Health-related behaviors and family quality of life in autism spectrum disorders: A systematic review and meta-analysis

Health-related behaviors —including sleep quality, physical-activity level, screen time, and mealtime behavior —, are often disrupted in children with Autism Spectrum Disorder (ASD), and may be associated with a lower family quality of life (FQoL). This systematic review and meta-analysis evaluated these associations, recognizing the central role that daily health habits may play in shaping FQoL. A registered protocol in PROSPERO (CRD42023408500) guided a comprehensive search across seven electronic databases and grey literature sources, yielding 12 eligible studies that included 6373 families of children with ASD who were evaluated on health-related behaviors and FQoL. Publication bias was assessed. Moderate correlations were found between FQoL and sleep problems ( k = 6 , r = − . 36 , p < . 001 ) , and moderate positive correlations with screen-time ( k = 3 , r = . 34 , p < . 05 ) . Physical activity showed no significant pooled association with FQoL ( k = 4 , r = . 14 , p = . 49 ) despite substantial heterogeneity. Mealtime behavior showed a negative association in a single study (k = 1, r = − 0.25 ). Future research should clarify the directionality of these associations and examine how multiple health-related behaviors may interact to influence FQoL. Targeted interventions addressing specific health-related behaviors could enhance existing approaches for improving FQoL in families of children with ASD. • Health-related behaviours affect family quality of life in ASD. • There is a moderate association between sleep problems and screen time and QoL. • Physical activity has a positive effect on young children. • Eating difficulties could negatively impact family quality of life. • Interventions promoting healthy habits could improve family well-being.