Towards a multi-level family resilience promotion framework: a meta-analysis of factors associated with family resilience in families of autistic children

Dinghua Jia; Changwu Zuo; Fengyang Xu; Xiaoyu Zhuang

doi:10.1186/s40359-026-05162-5

Towards a multi-level family resilience promotion framework: a meta-analysis of factors associated with family resilience in families of autistic children

Dinghua Jia
, Changwu Zuo^*
, Fengyang Xu
, Xiaoyu Zhuang^*

^*Corresponding author for this work

Academy of Wellness and Human Development

Research output: Contribution to journal › Journal article › peer-review

Abstract

Purpose
Families raising autistic children usually experience daily difficulties, such as accommodating their children’s unique communication patterns and behavioral expressions. Despite these potential challenges, families can demonstrate resilience by showing effective family functioning. However, research on the factors that may influence family resilience in this population remains limited. This meta-analysis aims to identify and synthesize the risk and protective factors associated with family resilience among families with autistic children.

Methods
We conducted a systematic review of studies based on six online English databases (PubMed, PsycINFO, Embase, Web of Science, MEDLINE, and Scopus) and two Chinese databases (CNKI and Wanfang). Combined Pearson correlations were calculated by using the random effects model. A moderator analysis was conducted to explore the impact of moderators such as the study region and study quality. The risk of bias and publication bias were also evaluated.

Results
Forty-one studies were examined, where 15 risk and protective factors were identified. Among the 15 factors, 12 are intrapersonal factors (e.g., parental self-efficacy, parental stress, etc.), and 3 are interpersonal factors (social support, family cohesion, and family quality of life).

Discussion
Our findings indicate that the strongest correlations with family resilience were observed among interpersonal factors. In addition, we identified a number of salient (e.g., family cohesion) and contextually unique (e.g., uncertainty about autism) risk and protective factors for family resilience. Building on this, we propose a multi-level family resilience conceptual framework that can inform targeted interventions for families raising autistic children.

Trial registration
This study was registered with PROSPERO (No: CRD42024595923).

Original language	English
Number of pages	27
Journal	BMC psychology
DOIs	https://doi.org/10.1186/s40359-026-05162-5
Publication status	E-pub ahead of print - 16 Jul 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

User-Defined Keywords

Autism spectrum disorder
family resilience
risk/protective factors
meta-analysis

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10.1186/s40359-026-05162-5Licence: CC BY

Cite this

@article{56a9ea5d3e1d438f8d2d18a230de5437,

title = "Towards a multi-level family resilience promotion framework: a meta-analysis of factors associated with family resilience in families of autistic children",

abstract = "Purpose Families raising autistic children usually experience daily difficulties, such as accommodating their children{\textquoteright}s unique communication patterns and behavioral expressions. Despite these potential challenges, families can demonstrate resilience by showing effective family functioning. However, research on the factors that may influence family resilience in this population remains limited. This meta-analysis aims to identify and synthesize the risk and protective factors associated with family resilience among families with autistic children. Methods We conducted a systematic review of studies based on six online English databases (PubMed, PsycINFO, Embase, Web of Science, MEDLINE, and Scopus) and two Chinese databases (CNKI and Wanfang). Combined Pearson correlations were calculated by using the random effects model. A moderator analysis was conducted to explore the impact of moderators such as the study region and study quality. The risk of bias and publication bias were also evaluated. Results Forty-one studies were examined, where 15 risk and protective factors were identified. Among the 15 factors, 12 are intrapersonal factors (e.g., parental self-efficacy, parental stress, etc.), and 3 are interpersonal factors (social support, family cohesion, and family quality of life). Discussion Our findings indicate that the strongest correlations with family resilience were observed among interpersonal factors. In addition, we identified a number of salient (e.g., family cohesion) and contextually unique (e.g., uncertainty about autism) risk and protective factors for family resilience. Building on this, we propose a multi-level family resilience conceptual framework that can inform targeted interventions for families raising autistic children. Trial registration This study was registered with PROSPERO (No: CRD42024595923).",

keywords = "Autism spectrum disorder, family resilience, risk/protective factors, meta-analysis",

author = "Dinghua Jia and Changwu Zuo and Fengyang Xu and Xiaoyu Zhuang",

note = "The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Guangdong Basic and Applied Basic Research Foundation [\#2022A1515111036], and the Guangdong Social Science Research Fund [\#GD22XSH02]. Publisher Copyright: {\textcopyright} The Author(s) 2026.",

year = "2026",

month = jul,

day = "16",

doi = "10.1186/s40359-026-05162-5",

language = "English",

journal = "BMC psychology",

issn = "2050-7283",

publisher = "BioMed Central Ltd.",

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TY - JOUR

T1 - Towards a multi-level family resilience promotion framework: a meta-analysis of factors associated with family resilience in families of autistic children

