Effects of Respite Care on the Quality of Life of Caregivers of Children With Autism Spectrum Disorder in Comparison With Parent Training: A Systematic Review and Meta-Analysis

Parents of children with autism spectrum disorder (ASD) experience substantial psychological, social, and physical burdens that negatively affect their quality of life (QoL). Although parent training (PT) is a well-recognized intervention for improving parental well-being, the effectiveness of respite care (RC) remains unclear. This systematic review and meta-analysis aimed to evaluate the effects of RC-containing programs in improving caregivers' QoL compared to PT programs. Six electronic databases were searched until September 2025 for quantitative studies that examined RC-containing or PT programs targeting caregivers of children with ASD aged 0-18 years. Eligible designs included randomized, quasi-randomized, pre-post, and cross-sectional studies. Outcomes were QoL measured using validated scales. The risk of bias was assessed using RoBANS-2. Random-effects meta-analyses were conducted using standardized mean differences (SMD). Five studies met the inclusion criteria for RC-containing programs, and 10 met those for PT programs. RC-containing programs showed a significant moderate effect on caregiver QoL (SMD = 0.45, 95% CI: 0.32-0.58; I² = 1%) with low heterogeneity (I² = 1%, τ² = 0.0057, p = 0.40). PT programs also demonstrated a significant but smaller effect (SMD = 0.31, 95% CI: 0.14-0.47; I² = 42%) with high heterogeneity (I² = 42%, τ² < 0.0001, p = 0.08). Although all included studies in both RC-containing and PT programs showed a high risk of bias, the point estimate suggested a comparative improvement in QoL among caregivers who received RC-containing support. RC-containing programs appear beneficial for improving the QoL of caregivers of children with ASD, and their effects are comparable to those of PT programs. This highlights the importance of recognizing RC as an essential component of family support and of integrating flexible, needs-based RC into clinical practice.