Caregiver Burden in Autism Spectrum Disorder: Insights from A Tertiary Hospital in West Africa.

Abstract

Background: Caregiving for children with autism spectrum disorder is associated with substantial psychological, social, and financial burden, particularly in low-resource settings. This study aimed to assess the magnitude and determinants of caregiver burden among caregivers of children with ASD in a tertiary hospital in Nigeria.

Methodology: This cross-sectional study analysed 420 caregivers of children aged 2-18 years diagnosed with autism spectrum disorder, which was conducted at Benue State University Teaching Hospital (2020- 2023). The Stress Process Model was used, and the Caregiver burden was assessed using the Zarit Burden Interview (ZBI-22). Child behavioural difficulties, financial hardship, and affiliate stigma were evaluated using structured scales. Data were analysed using Pearson correlation and multiple linear regression.

Results: The mean ZBI score indicated moderate-to-severe burden. Overall, 60% of caregivers experienced moderate-to-severe or severe burden. Significant correlations were observed between caregiver burden and child behavioural difficulties (r = 0.58, p < 0.001), financial hardship (r = 0.38, p < 0.001), and affiliate stigma (r = 0.45, p < 0.001). In multivariate analysis, all three factors independently predicted caregiver burden, with the overall model explaining 52.8% of variance (Adjusted R²= 0.528).

Conclusion: Caregiver burden in ASD is substantial and driven by behavioural, financial, and sociocultural factors. Interventions must integrate behavioural support, financial assistance, and stigma reduction strategies to improve caregiver well-being.