An Assessment on Daily Work-Life Balance Among Parents with Autistic Children

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by persistent difficulties in social communication and interaction, along with restricted or repetitive patterns of behaviour. The condition generally begins in early childhood and continues throughout life, often requiring long-term support in areas such as education, therapy, communication, and daily functioning ^[1]. The global prevalence of ASD has increased over recent decades, with current estimates indicating that approximately 1 in 100 children are affected worldwide ^[2]. In India, the prevalence of ASD has also shown an increasing trend, reflecting improved awareness, early diagnosis, and expanded access to healthcare services ^[3]. In addition to providing continuous caregiving and coordinating therapy sessions, many parents must simultaneously fulfil occupational and family responsibilities. Balancing these multiple roles often results in increased stress, reduced work productivity, financial strain, and impaired psychological well-being ^[4]. However, limited research has comprehensively evaluated parents knowledge of ASD, their attitudes towards balancing employment and caregiving, and the barriers affecting their daily work–life balance, particularly in the Indian healthcare setting. Understanding these aspects is essential for identifying the challenges faced by parents and for developing supportive workplace policies and family-centred interventions ^[5,6]. The present study was conducted to assess knowledge and awareness regarding ASD, attitudes towards balancing employment and caregiving responsibilities, and perceived barriers to maintaining daily work–life balance among parents of children with ASD. A total of 53 parents, predominantly mothers, participated in the study. Data were collected using a structured self-administered questionnaire consisting of four sections covering sociodemographic characteristics, knowledge, attitude, and perceived barriers.

MATERIALS AND METHODS

A hospital-based, cross-sectional study was conducted to assess the knowledge, attitude, and perceived barriers regarding daily work–life balance among parents of children with ASD. Participants were recruited using a convenience sampling method based on their availability and willingness to participate during the study period. The study was conducted at NIMS Spectrum Child Development and Research Centre, NIMS Medicity, Trivandrum. The sample size of the study was 57. Of these, 53 parents completed the questionnaire, and their responses were included in the final statistical analysis. The survey was conducted among the parents having autistic children within the age group of 25 - 40 years from April – May 2026. The researcher obtained signed informed consent and explained the background of the study, the purpose, the principle of privacy and confidentiality and the precaution before conduction the survey. The questionnaire was prepared after reviewing relevant literature and was assessed for content validity by subject experts. Necessary modifications were incorporated based on expert recommendations before its administration. There questionnaire included 3 sections including understanding and knowledge, attitude and barriers which constitute a total of 28 questions.  All the data were entered in Microsoft Excel Spreadsheet and proper analysis was carried out using Jamovi version 2.7.18. The study was conducted after protocol approval by the Institutional Research Committee of Ezhuthachan College of Pharmaceutical Sciences.

Inclusion Criteria 

• Parents [Mother if not available, Father] of a child diagnosed with Autism.
• Parents of children who are willing to participate in the study.

Exclusion Criteria 

• Parents of children with other developmental disorders or disabilities.
• Those who are not willing to participate and were failure to complete the questionnaire.
• Parents of children without a confirmed diagnosis of ASD.

Statistical Analysis

Descriptive statistics including frequencies, percentages, mean, standard deviation, median, and interquartile range were used to summarize the data. Associations between categorical variables including age group, gender, occupation and the classified levels of knowledge, attitude and barriers were examined using the Chi-square test while Pearson’s correlation coefficient was applied to determine the relationship between knowledge, attitude, and barrier scores. A p-value of less than 0.05 was considered statistically significant. A p-value of less than 0.05 was considered statistically significant. Data analysis was performed using “Jamovi version 2.7.18.

RESULTS

Demographic Characteristics

Among the 57 parents recruited, 53 provided complete responses and were considered for analysis. Table 1 summarizes the sociodemographic characteristics of the participants. Females accounted for the majority of the study population (98.1%), while over half of the participants were aged 25–29 years (52.8%). Employment was the most common occupational status (35.8%).

