From Child-Focused to Family-Centered: Caregiver Perspectives on Success in Autism Treatment

Autism treatment in the United States often centers on child behavior change, with caregivers viewed as adjunct rather than central. In contrast, this qualitative study examines caregiver perspectives at treatment entry, exploring how they conceptualize success and perceive barriers. We analyzed intake responses from 81 caregivers of autistic children across three developmental stages (<6, 6–11, 12–17 years) using a structured thematic analysis. Four core themes emerged, organized into two overarching themes: Understanding and Supporting the Autistic Child (Layers of Self; Help Them Thrive) and Empowering the Family System (We’re in This Too; Healing the System). Caregivers articulated layered goals spanning emotional regulation, social identity, autonomy, caregiving capacity, family wellbeing, and systemic navigation. Their perspectives challenge traditional child-only models by highlighting the reciprocity between child outcomes and family functioning. Findings underscore the suitability of Marriage and Family Therapists (MFTs) to lead holistic, family-centered autism care, bridging child and family priorities, tailoring support to caregiver readiness, and navigating systemic barriers. By centering caregiver voices within a systemic framework, this study offers a pathway toward more relationally responsive and sustainable autism interventions.