What Every Professional Needs to Know about Parent Stress and Autism

Last week London McCabe, an autistic six-year old, died a senseless, tragic and preventable death at the hands of his mother.  As professionals, there are steps we can take to prevent additional casualties of innocent lives.  The first thing we can do is to examine our own beliefs and make sure we are not communicating to parents that autism is a tragedy and something that should be “fixed”.  We must embrace a “presuming competency” model that helps parents understand, rather than fear neurodiversity. This includes helping parents reframe and successfully manage challenging behaviors as early as possible.

The second thing we can do is assess risk. Parents of autistic children are an invisible population, and many studies have documented that they experience anxiety and depression at rates much higher than the general population.  How do we find out which parents are most vulnerable, and get them help before they are a danger to their children?  One answer is that all professionals need to start attending to the mental health of parents, as they are not routinely provided with mental health support or services when their child is treated for developmental delays. The mental health of parents is left out of the equation, leaving them in a service delivery “vacuum”.

Even though the vast majority of professionals who work with special needs children are not mental health providers, we all have regular contact with parents. Speech and language therapists, occupational therapists, behavior therapists, service coordinators and teachers can learn how to identify parents who may be most vulnerable. The following are potential risk factors based on parent stress research.

Parents who have:

1. Fewer financial resources

2. Fewer sources of social support from family or community

3. A prior history of mental health issues

4.  A child who has not developed spoken language and/or has severe behavior difficulties

5. Ongoing feelings of hopelessness

6. A reduced ability to see positive attributes in his/her child

Chronic, unrelenting stress combined with the above risk factors, can help predict which parents require more support. As professionals, we must all learn how to nurture the sanctity of the parent/child relationship and help parents see positive attributes in their children. We also need to get better at identifying risk as part of all treatment paradigms. In doing so, we can join together to prevent more senseless deaths of innocent children.


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Thank you for writing this Dr. Mona. While I most certainly adore my children and feel absolutely blessed to know them sometimes stress gets the best of you. My son not sleeping for over two years now has been the thing that I struggle with the most, not sleeping right alongside him. I always think if I feel this bad how must he feel, he is non-speaking and cannot tell me really. Sleep deprivation is my lowest point as a parent.