The Autistic Parenting Journey: A Systematic Review of Qualitative Evidence and Thematic Meta-Synthesis

Abstract

Background:

The emerging literature about parenthood indicates specific differences in autistic individuals’ experiences compared with non-autistic ones.

Methods:

We conducted a systematic search of the literature across PubMed, Embase, Web of Science, and CINAHL Complete to identify articles related to pregnancy, childbirth, and parenthood in autistic individuals. The search was completed on March 5, 2024, and identified 35,581 records. Inclusion criteria included the use of semistructured interviews or focus groups for data collection and interpretative phenomenological analysis or thematic analysis for data analysis as the best methods for exploring our subject.

Results:

After applying inclusion and exclusion criteria, six articles were included in the systematic review and underwent thematic synthesis. Each study comprised between 7 and 24 autistic participants (all females except three). Their methodological quality was assessed with the Critical Appraisal Skills Programme tool for qualitative studies. We identified three key themes as follows: 1. Parental Challenges and Adaptations; 2. Social Relations and Support; and 3. Identity and Personal Growth. Our analysis identified that autistic individuals face diverse challenges in becoming parents and parenting, including primarily sensory and communication difficulties, which impact their ability to interact with professionals and to manage daily tasks, requiring the implementation of diverse strategies and adaptations to cope. Autistic adults reported a strong emotional connection they build with their children, the need to advocate for them when they are also neurodivergent, and the difficulty in finding formal and informal support fulfilling their specific needs.

Conclusion:

The educational approach of autistic parents seems influenced by their autism, bringing both strengths and challenges to create, ultimately, a supportive parenting environment. The experience of becoming a parent and raising a child is described as a key step in their personal development. These findings will help autistic parents by promoting a better understanding of their experiences, challenges, and strengths by health care professionals and social workers.

Community Brief

Why is this an important issue?

Many people are diagnosed autistic as adults, and some autistic children want to become parents when they grow up. However, there are few specific supports for autistic parents. Research shows that their experience of parenthood has unique aspects, which can be both strengths and challenges.

What was the purpose of this study?

We conducted a comprehensive review of the literature on pregnancy, childbirth, and parenthood in autistic adults. Our goal was to identify, synthesize, and analyze qualitative studies to pinpoint the strengths, challenges, and specific needs of autistic adults in this area and to propose supportive interventions.

What did the researchers do?

We performed a thorough search across four scientific databases to find relevant articles. We selected the applicable studies and analyzed their data by coding the results line by line. We reused codes from previous studies and created new ones as necessary. We then organized these codes into related areas to develop descriptive themes and combined them into analytical themes.

What were the results of the study?

We identified three key themes as follows: 1. Parental Challenges and Adaptations; 2. Social Relations and Support; and 3. Identity and Personal Growth. We found that autistic individuals encounter several challenges in becoming parents and raising children, mainly due to sensory and communication difficulties. These issues affect their interactions with professionals and their management of daily tasks. Despite this, autistic adults report deep emotional connections with their children, a strong need to advocate for them, and difficulties in finding adequate support. Their parenting style, shaped by their autistic traits, presents both strengths and challenges. They view parenthood as a major milestone in their personal growth.

What do these findings add to what was already known?

Our work identifies and describes the unique strengths, challenges, and needs of autistic adults in their parenting journey. It allows us to propose interventions to support autistic parents and highlights areas for future research.

What are the potential weaknesses in the study?

As a qualitative literature review, our study did not include data from quantitative or mixed-method studies. By focusing on studies using the most adequate methodology, we may have missed some other qualitative studies offering new insights. Some participants were included based on self-reported diagnoses rather than confirmed by a mental health professional. In addition, the studies included very few men and no autistic parents with intellectual disability or borderline intellectual ability, which limits the generalizability of our findings to these populations.

What do the authors recommend for future research on this topic?

Study the parenting experiences of autistic men, focusing on how sensory challenges affect their involvement with their children. Assess the importance of support from relatives and strategies to mobilize it. Describe the parenting style of autistic parents to enhance professional understanding and reduce bias. Identify obstacles to parenthood for autistic adults to develop suitable support. Examine the prevalence of autism in the children of autistic adults, which appears significant but remains unexplored.

How will these findings help autistic adults now or in the future?

These findings highlight the challenges autistic adults face in parenting and suggest interventions to support them. They also help counteract biases among health care professionals and society, fostering better understanding and support for autistic parents.