REVIEW PAPER A Systematic Review of Factors Relating to Parental Satisfaction with the Diagnostic Process for Autism Spectrum Disorder Adam W. McCrimmon 1 & Shawna M. Gray 1 Received: 4 July 2019 /Accepted: 5 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract Diagnostic assessment for autism spectrum disorder (ASD) is a complex and often stressful process for parents. This systematic review synthesized results of 26 articles that reported on factors related to parental (dis)satisfaction with the diagnostic process for ASD. The results are described in terms of factors related to satisfaction and those related to dissatisfaction (with some overlap between these), in the context of temporality within the diagnostic process. Subsequently, factors are described in terms of those that can be directly influenced by clinicians and those that are outside of direct clinician control. Implications of the findings and directions for future research are provided. Keywords Autism spectrum disorder . Diagnosis . Parents . Satisfaction Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder whose prevalence has in- creased dramatically over the past several decades (Baio et al., 2018). In alignment with this increase, re- search efforts have targeted effective assessment pro- cesses and related clinical activities to identify individ- uals with ASD. This paper will systematically review literature pertaining to an essential assessment-related consideration—the diagnostic assessment process and factors related to parental (dis)satisfaction with it. This topic has been explored by many researchers; however, the information arising from these studies has yet to be formally reviewed and synthesized for the benefit of clinicians and researchers. We begin by providing a brief description of ASD and an overview of common assessment approaches. We then report on literature pertaining to parental (dis)satisfaction with the assess- ment process and conclude with implications for clinical practice and suggestions for further research. ASD Assessment ASD is a pervasive (i.e., lifelong) neurodevelopmental disor- der characterized by impairment of socio-communicative functioning in conjunction with restricted and/or repetitive patterns of behaviours, activities, or interests as described in the current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychological Association [APA], 2013). Affected individuals experience qualitative impairment of social reciprocity, nonverbal com- munication, and peer relationships in addition to the demon- stration of stereotyped or repetitive speech, motor movements, or use of objects, insistence on sameness or adherence to rou- tines/rituals, fixated interests, and/or sensory interests or sen- sitivities. There is heterogeneity in phenotypic expression of these behavioural symptoms with varying severity and num- ber of symptoms across individuals and, in some cases and domains, across time (Richler et al., 2010; Szatmari et al., 2002). As such, ASD is considered a ‘spectrum’ disorder with affected individuals demonstrating differential cognitive, lan- guage, social, and behavioural abilities (National Research Council, 2001). As a result of the variability of symptom presentation, clin- ical assessment and diagnostic practices for ASD are complex. Assessment and diagnosis of ASD most often, though not always, occurs before elementary school (Centers for Disease Control and Prevention, 2007; Shea & Mesibov, 2009). Clinicians often strive to diagnose children as early * Adam W. McCrimmon awmccrim@ucalgary.ca 1 Werklund School of Education, University of Calgary, Calgary, Alberta, Canada Review Journal of Autism and Developmental Disorders https://doi.org/10.1007/s40489-020-00224-9