool and I am not there, he cries, he looks for me “ “We have a very strong bond” “I think I give him a sense of security” “He asks ‘where is mom?’ and I say ‘mom will return’ but he keeps asking, he cries. It’s like she’s his shelter, his security”
(4) Guidance	“His father is more authoritative. He listens more to his father” “His mother is tougher than me, she disciplines more” “I teach him, give him as much knowledge as possible. It’s important because I know these ages are critical for brain development” “I treat him like a typical, normal child. He knows from my voice when I’m angry. I tell him ‘go to your room’. I don’t cut him slack” “When I’m in the kitchen I place a little stool and he’s next to me. He helps me with the food mixer, the oven, flipping an omelet, and I’m next to him the whole time. I let him be independent”
(5) Worry	“I’m very worried. No matter what, there’s this cross to bear” “I want to give him tools to succeed. But somewhere there’s also my fear” “I wish to see that he finds his way, to see him happy, to see that when I leave the room he doesn’t fall apart and can play” “Most of the time he doesn’t understand. It is disturbing” “This whole issue caused his mother to be depressed”
(6) Difficulties	“The psychiatrist also told us that as he grows it’ll be more difficult, it won’t be easier” “He’s aware of what is happening around him, but there is no communication” “At his day care we were told that he’s low functioning, one of the lowest in his group. It upset us . . . sometimes you give up, I mean, not give up but you rest for a while, until someone comes and shakes you out of it and you get up again and start running” “We’re very connected now. In the first year it was very hard for me to connect with him, to be honest. It’s not that I didn’t love him, but . . . sometimes it takes time” “Even though we had lots of difficulties in the beginning, a very strong connection has grown between us”
(7) Pleasure in Joint Activities	“I’m the more playful and mischievous parent, the one who has fun with him” “We do a lot of things together, whether it’s going to the mall, doing silly things, buying him things” “We’re best friends. We play a lot together, pretend fighting, doing everything together. Going to restaurants, I take him with me.”
(8) High Involvement and Care	“I take care of him . . . I’m always there for him, always” “He’s not alone, and no matter what he or others think, we will support him and be with him” “I’m his mother—loving, educating, being, doing, everything” “I see myself as a therapist-parent . . . to treat, mediate, advance him”
(9) Limited Time with Child	“His mother stopped working . . . she cleared all her time for him, so she’s present in his life for 80% of the time, and me, at best it’s 40%” “I’m not with them a lot, but when I arrive he jumps at me right away . . . We get together three times a week on average” “His mother has more hours with him. I leave early . . . when I return I have my hour or hour and a half with him” “My time with him is very limited” “I think I’m secondary in this story with him. I work in many jobs, I have to provide for the family. Therapies and ABA alone are very expensive . . . so I’m less there” “His relationship with his mother is stronger than my relationship with him . . . I simply wasn’t there . . . there were times that I was not there for months”

Results

Preliminary analyses

Frequencies of mothers and fathers mentioning each theme

The number of parents mentioning each theme in their responses to each of the two questions (i.e. in mothers’ descriptions of their relationship with the child; mothers’ descriptions of the father–child relationship; fathers’ descriptions of their relationship with the child; fathers’ descriptions of the mother–child relationship) is presented in Table 2.

Table 2.

Frequencies and percentages of mothers and fathers (N = 75 dyads) mentioning relationship themes.

