Factors associated with social inclusion of parents of children with autism spectrum disorder: a multicenter cross-sectional study in China.

BACKGROUND

Social inclusion of parents of children with autism spectrum disorder (ASD) affects their well-being and caregiving capacity. However, evidence on its factors remains limited in China. This study aimed to assess the social inclusion of parents of children with ASD and identify key factors, with attention to gender differences.

METHODS

1007 parents were enrolled from 33 rehabilitation centers in Hunan, China. Self-reported psychometric scales and a revised Chinese Social Inclusion Scale were used. Guided by the ecological model, univariate and multivariate regression analyses were performed to identify factors associated with social inclusion. Subgroup analyses and interaction effect tests were carried out to explore potential gender differences.

RESULTS

At the individual level, higher education (B = 1.764, P = 0.02), self-esteem (B = 0.472, P < 0.001), and hope (B = 0.139, P = 0.03) demonstrated positive associations with social inclusion. At the external level, intergroup relations (B = 0.271, P = 0.001) and social support (B = 0.238, P < 0.001) showed significant positive associations, while perceived discrimination (B=-0.189, P < 0.001) exhibited a significant negative association. Gender subgroup analyses showed fathers' inclusion was mainly influenced by self-esteem and social support, while mothers' patterns aligned with the overall group, except hope was not significant.

CONCLUSIONS

Both psychological and social factors influence the social inclusion of parents of children with ASD, with gender-specific patterns. To enhance social inclusion of parents, healthcare providers could consider gender-responsive approaches that strengthen psychological resources while addressing external barriers.