Abstract

Background and Aim: Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders and has profound effects on family dynamics and caregivers’ mental health. This systematic review aimed to identify and categorize the psychological and family-related challenges experienced by caregivers of children with autism and to examine effective coping strategies.

Methods: A systematic search was conducted in reputable databases, including PubMed, Scopus, ScienceDirect, Magiran, SID, and Google Scholar, up to 31 Mordad 1405 (22 August 2026). Articles meeting the inclusion criteria included quantitative–qualitative, qualitative, and review studies concerning the psychological and family challenges of caregivers of children with autism. Methodological quality was assessed using the CASP and AMSTAR tools.

Results: Of the 126 articles retrieved in the initial search, 11 relevant articles were fully reviewed. The findings indicate that mothers, as primary caregivers, experience the highest levels of stress, anxiety, and depression. The main challenges were categorized into six domains: (1) delayed diagnosis and flawed diagnostic processes; (2) difficulty accepting the diagnosis and coping with the child’s behavioral symptoms; (3) poor access to treatment services and social support; (4) financial problems and reduced parental employment; (5) lack of adequate leisure and educational activities; and (6) social stigma and social isolation. Predominant coping strategies included religious and spiritual support, seeking social support, and use of specialized rehabilitation services.

Conclusion: Autism spectrum disorder imposes considerable psychological and emotional strain on families, particularly mothers. Designing comprehensive support systems, ensuring access to specialized services, and training in coping strategies are essential to reduce caregivers’ psychological burden and improve the quality of life of families with a child with autism.