Parents of 44 autistic children rated their children's symptom severity and their own stress on a 14-item symptom scale. Thirteen child and family characteristics were also examined to assess how they affected symptom perception and stress. Preschoolers were rated less symptomatic by their parents than by clinicians. Lower functioning, nonverbal, odd-looking, self-abusive, seizuring and hyperirritable children were rated more symptomatic than their peers. Best predictor of stress for both parents was a child's self-abuse; for mothers hyperirritability and older age were also associated with elevated stress scores. Compared with parents of matched normal children, mothers of autistic children reported the most aggravations and expressed the need for additional support from their spouses.