Families raising children with special needs frequently manage sustained caregiving demands, uncertainty, role strain, service navigation burdens, and concerns about the child’s future. Parental stress is consistently elevated across autism, intellectual and developmental disabilities, special educational needs, and chronic pediatric conditions, but the magnitude and meaning of this stress vary significantly based on family resources, coping processes, and the broader ecological context. This article offers a critical narrative review of major psychological models used to explain parental stress, coping, and family functioning in these families. Rather than treating parental distress as a direct or inevitable consequence of diagnosis, the review argues that adaptation is better understood as a dynamic, transactional, and systemic process shaped by appraisal, child behavior, social support, family organization, meaning-making, and access to services. Five major conceptual traditions are synthesized: the transactional model of stress and coping; the Double ABCX model; the Family Adjustment and Adaptation Response model; family systems perspectives, including the McMaster model; family resilience frameworks; and ecological systems theory. Across these traditions, several robust conclusions emerge. First, behavior problems, caregiving intensity, and unmet support needs often predict parental stress more strongly than diagnosis alone. Second, coping is not merely an individual act but a family-embedded process that interacts with a couple’s functioning, co-parenting, and social support. Third, family functioning is both a context for adaptation and an outcome affected by prolonged stress. The review concludes with an integrative framework and implications for assessment, intervention, and future research.
Cao et al. (2026) studied this question.