	Mothers’ responses				Fathers’ responses
	About themselves		About the fathers		About themselves		About the mothers
Relationship theme	n	(%)	n	(%)	n	(%)	n	(%)
Love	39	(52.0)	30	(40.0)	20	(26.7)	30	(40.0)
Tenderness and Sensitivity	36	(48.0)	17	(22.7)	22	(29.3)	32	(42.7)
Security and Closeness	44	(58.7)	41	(54.7)	34	(45.3)	37	(49.3)
Guidance	11	(14.7)	14	(18.7)	24	(32.0)	13	(17.3)
Worry	8	(10.7)	3	(4.0)	3	(4.0)	8	(10.7)
Difficulties	24	(32.0)	16	(21.3)	12	(16.0)	10	(13.3)
Pleasure in Joint Activities	16	(21.3)	42	(56.0)	40	(53.3)	18	(24.0)
High Involvement and Care	26	(34.7)	9	(12.0)	10	(13.3)	26	(34.7)
Limited Time with Child	0	(0)	12	(16.0)	14	(18.7)	0	(0)

n = number of mothers or fathers who mentioned the theme in their responses; % = percent of mothers or fathers from the total number of mothers or fathers, respectively, who mentioned the theme in their responses.

Associations between relationship themes and background variables

The associations between the themes’ frequencies and the following background variables were examined: children’s age, number of children in the family, birth order, maternal and paternal years of education, children’s CSS scores, and IQ. Of the 252 correlations examined (9 themes × 4 answers × 7 background variables), a negligible number of 16 correlations (6.3%) were significant. Consequently, the study analyses did not include the background variables.

Differences between the number of themes in mothers’ and fathers’ responses

Paired t-tests were conducted to examine whether mothers and fathers differed in the total number of themes in their responses. No significant differences between the number of themes provided by mothers (M = 5.17, SD = 2.0) and fathers (M = 4.71, SD = 1.68) were found (t₍₇₄₎ = 1.55, p = 0.12).

Comparison of mothers and fathers

Three sets of analyses are presented next: comparisons of the themes in mothers and fathers discussion of their relationships with their child; comparison of mothers’ perceptions of their relationship with their child and fathers’ perception of the same (i.e. maternal) relationship to examine whether both parents have similar perceptions of the mother–child relationship; and the same comparison only regarding the father–child relationship. We describe these analyses next.

A paired sign test was performed for each theme comparing the number of mothers mentioning the theme when describing their relationship with their child with the respective number of fathers (see Figure 1). In their discussion of their relationships with their child, more mothers mentioned the themes “Love” (p < 0.01), “Tenderness and Sensitivity” (p < 0.05), “Difficulties” (p < 0.05), and “High Involvement and Care” (p < 0.01) than did fathers, whereas more fathers mentioned the themes “Guidance” (p < 0.05), “Pleasure in Joint Activities” (p < 0.001), and “Limited Time with Child” (p < 0.001) than did mothers. No significant differences were found for the themes “Security and Closeness” (p = 0.18) and “Worry” (p = 0.23).

Figure 1.

Number of mothers and fathers mentioning each theme in responses about themselves.

Next, the concordance between the mothers’ perceptions of their relationship with their child and how the fathers perceive the mother–child relationship was examined. Using the paired sign test, the number of mothers mentioning each theme when describing themselves was compared with the number of fathers mentioning that theme when describing the mothers (see Figure 2). More mothers mentioned the theme of “Difficulties” (p < 0.05) in their responses about themselves than did fathers in their responses about the mothers, but no additional significant differences were found (all p-values above 0.22).

Figure 2.

Number of mothers and fathers mentioning each theme in responses about the mothers.

Similarly, but regarding the fathers this time, the concordance between the fathers’ perceptions of their relationship with their child and how the mothers perceive the father–child relationship was examined. Using the paired sign test, the number of fathers mentioning each theme when describing themselves was compared with the number of mothers mentioning that theme when describing the fathers (see Figure 3). No significant differences were found (all p-values above 0.09).

Figure 3.

Number of mothers and fathers mentioning each theme in responses about the fathers.

Comparison of positive versus challenging themes

To conduct this comparison positive and challenging themes scores were formed. The positive themes score was based on the number of positive themes (including “Love,” “Tenderness and Sensitivity,” “Security and Closeness,” and “Pleasure in Joint Activities”) in a parent’s response divided by 4 (the total number of positive themes). The challenging themes score was based on the number of challenging themes (including “Worry” and “Difficulties”) in a parent’s response divided by 2 (the total number of challenging themes). The “Guidance,” “High Involvement and Care,” and “Limited Time with Child” themes were not seen as indicating a specific emotional tone (i.e. positive or challenging) and were therefore not included in this analysis. Paired t-tests revealed that for both mothers and fathers, the positive theme score was significantly higher than the challenging score (see Table 3).

