Physical abuse of autistic children by parents: a systematic review of prevalence, influencing factors, and impacts

Children with Autism Spectrum Disorder (ASD) are at a disproportionately high risk of parental physical abuse. This systematic review examines the prevalence, parental perceptions, and the multi-level influencing factors of physical abuse against autistic children. Findings indicate that the prevalence of physical abuse is alarmingly high, ranging from 8.3% to 69.7%. Parents often normalise violence, misinterpreting autism-related behaviours as wilful defiance and viewing physical punishment as justified. Key risk factors operate at structural, interactional, and individual levels, includingin sufficient policy support, maladaptive parent-child interactions, parental mental health issues, and child characteristics such as age and symptom severity. Abuse harmed children’s emotional, behavioural, cognitive development and strained parent-child relationships. This review calls for a multi-system intervention framework that integrates policy support, parental cognitive interventions, trauma-informed care for children, and community resources. High-quality, cross-cultural, mixed-methods longitudinal studies are needed to clarify the dynamics of abuse and evaluate intervention effectiveness.