Parenting Practices and Externalizing Behaviors in Autistic Children: A Systematic Literature Review

Abstract

There is limited recent research on the association between parenting practices and externalizing behaviors in autistic children. To address this gap, the current systematic review examined the associations between parenting practices and externalizing behaviors in autistic children, along with the mediating and moderating effects of parent and child variables (PROSPERO registration number CRD42022268667). Study inclusion criteria were (1) Peer-reviewed journals, (2) Participants included parents of autistic children and their children, (3) Quantitative measures of both parenting practices or behaviors/style and child externalizing behaviors, (4) Cross-sectional or longitudinal studies only, and (5) Studies published in English. Study exclusion criteria were: (1) Qualitative studies, (2) Published in a language other than English, (3) Participants included non-human participants, (4) Participants that did not include parents and their autistic children as participants or did not report this group separately, (5) Systematic review and meta-analyses, and (6) No quantitative measures of parenting practices and/or child externalizing behaviors. Quality appraisal and risk of bias were conducted using the McMaster Tool and results were synthesized in Covidence and Excel. Thirty studies were included in the review. Results demonstrated that mindful parenting was associated with fewer or lower levels of externalizing behaviors; positive parenting practices had non-significant associations with externalizing behaviors; specific parenting practices had differing associations with externalizing behaviors; and negative parenting practices were associated with higher levels of externalizing behaviors. We are unable to draw causal relationships due to focus on cross-sectional and longitudinal articles only. The potential for future research to target specific parent practices to support children’s externalizing behaviors is discussed.

Relationship between Parenting Educational Styles and Well-Being in Families with Autistic Children: A Systematic Review

“…Another example of problems when it comes to establishing the effect can be found in de Clercq et al [ 39 ], as it is not clear whether parental stress drives Expressed Emotion (EE) or whether EE is a determinant of stress. Suvarna et al [ 8 ] include in their limitations that a choice was made a priori to focus on only quantitative articles and qualitative studies and synthesis such as meta-synthesis may be valuable in the future to provide an in-depth understanding of particular behaviors [ 40 ].…”

“… STROBE bias analysis sorted by year of publication [ 6 , 8 , 17 , 20 , 29 , 30 , 31 , 32 , 33 , 35 , 36 , 37 , 38 , 39 , 41 , 42 , 43 , 44 ]. …”

“…Responding to our objective (relationship between well-being and parenting style in ASD), we can determine that family well-being is positively related to the authoritative style, warmth, relationship building, affective bonding, priority in relationship building, and low EE. Higher levels of authoritarian parenting and parenting behaviors, including harsh and psychological control, are associated with higher levels of externalizing behaviors, whereas parenting behaviors including warmth and behavioral control are associated with lower levels of externalizing behaviors (Suvarna et al [ 8 ]). In the same way, permissive parenting style is associated with higher levels of externalizing behaviors.…”

“…Some parenting practices are associated with lower or higher levels of externalizing behaviors in autistic children. Internalizing behaviors include symptoms associated with anxiety, mood conditions, and somatization, and externalizing behaviors include behaviors that others may find challenging like aggression, non-compliance, tantrums [ 8 ]. Stress-resilient attributes of parents with children with developmental disorders are considered one of the factors that have a decisive influence on the behavior of parents related to raising their children and that affect greater well-being and life satisfaction [ 9 ].…”

“…Figure 2. STROBE bias analysis sorted by year of publication[6,8,17,20,[29][30][31][32][33][35][36][37][38][39][41][42][43][44].…”