{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:53:09Z","timestamp":1781711589767,"version":"3.54.5"},"reference-count":42,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Marth and Vincent Wagar Intellectual Disability and Autism Research Fund"},{"name":"Jack Laidlaw Endowed Chair in Patient-Centered Healthcare"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,5,15]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Autistic children can experience elevated levels of emotional and behavioural problems, which adversely impact their psychosocial functioning. Positive parenting behaviours can significantly shape children\u2019s emotional and behavioural developmental trajectories. However, for autistic children, these parenting behaviours may vary depending on their social, sensory and intellectual profiles. Literature on the association between parenting behaviours and autistic children\u2019s internalising and externalising symptoms has been mixed. Thus, the main objective of this study will be to conduct a systematic review and meta-analysis of studies evaluating the effect of parenting behaviours on autistic children\u2019s internalising and externalising symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Included studies have child samples between ages 6 and 17 years and a primary diagnosis of autism\/Autism Spectrum Disorder (ASD), pervasive developmental disorder and\/or Asperger\u2019s syndrome as well as a measure of parenting behaviour. Primary outcomes are internalising and externalising symptoms. Substantive and methodological moderators will be examined. Searches will be conducted in MEDLINE, PsycINFO, Embase, Education Resources Information Center (ERIC) and ProQuest Dissertations and Theses Global from their inception onwards, and we will also conduct backward\/forward searching of eligible studies. Published and unpublished studies will be examined. Two independent reviewers will conduct title\/abstract and full-text screening as well as data extraction. Risk of bias will be assessed using the Newcastle-Ottawa Quality Assessment Scale and JBI Critical Appraisal tools. A random-effects meta-analysis model will be used, and summary effect sizes will be calculated. Moderation will be examined via Q-statistics and meta-regression to determine factors contributing to between-study variation in effect sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics approval is not required, as this review will use secondary data from published studies. Results will be disseminated through a peer-reviewed publication and conference presentations. The protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42024528043).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>PROSPERO CRD42024528043.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-116131","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:10:31Z","timestamp":1781709031000},"page":"e116131","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Parenting behaviours and autistic children\u2019s internalizing and externalizing symptoms: a protocol of a systematic review and meta-analysis"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6879-2292","authenticated-orcid":false,"given":"Krysta","family":"Andrews","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada"},{"name":"Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawal","family":"Masood","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arooba","family":"Mansoor","sequence":"additional","affiliation":[{"name":"Faculty of Science, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada"},{"name":"Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Drmic","sequence":"additional","affiliation":[{"name":"Ron Joyce Children\u2019s Health Centre, McMaster Children\u2019s Hospital, Hamilton Health Sciences, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada"},{"name":"Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada"},{"name":"Ron Joyce Children\u2019s Health Centre, McMaster Children\u2019s Hospital, Hamilton Health Sciences, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"2026061708101773000_16.6.e116131.1","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.jaac.2024.11.004","article-title":"Early-Onset Trajectories of Emotional Dysregulation in Autistic Children","volume":"64","author":"Bennett","year":"2025","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2026061708101773000_16.6.e116131.2","doi-asserted-by":"crossref","first-page":"2064","DOI":"10.1007\/s10803-018-3467-3","article-title":"Profiles of Social and Coping Resources in Families of Children with Autism Spectrum Disorder: Relations to Parent and Child Outcomes","volume":"48","author":"Zaidman-Zait","year":"2018","journal-title":"J Autism Dev Disord"},{"key":"2026061708101773000_16.6.e116131.3","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1080\/15374416.2020.1750021","article-title":"Profiles and Predictors of Academic and Social School Functioning among Children with Autism Spectrum Disorder","volume":"50","author":"Zaidman-Zait","year":"2021","journal-title":"J Clin Child Adolesc Psychol"},{"key":"2026061708101773000_16.6.e116131.4","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000308"},{"key":"2026061708101773000_16.6.e116131.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.2003.00567.x"},{"key":"2026061708101773000_16.6.e116131.6","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/S2215-0366(19)30289-5","article-title":"Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis","volume":"6","author":"Lai","year":"2019","journal-title":"Lancet Psychiatry"},{"key":"2026061708101773000_16.6.e116131.7","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-006-0147-5"},{"key":"2026061708101773000_16.6.e116131.8","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association . 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