Parental Acceptance and Its Network Relations With Stigma, Parenting Competence and Stress in Families of Children With Autism Spectrum Disorder: A Network Approach

Parents of children with clinically diagnosed autism spectrum disorder (ASD) often experience high levels of parenting stress, reduced confidence in their caregiving abilities and internalized (affiliate) stigma, all of which can impede acceptance of the diagnosis and engagement with support services. Understanding how these factors interrelate is essential for designing effective interventions. This study evaluated a culturally adapted family counselling programme for Saudi parents of children with clinically confirmed ASD. It used network analysis to examine the connections among parental acceptance, parenting competence, affiliate stigma and parenting stress. A total of 240 parents of children with formal clinical ASD diagnoses participated, with 120 parents receiving a 12-session group counselling programme over 6 weeks and 120 parents assigned to a waitlist control group. Parents completed validated Arabic measures assessing acceptance and understanding of their child's diagnosis, parenting competence (efficacy and satisfaction), affiliate stigma (cognitive, affective, behavioural) and parenting stress at baseline and post-intervention. Network analysis at baseline identified parental acceptance as the most central node, positively linked with understanding and competence and negatively associated with stress and stigma. Following the intervention, parents in the counselling group demonstrated significant improvements in acceptance, understanding and expectations, along with reductions in maladaptive beliefs and affiliate stigma across all domains. Parenting satisfaction increased substantially, efficacy improved modestly and parenting stress decreased, highlighting the programme's effectiveness in alleviating caregiver burden. These findings indicate that parental acceptance may serve as a key leverage point for supporting families after an ASD diagnosis and that structured, culturally sensitive counselling can simultaneously enhance parental competence and reduce psychological distress. Network-informed approaches can guide clinicians in targeting central processes, optimizing outcomes and promoting family resilience. Overall, early, focused family counselling provides parents of clinically diagnosed children with ASD the skills, confidence and support necessary to adapt effectively, improving both caregiver well-being and family functioning within the Saudi cultural context.