Experiences of parenting stress in caring for children with autism spectrum disorder during the COVID-19 pandemic in the Netherlands

Parents of autistic children face unique challenges, further intensified by the COVID-19 pandemic. This context offers valuable insights into how parents adapt during crises. In this mixed-method study, parenting stress among parents of autistic children (ages 5-22) was longitudinally assessed using the Parenting Stress Questionnaire during a strict lockdown (T1, n = 49) and a period with relaxed COVID-19 safety measures (T2, n = 39) in The Netherlands. Additionally, deductive thematic analysis was applied to semi-structured parent interviews during T1 (n = 25). Results from T1 indicated severe parental role restrictions and mild issues in parent-child relationship, physical health, and overall burden, with normal parenting problems and depressive mood. Parent-child relationship problems significantly decreased from T1 to T2, suggesting improved relationships as COVID-19 restrictions eased and families adapted. Interviews highlighted parents' adeptness at creatively managing pre-existing challenges during the pandemic. However, parents expressed vulnerability and a precarious balance regarding mental and physical health. Using the stress process model, this study shows that parents of autistic children may exhibit greater proficiency in handling primary stressors (parenting and parent-child relationship issues), compared to secondary stressors (role restrictions, depression, and health concerns). These insights offer valuable implications for parenting in times of crises, such as the COVID-19 pandemic.