In this chapter, we explore the family dynamics of children and adolescents with autism spectrum disorder (ASD), concentrating on the multifaceted challenges experienced by some caregivers. This includes a discussion of the ASD-specific factors that influence caregiver stress and, in turn, family dynamics, such as challenges involved in obtaining a diagnosis and accessing treatment, stressors related to ASD characteristics, financial strain, and social stigma. We also describe the relationships between children with ASD and their siblings. Drawing on empirical evidence and personal narratives, we highlight the complex issues that professionals who work with children and adolescents with ASD should consider when supporting their needs while considering the well-being of the entire family unit. This chapter concludes with a discussion of how applied behavior analysis (ABA) can enhance family dynamics by mitigating caregiver stress and facilitating positive family interactions. General recommendations for professionals that emphasize compassion and understanding while addressing caregiver concerns are provided.