ORIGINAL RESEARCH article
Front. Psychol.
Sec. Human Developmental Psychology
Challenging Behaviours in Children with Autism Spectrum Disorder and Parental Quality of Life and the Association of Challenging Behaviours with Parental Quality of Life
Norazlin Kamal Nor 1,2
Nur Hidayah Yahya 2
Wai Wai Yang 1,2
NurAzah Isa 2
Wan Syanaz Wan Ghazali 2
1. Universiti Kebangsaan Malaysia Faculty of Medicine, Kuala Lumpur, Malaysia
2. Hospital Tunku Ampuan Besar Tuanku Aishah Rohani Hospital Pakar Kanak-Kanak UKM, Kuala Lumpur, Malaysia
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Abstract
Word count: 328 Background: Autism spectrum disorder (ASD) is frequently associated with challenging behaviours (CBs). CBs can make caring for children with ASD difficult and negatively impact the quality of life (QoL) of their parents. Understanding CB prevalence, subtypes, their predictors and how they affect the quality of life of their parents are crucial to optimize ASD management. Objectives: This study was conducted to determine the prevalence and types of challenging behaviours in children with ASD, and factors that predict them. The quality of life in parents of children with ASD, and predictors for these, were also assessed. Finally, the association between challenging behaviours and quality of life in parents of children with ASD was determined. Methods: In this purposive consecutive study, a total of 166 parents of children with ASD aged between 2 to 18 years old were recruited from the Child Development Centre in Universiti Kebangsaan Malaysia between 1st June 2021 and 31st May 2022. The ASD-BPC questionnaire was translated to the Malay language and used to assess prevalence and subtypes of challenging behaviours in ASD children. The quality of life of parents with ASD children was ascertained using the Quality of Life in Autism (QoLA) questionnaire. Univariate and multivariate regression were performed to assess predictors for CBs and parental quality of life. Mann-Whitney test assessed the association between CBs and parental quality of life.Results: The overall prevalence of CBs in ASD children was 89.8%, with the highest prevalence seen for stereotypic behaviours (75.9%). The predictors for CBs were younger child age and lower family income. The median quality of life score in parents of ASD children in this study was 103.0 (IQR:25). CBs in ASD children were associated with lower parental quality of life, especially those with 'aggressive/ disruptive' (p=0.041) and 'self-injurious' behaviours (p=0.042). Conclusions: The prevalence of challenging behaviours amongst ASD children in this study was high (89.8%). Presence of aggressive or disruptive and self-injurious behaviours were linked to lower quality of life in parents of children with ASD.
Summary
Keywords
ASD-BPC, Autism Spectrum Disorder, Challenging behaviours, parental quality of life, QoLA, Stereotyped behaviors
Received
11 February 2025
Accepted
03 February 2026
Copyright
© 2026 Kamal Nor, Yahya, Yang, Isa and Wan Ghazali. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Norazlin Kamal Nor
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