Figure 1: Histogram of age in years

Figure 2: Percentage distribution of participants by gender

Figure 3: Percentage distribution of participants by Occupation

Figure 5: Percentage distribution of participants by of Knowledge level

Figure 6: Percentage distribution of overall Barrier levels

DISCUSSION

The present study found that most parents (79.2%) of children with Autism had good knowledge and 83% had a positive attitude towards balancing employment and caregiving responsibilities, although they experienced significant barriers in maintaining work–life balance. These findings are similar to the study by Dr. Nihal Rehim et al. (2025), which reported that participants had good knowledge of ASD, but higher knowledge did not always lead to better practical outcomes or confidence ^[7]. Likewise, in the present study, despite parents having good knowledge and awareness, 54.7% experienced severe barriers in maintaining work–life balance. This suggests that knowledge alone is not sufficient to reduce the challenges faced by parents and should be supported by practical assistance and workplace accommodations. The finding from other studies reported that although participants demonstrated good knowledge, their attitudes and confidence in applying that knowledge were only moderate. The present findings are also consistent with Zuleyha Cidav et al. (2012), who reported that parents, especially mothers of children with ASD, were less likely to be employed, worked fewer hours, and experienced financial difficulties ^[8]. However, many parents still faced major challenges such as financial burden, long working hours, therapy appointments, and limited family or workplace support. The significant relationship between attitude and barriers indicates that parents who are more aware of work–life balance also recognize the challenges they face more clearly. In addition, the findings agree with Gülsah Zengin Yazici and Yildirim et al. (2025), found that parents of children with autism had reduced occupational balance and lower life satisfaction. Therefore, the present study supports previous research and emphasizes that improving work–life balance among parents of children with ASD requires not only awareness but also financial support, flexible workplace policies, and stronger family and community support systems ^[1,9]. The present study also showed that 83% of parents had a positive attitude, but many were uncertain about flexible working hours, workplace support, and equal sharing of caregiving responsibilities. Both studies indicate that improving awareness alone is not enough, and parents require guidance, counselling, and supportive policies to confidently manage both employment and caregiving responsibilities. More than half of the parents in the present study experienced severe barriers, with financial burden, long working hours, therapy appointments, limited family support, and inadequate workplace support being the most common problems. Similarly, the present study found that financial burden was the most frequently reported barrier affecting work–life balance, highlighting the significant economic impact of caring for a child with ASD. Overall, the present study agrees with previous research by showing that parents of children with ASD generally have good awareness of the disorder but continue to face significant financial, occupational, and social challenges. These findings highlight the need for family-centered interventions, flexible workplace policies, caregiver support programmes, and financial assistance to improve the quality of life and work–life balance of parents caring for children with ASD ^[10,11]. These findings are consistent with Karst et al. (2012), who reported that although parents of children with ASD are well informed about their child's condition, they experience high levels of caregiver stress and difficulties in managing family and work responsibilities ^[4,12].

CONCLUSION

The study concludes that parents of children with ASD generally possess good knowledge and demonstrate a positive overall attitude towards balancing caregiving and employment responsibilities. Nevertheless, a large proportion experience moderate to severe barriers that interfere with their daily work–life balance ^[13]. Financial strain, long working hours, frequent therapy and hospital visits, limited family support, and insufficient workplace support emerged as major challenges. Thus, the burden experienced by these parents appears to arise not primarily from a lack of awareness, but from practical, financial, occupational, and social constraints. These findings emphasise the need for family-centred interventions, caregiver education programmes, flexible workplace policies, and financial assistance to support parents caring for children with ASD. Policymakers and healthcare professionals should collaborate to develop services that reduce caregiver burden and promote a healthier work–life balance ^[15]. Future research involving larger and more diverse populations from multiple centres is recommended to further explore factors influencing work–life balance and to evaluate interventions aimed at improving the well-being of parents of children with ASD.

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