Table 3.

Differences between “positive themes score” and “challenging themes score” in parents’ answers about themselves.

	Positive themes scoreM (SD)	Challenging themes scoreM (SD)	t (Positive—challenging)
Mothers’ answers about themselves	0.45 (0.23)	0.21 (0.30)	5.15***
Fathers’ answers about themselves	0.39 (0.22)	0.10 (0.23)	6.81***

df = 74.

***

p < 0.001.

Fathers and the theme of “Limited Time with Child.”

Since the “Limited Time with Child” theme did not appear at all in descriptions of the mother–child relationships (neither in mothers’ answers about themselves nor in fathers’ answers about the mothers), but did appear in descriptions of some father–child relationships, we examined whether these fathers (or their children) had any specific characteristics. Of all participating fathers (N = 75), the theme was mentioned with regard to 22 fathers: in 4 cases by both parents, in 10 cases by the fathers (and not their spouses), and in 8 cases by the mothers (and not their spouses). Since each of these three sub-groups contained a relatively small number of fathers, they were combined.

The fathers in the “Limited Time with Child” group (n = 22) were compared with the rest of the fathers (n = 53) on the following demographic and background variables: children’s age, maternal and paternal years of schooling, children’s CSS scores, and IQ. No significant differences were found (children’s age: t₍₇₃₎ = 0.81, p = 0.42; paternal education: t₍₇₃₎ = 0.58, p = 0.57; maternal education: t₍₇₃₎ = −1.04, p = 0.30; CSS score: t₍₇₃₎ = 0.66, p = 0.51; IQ: t₍₇₃₎ = −0.66, p = 0.51).

Discussion

The aim of this study was to deepen our understanding of the experience of parenting children with autism by offering parents an opportunity to share their views about their relationships with their children in a non-directive, open-ended way. Specifically, the study sought to uncover what themes parents bring up when describing their and their spouse’s relationships with their children, how frequently positive and challenging themes arise, and the similarities and differences between the themes mentioned by mothers and fathers. We address the findings related to each of the questions in turn.

Parents raised a diverse array of themes in their discussions. In descending order, the three themes mentioned by most mothers were “Security and Closeness,” “Love,” and “Tenderness and Sensitivity,” and the three themes mentioned by most fathers were “Pleasure in Joint Activities,” “Security and Closeness,” and “Guidance.” Additional themes mentioned by fewer parents were “Worry,” “Difficulties,” “High Involvement and Care,” and “Limited Time with Child.” Generally speaking, the themes appear to be similar to themes that parents of neurotypical children might raise, although a parallel study with parents of neurotypical children is needed to confirm this.

To answer the second question of the study, positive and challenging themes were grouped into clusters. Perhaps surprisingly, given the relatively large number of studies on the stress experienced by parents of children with autism, twice as many mothers and four times as many fathers raised positive as compared to challenging themes. This finding is in line with the small body of research reviewed earlier documenting positive experiences of parenting children with autism alongside the difficulties and challenges (Altiere & von Kluge, 2009; Cost et al., 2021; Kayfitz et al., 2010), but extends these findings by showing that positive aspects were not only present but mentioned by considerably more parents than challenging aspects. This does not diminish the importance of the difficulties faced by parents of children with autism and the stress that results from these difficulties (Baker-Ericzen et al., 2005; Cohrs & Leslie, 2017), but suggests that these difficulties do not preclude the presence of positive experiences.

