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Rivard M, Mello C, Patel S, Morin M, Morin D. A Window into the Use of Post-diagnostic Services for Autism and Parents' Perspective on the Quality of Early Childhood Services Trajectory in a Canadian Province. J Autism Dev Disord 2024:10.1007/s10803-024-06265-x. [PMID: 38367101 DOI: 10.1007/s10803-024-06265-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/19/2024]
Abstract
The pathway for post-diagnostic services for autism tends to be complex, heterogeneous, and fraught with delays. This situation has repercussions for families' experience with care systems, the quality of early interventions, and family adjustment. To date, studies of parents' point of view on autism services have predominantly focused on the diagnostic phase of the services trajectory. The goal of the present study was to investigate the perspective of parents on autism early childhood services within a public healthcare and social services system in a Canadian province (Québec). Participants were 91 parents who completed a structured framework for the evaluation of the quality of services trajectories, the Evaluation of the services Trajectory in Autism by Parents (ETAP; Mello et al., in Research in Developmental Disabilities 133, 2023). Approximately three-quarters of families received interim services (e.g., punctual speech therapy interventions) for which they had overall neutral-to-positive appraisals but viewed as having comparably low validity and continuity. Although all children diagnosed with autism are entitled to receive early behavioral intervention (EBI) dispensed by the public health and social services system, approximately a quarter of families did not receive this service. Families who received EBI evaluated this service positively on all ETAP dimensions. The empathy (i.e., parent-provider relationships) dimension was rated highest for both interim and EBI services. Some systemic, family, and child-related factors were associated with the perceived quality of services for both interim and early childhood services. Our results emphasize the need for services for children and families as soon as possible, both during assessment and after diagnosis.
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Affiliation(s)
- Mélina Rivard
- Département de Psychologie, succursale Centre-ville, Université du Québec à Montréal, Montréal, Québec, C.P. 8888, H3C 3P8, Canada.
| | - Catherine Mello
- Department of Psychology, The Pennsylvania State University - Berks, State College, USA
| | - Shaneha Patel
- Département de Psychologie, succursale Centre-ville, Université du Québec à Montréal, Montréal, Québec, C.P. 8888, H3C 3P8, Canada
| | - Marjorie Morin
- Département de Psychologie, succursale Centre-ville, Université du Québec à Montréal, Montréal, Québec, C.P. 8888, H3C 3P8, Canada
| | - Diane Morin
- Département de Psychologie, succursale Centre-ville, Université du Québec à Montréal, Montréal, Québec, C.P. 8888, H3C 3P8, Canada
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Cosman T, Finless A, Rideout AL, Lingley-Pottie P, Palmer LD, Shugar A, McDonald-McGinn DM, Swillen A, McGrath PJ, Bassett AS, Cytrynbaum C, Orr M, Meier S. An online survey to understand the needs of caregivers of family members with 22q11 deletion syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:860-868. [PMID: 37449408 DOI: 10.1111/jir.13061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 03/29/2023] [Accepted: 05/24/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Most individuals with 22q11.2 deletion syndrome (22q11DS) have multi-system and lifelong needs requiring substantial support. Their primary caregivers are usually family members who dedicate lifelong time and effort to their role. The pressures of their roles can negatively impact caregivers' psychosocial well-being, suggesting a need for additional support for this community who currently have no specialised interventions available. METHOD This online study surveyed 103 caregivers of family members with 22q11DS to determine the barriers to accessing support that they faced, the kind of support they would value and whether an online intervention could meet their needs. RESULTS The caregivers indicated that a brief online intervention focused on teaching practical skills and connecting them with a peer network of support would be most valuable. CONCLUSIONS Future studies are planned that will build on these results by designing and testing online interventions tailored to this community.
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Affiliation(s)
- T Cosman
- Department of Psychology/Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - A Finless
- Department of Psychology/Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - A L Rideout
- Maritime Medical Genetics Service, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - P Lingley-Pottie
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - L D Palmer
- Dalgish Family 22q Clinic, Department of Psychiatry, Division of Cardiology Department of Medicine, Toronto General Hospital Research Institute, University Health Network, Clinical Genetics Research Program, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - A Shugar
- Division of Clinical and Metabolic Genetics and the Department of Genetic Counselling, the Hospital for Sick Children, Department of Molecular Genetics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - D M McDonald-McGinn
- Division of Human Genetics, 22q and You Center, Clinical Genetics Center, and Section of Genetic Counselling, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - A Swillen
- Center for Human Genetics, UZ Leuven, Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - P J McGrath
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Psychiatry and Specific Care Clinics, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - A S Bassett
- Dalgish Family 22q Clinic, Department of Psychiatry, Division of Cardiology Department of Medicine, Toronto General Hospital Research Institute, University Health Network, Clinical Genetics Research Program, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry and Division of Cardiology Department of Medicine, and Toronto General Hospital Research Institute, University Health Network; Clinical Genetics Research Program and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - C Cytrynbaum
- Division of Clinical and Metabolic Genetics and the Department of Genetic Counselling, the Hospital for Sick Children, Department of Molecular Genetics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - M Orr
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - S Meier
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Psychiatry and Specific Care Clinics, IWK Health Centre, Halifax, Nova Scotia, Canada
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Martin JA, Robertson K, Richards C, Scerif G, Baker K, Tye C. Experiences of parents of children with rare neurogenetic conditions during the COVID-19 pandemic: an interpretative phenomenological analysis. BMC Psychol 2023; 11:179. [PMID: 37291611 PMCID: PMC10249551 DOI: 10.1186/s40359-023-01205-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND The Coronavirus disease 2019 (COVID-19) pandemic has impacted parental and child mental health and wellbeing in the UK. This study aimed to explore the experiences of parents of children with rare neurological and neurodevelopmental conditions with a known or suspected genetic cause (neurogenetic) across the first year of the pandemic in the UK. METHODS Semi-structured interviews were conducted with 11 parents of children with rare neurogenetic conditions. Parents were recruited via opportunity sampling from the CoIN Study, a longitudinal quantitative study exploring the impact of the pandemic on the mental health and wellbeing of families with rare neurogenetic conditions. Interviews were analysed using Interpretative Phenomenological Analysis. RESULTS Four main themes were identified: (1) "A varied impact on child wellbeing: from detrimental to 'no big drama'"; (2) "Parental mental health and wellbeing: impact, changes, and coping"; (3) "'The world had shut its doors and that was that': care and social services during the pandemic"; and (4) "Time and luck: abstract concepts central to parents' perspectives of how they coped during the pandemic". The majority of parents described experiencing an exacerbation of pre-pandemic challenges due to increased uncertainty and a lack of support, with a minority reporting positive effects of the pandemic on family wellbeing. CONCLUSIONS These findings offer a unique insight into the experiences parents of children with rare neurogenetic conditions across the first year of the pandemic in the UK. They highlight that the experiences of parents were not pandemic-specific, and will continue to be highly relevant in a non-pandemic context. Future support should to be tailored to the needs of families and implemented across diverse future scenarios to promote coping and positive wellbeing.
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Affiliation(s)
- Jessica A Martin
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
| | - Kathryn Robertson
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Caroline Richards
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Kate Baker
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Charlotte Tye
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
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