Managing Tensions in Intergenerational Care of Children With Autism Spectrum Disorder in China: A Qualitative Study of Grandparents’ Experiences

This exploratory qualitative study examines how grandparents of children with Autism Spectrum Disorder (ASD) in China experience and cope with tensions in the context of daily intergenerational family caregiving. Seventeen grandparents were interviewed using semi-structured interviews conducted in three provinces of western China. Data were analyzed using thematic analysis. The Consolidated Criteria for Reporting Qualitative Research was used to guide the specific processes of this study. Two main themes were identified: intergenerational tensions within the family system and coping with intergenerational tensions. Specific tensions included responsible but unrecognized family role, conflicts between experiential and expert knowledge, hesitation in family care process, being caught in the middle of family conflicts, and personal life sacrificed to care. Coping strategies involved protecting harmony through silence and withdrawal, compromise in family care, psychological adjustment and acceptance, and turn emotions toward grandchildren. These findings highlight how grandparents navigate care not only through practical routines but also through moral and emotional labor shaped by cultural norms. This study contributes to a more inclusive understanding of caregiving of children with ASD and calls for culturally responsive, extended-family-oriented support systems in Chinese and similar cultural contexts.