It is important to note that the themes raised by parents were not associated with the severity of their children’s symptoms or cognitive delays. This suggests that the positive or challenging experiences highlighted in the study are not solely a product of the level of the children’s developmental abilities and/or disabilities. Instead, the themes mentioned by parents in their interviews appear to reflect their own perspective and interpretations of their child’s condition (Oppenheim, 2006).

We turn to the study’s third question, which involved comparing mothers and fathers’ responses. More mothers mentioned the themes “Love,” “Tenderness and Sensitivity,” “High Involvement and Care,” and “Difficulties” than did fathers, whereas more fathers mentioned the themes “Guidance,” “Pleasure in Joint Activities,” and “Limited Time with Child” than did mothers. No differences were found between mothers and fathers in the themes “Security and Closeness” and “Worry.” Importantly, the lack of differences between parents’ views regarding themselves and their spouses’ views of them (i.e. comparing how mothers described their relationships with their child and how the fathers described the mothers’ relationship with the child, and comparing how fathers described their relationship with the child and how mothers described the father’s relationship with the child, see Figures 2 and 3) suggests that mothers and fathers were in general agreement in their perceptions.

Considering the overall picture of differences and similarities in the themes brought up by mothers and fathers reveals an interesting picture. If we consider “Security and Closeness” as reflecting the secure-base function of parenting (Ainsworth et al., 1978; Bowlby, 1969), the lack of differences between mothers and fathers suggests that both perceived themselves as important in providing their children a sense of security. Also, the results of the ranking of the themes reviewed above showed that this function was important for both mothers and fathers, because it was mentioned by the highest number of mothers and the second highest number of fathers. Together they point to the central place of attachment and the provision of security accorded by both mothers and fathers of children with autism.

Alongside this similarity, the ways and contexts in which this parenting function is expressed may differ between mothers and fathers: the themes “Love” and “Tenderness and Sensitivity” were mentioned by more mothers than fathers, whereas the themes “Pleasure in Joint Activities” and “Guidance” were mentioned by more fathers than mothers. This is consistent with attachment studies of neurotypical children comparing children’s interactions with their mothers and fathers (Bretherton, 2010; Grossmann et al., 2008). Although both parents are seen as important in providing comfort and encouraging exploration, these authors argue that mothers are more salient as a haven of safety and fathers as promoting secure exploration.

A final methodological point regarding the comparisons between mothers and fathers should be mentioned: the overall number of themes brought up by mothers and fathers was not significantly different. Together with the coding strategy of giving the same score to a parent who mentions a theme once or more, any difference that was found between mothers and fathers was not simply a function of parents of one gender talking more or providing more elaborate responses than the other gender.

Alongside the emphasis on positive experiences, parents’ discussion of difficulties should not be overlooked. More mothers, compared to fathers, brought up the “Difficulties” theme, which included interaction and communication difficulties. This could be a reflection of the greater involvement of mothers in the care of young children, as indicated in the higher number of mothers mentioning the “High Involvement and Care” theme, which necessarily also exposes them to more challenging behaviors and interactions. This is true regarding parenting in general and may be true regarding children with autism in particular.

The theme “Limited Time with Child” revealed striking differences between mothers and fathers: it appeared only in descriptions of the father–child relationship and not even once regarding the mother–child relationship. This was true both regarding maternal responses to the question about the fathers and fathers’ responses to the questions about themselves. Although the percentage of fathers in the “Limited Time with Child” group was not high (18.7% of the fathers mentioned this theme in their responses about themselves, and 16.0% of the mothers’ mentioned this theme about the fathers), it appears to be meaningful given the striking gender differences. As described earlier, we compared the fathers who described themselves with the “Limited Time with Child” theme, or were described like that by their spouses, with the fathers who were not so described on a range of paternal and child variables. No differences were found. Thus, the father or child characteristics we examined did not seem to explain the “Limited Time with Child” perceptions of these fathers, and we can only speculate about other explanations. For example, it may be that fathers’ “Limited Time with Child” was due to extended work hours, possibly related to general societal expectations from fathers to provide for families financially. These expectations may be even more pronounced in families with a child with autism in light of the economic burden involved in providing interventions for the child and/or because mothers decreased their workload to be more available to the child. It is possible and likely that at least some of the fathers experiencing “Limited Time with Child” may feel guilty and would aspire to be more involved with their children, and the findings suggest that extra effort should be placed to facilitate such involvement.

