A comprehensive review of 216 studies reveals persistent emotional and social challenges faced by autistic children and their families worldwide, calling for holistic support strategies beyond symptom management.
A large systematic review has found that quality of life is significantly lower in children and adolescents with autism spectrum disorder, and in the people who care for them, with the greatest strain appearing in emotional and social wellbeing. Published in Autism Research, the analysis pooled data from 216 studies carried out between 2013 and 2025 and found that autistic children and adolescents scored 21.7 points below peers on quality-of-life measures, while caregivers scored 13.64 points lower than comparison groups.
The review, which followed PRISMA guidance and was registered in advance, drew on nearly 14,400 records from major medical databases and preprint servers. The authors said the evidence covered a wide range of validated tools, including the PedsQL, SF-36, WHOQOL-BREF and family-quality-of-life scales. Most of the studies were cross-sectional, meaning they captured a single point in time rather than tracking families over years.
Across the pooled results, overall quality-of-life scores were low for both groups. In autistic children and adolescents, the mean score was 55.75 out of 100, while caregivers averaged about 60.23. Emotional and social domains were the most affected, with caregivers showing especially weak scores in social wellbeing. The review also found no meaningful difference between children and adolescents, suggesting that these challenges persist across development rather than easing with age.
The authors reported wide variation between countries and continents, with higher human development levels linked to better quality-of-life scores. They cautioned that this does not prove a direct causal relationship, but said it points to the importance of service access, social policy and local support systems. They also noted signs of publication bias and a generally mixed risk of bias across the underlying studies, which means the findings should be read as broad trends rather than exact population estimates.
The new review adds to earlier research showing that caregiver wellbeing is closely tied to coping style and social support. A 2022 meta-analytic structural equation modelling study found that positive coping was associated with stronger social support and better family quality of life, while negative coping worked in the opposite direction. A 2019 scoping review likewise concluded that caregivers face high stress and a greater risk of poor mental health, strengthening the case for targeted support. Other recent work has linked family quality of life with sleep problems and screen time, suggesting that practical lifestyle changes may also matter.
Together, the findings point to a clear message for clinicians and policymakers: autism care needs to go beyond symptom management. The authors argued for multidimensional, equitable support that includes mental health care for caregivers, social participation for autistic children and adolescents, and better access to services across different economic settings. In their view, improving quality of life for autistic people means supporting the whole family.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
