ORIGINAL ARTICLE Comparison of Burden Among Primary Care-givers of Children with Autism and Intellectual Disability Against Children with Intellectual Disability Only in a Hospital Population in India Ann Patricia Catherine Suresh & Tanya Elizabeth Benjamin & Jewel Elias Crasta & Merlin Thanka Jemi Alwinesh & Gomathi Kanniappan & Sanjeev M. Padankatti & M. K. C. Nair & Paul Swamidhas Sudhakar Russell Received: 31 March 2014 /Accepted: 22 October 2014 /Published online: 13 November 2014 # Dr. K C Chaudhuri Foundation 2014 Abstract Objective To compare the burden among the primary care- givers (PCG) of children with autism and intellectual disabil- ity (ASD + ID) against intellectual disability (ID) only, and identify the factors that predict high caregiver burden. Methods Children with either ASD + ID (N =41) or ID (N = 56) and their PCG were recruited and assessed using the Family Burden Interview Schedule, Binet Kamat Scale of Intelligence or Gesell’ s Developmental Schedule and Vine- land Social Maturity Scale, Childhood Autism Rating Scale, Sensory Profile and Brief Autism Mealtime Behavior Inven- tory after collecting the socio-demographic details. Appropri- ate bivariate and multivariate statistical test were used. Results The total burden and level of burden was similar among PCG of children with ASD + ID and ID (P =0.8). However, financial burden (P =0.03) and burden due to the effects on the physical health of other family members (P = 0.03) was more among the ID group. The burden due to the effects on family interaction was more (P =0.009) in the ASD + ID group. The socio-economic status (OR=3.60; P =0.03) and the kinship of the primary care-giver (OR=0.37; P = 0.008) were significantly associated with high level of burden. In addition, the diagnosis, and gender of the child contributed to the prediction model for high level of burden. Conclusions The interventions for children with ASD + ID and ID should have modules to address burden among PCG. Disability specific burden alleviating strategies should be used among PCG who are at risk of having high burden. Keywords Autism . Burden . Care-giver . India Introduction A substantial number of family members are directly involved in the care of children with Autism Spectrum Disorders (ASD) and Intellectual Disability (ID) [1]. Some level of burden associated with child-rearing although is normal and even be adaptive for the family members [2], primary caregivers (PCG) of children with ASD experience a higher level of burden than parents of typically developing children and chil- dren with ID [3]. Many factors like uncertainty over health outcomes of the child, daily hassles of medical regimens, social seclusion, role restriction, financial strain and searching for appropriate health care services increase the level of bur- den. Many child related factors like severity of ASD add to their burden [4, 5]. Little data is available about the care-giving burden among PCG of children with ASD from India. The present study compared the perceived burden among PCG of children with Autism Spectrum Disorders and ID (ASD + ID) with another developmental disability namely ID, and the factors that predict PCG burden in these populations. Material and Methods This prospective study was conducted at the Autism Clinic, Child and Adolescent Psychiatry Unit of a teaching hospital in A. P. C. Suresh : T. E. Benjamin : J. E. Crasta : S. M. Padankatti Department of Occupational Therapy, Christian Medical College, Vellore, Tamil Nadu, India M. T. J. Alwinesh : G. Kanniappan : P. S. S. Russell (*) Child and Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College, Vellore 632 002, Tamil Nadu, India e-mail: russell@cmcvellore.ac.in M. K. C. Nair Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, Kerala, India Indian J Pediatr (December 2014) 81(Suppl 2):S179–S182 DOI 10.1007/s12098-014-1626-x