Should Parents of an Autistic Child Have a Second Child?

You've always planned to have several children. Then your first child was diagnosed with autism, and you've struggled to come to terms with all that the diagnosis entails. Life with an autistic child is tougher than you'd anticipated, but it also comes with its own joys. Now it's time to ask the question "should you get pregnant again?"

Two siblings playing in the sand
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A Complex Question to Consider

This question is, of course, only relevant to families who feel comfortable with birth control. But for those families, the question is very complex. Researchers agree that couples with one autistic child do have an increased risk of having a second child with the disorder, though the exact level of risk is debatable. This means you'd need to feel comfortable with the possibility of raising multiple children with disabilities. In addition, when considering this issue, parents need to examine their feelings. Here are just a few of the possible challenges that may arise if you say "yes" to a second child:

  • You may feel guilty about "short changing" their autistic child by tending to a second child's needs;
  • You may feel anxious about their ability to manage the needs of a second child, especially if that child is also autistic;
  • You may feel worried about whether your finances, energy, and personal resources will be enough to manage a larger family that includes at least one disabled child;
  • You may feel hopeful about the possibility of having a child whose experiences will be closer to those of other children around them;
  • You may feel mixed emotions about the idea of bringing a child into the world knowing that he or she, if typically developing, will ultimately have to take on at least some responsibility for a disabled sibling.

A Psychologist's Perspective

Robert Naseef, Ph.D., and Cindy Ariel, Ph.D. specialize in working with parents of children with special needs. Here is their advice to parents as they consider conceiving a second child.

You are not alone, as an individual or as a couple, in facing the risks of what seems like a genetic lottery. Research now confirms that the risk of having a child who will be eventually diagnosed on the autistic spectrum is high. While this is nothing to take lightly, still the chances of having a neurotypical child are far greater. This makes this a personal decision that will shape the rest of your life and your family’s life.

What happens if you do have more than one child on the spectrum? One thing is sure: These children are different as individuals in terms of their functional levels and their personalities. They are also quite connected to each other as siblings.

Some parents cope well, and others are overwhelmed. Some have no regrets and love and cherish each child as unique and special in the universe. Others wish they had never tried to have another child and wonder what might have been. There are also couples who cannot make up their minds as well as couples deeply divided on the issue. There are also many people who had a neurotypical child and feel “brand new.”

With all this in mind, it is important to talk openly and honestly about your reasons for wanting another child and about how they would feel if they had another child with special needs. Also, it is essential to consider what kind of life that hoped-for neurotypical child might have. The most important thing is to not push your partner one way or the other while being really honest about how you imagine you would deal with a second child with autism as well as how you could deal with each other without trying to have a second child. Some people resent each other and even if they stay married, they begin to live separate emotional lives.

Another way to look at life in your situation is to put all of your parenting energy in the child you have. The joy and satisfaction can make you happy for a lifetime if you are secure with this decision for yourself and your marriage. Some people go the adoption route which is also not without risks. So you have a lot to think about. Definitely, there is no right or wrong decision.

What’s important is how you get there. If you still can’t arrive at a decision you are both comfortable with, you might want to consider consulting with a mental health professional who has experience helping people sort out these kinds of dilemmas. Having a child with a disability such as autism certainly teaches how little we are in control of. What we do have control over is the decisions that we can make when we do so with an open and clear mind.

A Word From Verywell

If you do have a neurotypical second child, he or she will eventually live with the struggles inherent in having a sibling who does not develop in the same way as other children. But that's not necessarily a bad thing. Many children with siblings with special needs develop a maturity and tolerance not seen as often in the general population. The fact of having a sibling on the spectrum may be more of a blessing than a curse.

Whatever the decision you make, it's important to remember that you have no obligation to anyone except yourselves and your children. Neither grandma, your best friend, or your sister have the right to make the decision for you.

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  1. Grønborg TK, Schendel DE, Parner ET. Recurrence of autism spectrum disorders in full- and half-siblings and trends over time: a population-based cohort study. JAMA Pediatr. 2013;167(10):947-53. doi:10.1001/jamapediatrics.2013.2259

Additional Reading
  • Gronborg, T. K., Schendel, D. E., & Parner, E. T. (2013). Recurrence of autism spectrum disorders in full- and half-siblings and trends over time: A population-based cohort study. JAMA Pediatrics, 2259, E1-E7.

  • Kaiser Permanente. Autism risk in younger children increases if they have older sibling with disorder. Science Daily, 5 August 2016
  • Ozonoff, Sally et al. Recurrence risk for autism spectrum disorders: a baby siblings research consortium study. Pediatrics, August 2011.