Maternal Stress and Psychological Well-Being in Autism Caregiving: A Multicultural and Structural Narrative Review

Abstract

The current narrative review on multiculturalism compiled evidence about well-being of mothers of children with Autism Spectrum Disorder (ASD) worldwide. Overall, the results suggest that child-specific factors per se are less important for maternal well-being than interactive (child-centred) demands, and peripheral socioeconomic or cultural influences. The universality of stress is explained by a matrix chronic stress and acute caregiving crises, overlaid with gendered discursive by-products care (i.e. affiliate stigma; conceptual invisibility of autism across the spectrum) in many non-Western cultural frames. Family support networks and peer support interventions which are culturally-orientated may counter these stressors (see below), but is access to such protective factors still so profoundly inequitable? The review identifies the following priority areas for future research: Western epistemologies remain dominant; measures used currently are not culturally salient across all populations; and lack of longitudinal studies that reflect diverse samples. The findings inform the development of recommendations for policy and practice: culturally competent service models; interdependent health care and education systems; necessary funding support structures; and litigation-enforceable access to equitable care. By integrating in this final review the three previous excerpted themes, structural sensitivity, cultural centredness and maternal autonomy are shown to together create a path towards a more compelling definition of attuning altogether to build larger feelings of maternal agency and sustainable well-being across distinct sociocultural circumstances.