Several strengths of the study are noteworthy. The first was the inclusion of fathers in addition to mothers. Fathers are still absent in many parenting studies of children with autism or, if present, only complete self-report questionnaires. In this study, fathers and mothers were interviewed, and this offered an opportunity to compare their experiences and revealed interesting similarities and differences. An additional strength was that the study offered an open-ended opportunity for parents to describe their relationships with their children without a priori assumptions regarding the topics or issues that are most salient for parents. This is not the first study to adopt this approach (e.g. Altiere & von Kluge, 2009; Hall & Graff, 2010), but studies using such an open-ended approach typically included a small number of parents. Also, these studies did not include gold standard assessments of children’s diagnosis and cognitive functioning as was done in this study. Using such assessments, it was possible to confirm the diagnoses of the children and reveal that parents’ descriptions of their relationships with their children appear to be more a function of their perceptions of their relationship with the child than the severity of the child’s symptoms or the level of cognitive delay.

Finally, the study contributes to the neurodiversity approach (Dawson et al., 2022) that views autism as a developmental pathway which may be atypical in some aspects but similar to typical development in others. In a parallel fashion, the experience of parenting children with autism that emerged from this study is nuanced, with many feelings and issues similar to those experienced by parents in general (e.g. fathers who report on not spending enough time with their child).

Along with the insights emerging from this study, three limitations are noteworthy. First, because the study is based on themes parents mentioned in response to open-ended questions, the absence of a theme does not mean that it is irrelevant for the parent’s experience. Parents may not mention a theme for a wide range of reasons: their understanding of the question or the goal of the interview, the comfort with the interviewer, and a myriad of additional contextual factors. It is possible that in response to direct questions additional responses would have been obtained. Second, coding of the themes identified only the appearance or absence of the theme and not the salience of the theme (e.g. the number of times a theme was mentioned, how long it was discussed, nor its strength). This was done intentionally in order to focus on the themes and not stylistic speech differences (e.g. verbosity). However, taking salience into consideration could have possibly revealed additional findings. A final limitation is that only boys were included. This limitation is of particular relevance because it confounds the gender of the parent with the similarity between the parent’s gender and the child’s: fathers in the study spoke about a same-gender child whereas mothers about an opposite-gender child. Additional studies with children of all genders could help clarify this issue.

In sum, the findings of this study expand our understanding of the experiences of parenting children with autism. They provide a more nuanced view of the positive and rewarding aspects alongside the difficult and challenging aspects, as well as of similarities and differences between mothers and fathers. In addition, the findings may be significant as a “roadmap” for clinicians working with children with autism and their parents. Such a “roadmap” can provide a background against which to assess the experience of specific parents, both mothers and fathers. The findings regarding the dominance of positive themes may encourage clinicians to seek and highlight such experiences as points of resilience in the challenges that many parents of children with autism experience. In addition, the findings regarding the importance that parents see in providing security can guide interventions to support this aspect of parenting. Taken together, the results of the study provide a deeper understanding of the parenting experience of young children with autism and can help provide support for parents, particularly because they are increasingly appreciated as crucial agents of change in early interventions with young children with autism (Pickles et al., 2016; Rogers et al., 2021; Siller & Morgan, 2018).

Footnotes

Acknowledgements

The authors wish to thank the research assistants involved in the study and particularly Ms Michal Medved for her help in coding the interviews. The authors also wish to thank the participating families for their time and for sharing their experience with us.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by an Israel Science Foundation grant 155/15 and by the Harry and Sadie Lasky Foundation.

ORCID iD

Shir Moshe

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