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This study analyzes the 2021 National Survey of Children’s Health to examine family resilience while raising children with mental, emotional, developmental, or behavioral (MEDB) conditions. Guided by the original ABCX stress–adaptation framework and its double-ABCX extension, we test how parent stress (A), resources (B), and meaning appraisal (C) predict family adaptation (X). Structural models identify coping strategies and social support as key mediators linking perceived stress to resilience. Higher stress is associated with stronger coping and broader support networks, which in turn significantly enhance family resilience, especially among culturally and linguistically diverse households. Findings clarify mechanisms families use to buffer MEDB-related challenges, suggest targets for interventions and policy, and highlight directions and limitations for future research.