Trajectories of psychological distress for Australian fathers parenting a child on the autism spectrum: Evidence from early childhood to adolescence.

Fathers from lower socioeconomic and cultural backgrounds were under-represented, and excluded fathers were more likely to have experienced financial hardship and not be in paid employment. Attrition across timepoints and missing data were not random; missing fathers' K6 data reached 22.1%. Autism diagnosis was based on parent report and was not confirmed; diagnosis was not collected at child age 4-5 years and was implied from the mean diagnosis age of 48.37 months. The study did not measure social support at child age 4-5 years in one cohort or parent neurodivergence, so these possible factors were not explored. Ongoing medical conditions were grouped broadly, including physical and mental health conditions, so the effect of specific conditions could not be separated. Fathers' distress and interparental conflict were self-reported, which can be affected by social desirability and cognitive biases. The elevated and increasing distress group was small (45 fathers), so findings for this subgroup may be less stable. Predictors were measured at child age 4-5 years and were associated with later trajectories; the study cannot show causation.

The authors declared no potential conflicts of interest. Funding: M.S. is supported by an Executive Dean of Health Research Fellowship through Deakin University, Melbourne, Australia (2023-2026).

Do not read the 16% elevated and increasing distress group as evidence that most fathers of autistic children have poor mental health. Most fathers (236, 84%) were assigned to the minimal distress trajectory, and the study was observational, so it cannot show that any factor caused distress.