AU - Jia, Dinghua

AU - Zuo, Changwu

AU - Xu, Fengyang

AU - Zhuang, Xiaoyu

N1 - The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Guangdong Basic and Applied Basic Research Foundation [#2022A1515111036], and the Guangdong Social Science Research Fund [#GD22XSH02]. Publisher Copyright: © The Author(s) 2026.

PY - 2026/7/16

Y1 - 2026/7/16

N2 - Purpose Families raising autistic children usually experience daily difficulties, such as accommodating their children’s unique communication patterns and behavioral expressions. Despite these potential challenges, families can demonstrate resilience by showing effective family functioning. However, research on the factors that may influence family resilience in this population remains limited. This meta-analysis aims to identify and synthesize the risk and protective factors associated with family resilience among families with autistic children. Methods We conducted a systematic review of studies based on six online English databases (PubMed, PsycINFO, Embase, Web of Science, MEDLINE, and Scopus) and two Chinese databases (CNKI and Wanfang). Combined Pearson correlations were calculated by using the random effects model. A moderator analysis was conducted to explore the impact of moderators such as the study region and study quality. The risk of bias and publication bias were also evaluated. Results Forty-one studies were examined, where 15 risk and protective factors were identified. Among the 15 factors, 12 are intrapersonal factors (e.g., parental self-efficacy, parental stress, etc.), and 3 are interpersonal factors (social support, family cohesion, and family quality of life). Discussion Our findings indicate that the strongest correlations with family resilience were observed among interpersonal factors. In addition, we identified a number of salient (e.g., family cohesion) and contextually unique (e.g., uncertainty about autism) risk and protective factors for family resilience. Building on this, we propose a multi-level family resilience conceptual framework that can inform targeted interventions for families raising autistic children. Trial registration This study was registered with PROSPERO (No: CRD42024595923).

AB - Purpose Families raising autistic children usually experience daily difficulties, such as accommodating their children’s unique communication patterns and behavioral expressions. Despite these potential challenges, families can demonstrate resilience by showing effective family functioning. However, research on the factors that may influence family resilience in this population remains limited. This meta-analysis aims to identify and synthesize the risk and protective factors associated with family resilience among families with autistic children. Methods We conducted a systematic review of studies based on six online English databases (PubMed, PsycINFO, Embase, Web of Science, MEDLINE, and Scopus) and two Chinese databases (CNKI and Wanfang). Combined Pearson correlations were calculated by using the random effects model. A moderator analysis was conducted to explore the impact of moderators such as the study region and study quality. The risk of bias and publication bias were also evaluated. Results Forty-one studies were examined, where 15 risk and protective factors were identified. Among the 15 factors, 12 are intrapersonal factors (e.g., parental self-efficacy, parental stress, etc.), and 3 are interpersonal factors (social support, family cohesion, and family quality of life). Discussion Our findings indicate that the strongest correlations with family resilience were observed among interpersonal factors. In addition, we identified a number of salient (e.g., family cohesion) and contextually unique (e.g., uncertainty about autism) risk and protective factors for family resilience. Building on this, we propose a multi-level family resilience conceptual framework that can inform targeted interventions for families raising autistic children. Trial registration This study was registered with PROSPERO (No: CRD42024595923).

KW - Autism spectrum disorder

KW - family resilience

KW - risk/protective factors

KW - meta-analysis

UR - https://link.springer.com/article/10.1186/s40359-026-05162-5

U2 - 10.1186/s40359-026-05162-5

DO - 10.1186/s40359-026-05162-5

M3 - Journal article

SN - 2050-7283

JO - BMC psychology

JF - BMC psychology

ER -

Towards a multi-level family resilience promotion framework: a meta-analysis of factors associated with family resilience in families of autistic children

Abstract

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