Objective:

To investigate the cross-cultural associations between emotional/behavioural and cognitive/adaptive differences in autistic children and parental wellbeing.

Approach:

• Study Design: Cross-sectional, observational study using multinational data from parents of autistic children across five countries.
• Participants: Data were obtained from 219 autistic children aged up to 18 years across Australia, Singapore, Hungary, Romania, and the United Kingdom.
• Assessment: Standardised instruments assessed parental QoL, parental stress, child’s behavioural/emotional difficulties, and cognitive/adaptive differences.
• Analysis: Multivariable logistic regression models examined associations between children’s autistic difficulties and parental wellbeing.

Key Findings:

• Higher emotional/behavioural difficulties in children were significantly associated with lower parental QoL (AOR = 0.36, 95% CI 0.11-0.97) and increased parental stress (AOR = 2.11, 95% CI 1.08-4.54).
• Cognitive/adaptive difficulties did not show a statistically significant association with parental QoL or stress.
• No evidence of country- or measure-level heterogeneity for parental wellbeing outcomes, indicating consistent associations across cultures.

Interpretation:

Emotional and behavioural difficulties in autistic children are linked to poorer parental quality of life and increased stress across diverse cultures.

Limitations:

• Different standardised instruments were used across countries, which may affect comparability.
• The study's cross-sectional design limits causal inferences.

Conclusion:

The findings suggest the importance of early identification and culturally responsive supports to improve wellbeing for both autistic children and their parents.