1
|
“People Keep Staring At You In Public For No Reason”: Experiences And Coping Strategies Of Parents WITH Autistic Children In Accra, Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2023. [DOI: 10.1016/j.ijans.2023.100536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
|
2
|
Stein Duker LI, Goodman E, Pomponio Davidson A, Mosqueda L. Caregiver perspectives on barriers and facilitators to primary care for autistic adults: A qualitative study. Front Med (Lausanne) 2022; 9:1022026. [PMID: 36438029 PMCID: PMC9685801 DOI: 10.3389/fmed.2022.1022026] [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] [Received: 08/18/2022] [Accepted: 10/27/2022] [Indexed: 09/19/2023] Open
Abstract
Background Primary care is associated with greater access to healthcare services and improved health outcomes. However, autistic adults report challenges accessing and utilizing primary care, in addition to unmet healthcare needs. The need to minimize existing barriers and identify strategies to facilitate successful healthcare encounters is increasingly important as autistic adults represent a growing segment of society. Minimal research has examined primary healthcare encounters for this population. Methods As part of a larger convergent parallel design mixed-methods study that recruited autistic adults, caregivers of autistic adults, and primary care providers treating autistic adults, interviews were conducted with 31 caregivers of autistic adults. Caregivers were predominantly female (94%), and the autistic adult they cared for were primarily male (87%), with a mean age of 24 years. Thematic analysis was employed to elucidate the barriers to care, suggestions to mitigate challenges, and/or successful strategies implemented during care encounters for autistic adults, as reported by their caregivers. Results Reported here are the results only from the caregiver interviews, in which seven themes emerged: (1) finding a primary care provider; (2) patient-provider communication; (3) anxiety due to unpredictability, an overstimulating sensory environment, and waiting time; (4) participation of consumers in the healthcare process; (5) stigma and assumptions about autism; (6) caregiver experiences; and (7) the impact of culture and ethnicity on care. Conclusion Findings from this study have the potential to inform the development of, or improve existing, client-centered interventions to improve primary healthcare services for autistic adults.
Collapse
Affiliation(s)
- Leah I. Stein Duker
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, United States
| | - Elizabeth Goodman
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, United States
| | - Amber Pomponio Davidson
- Department of Health and Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Laura Mosqueda
- Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| |
Collapse
|
3
|
Buffle P, Gentaz E, Vivanti G. Perception, Beliefs, and Causal Attribution of Autism Early Signs in Ecuadorian General Population. Front Psychol 2022; 13:915817. [PMID: 35814115 PMCID: PMC9260421 DOI: 10.3389/fpsyg.2022.915817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
The identification and diagnosis of children with autism currently rely on behavioral presentation and developmental history. Cultural norms and other socio-demographic factors can influence what is expected or non-expected behaviors in a developing child. Perceptions, beliefs, and causal attribution of early signs can influence families’ help-search behaviors. Lack of recognition of autism’s first manifestations can critically delay the age of diagnosis, the provision of informed guidance to families, and the implementation of adapted interventions during the critical period of early development. Furthermore, a lack of understanding of early signs as the manifestations of a developmental condition may increase stigma and non-conventional explanations. Still, cultural and socio-demographic factors are largely understudied, particularly in low-and middle-income settings. Based on the hypothesis that non-specialists such as family members and friends are one of the first sources of referral in Latin American contexts, we aimed to study the general population’s perceptions and the explanatory causes of autism’s early signs. One-hundred-and-eighty-three Ecuadorian adults responded to a questionnaire developed for this study, describing sixteen ASD-related behaviors. Results indicated that, with the exemption of language impairment and self-injurious behaviors, a substantial proportion of participants did not endorse many behaviors as “concerning and requiring professional attention.” Also, language impairment was the only behavior identified as related to a developmental disorder. Additionally, most participants attributed the majority of behaviors listed in the questionnaire to causes unrelated to ASD, such as child personality. We discuss the impact of those findings in clinical practice and on awareness programs.
Collapse
Affiliation(s)
- Paulina Buffle
- Department of Psychology and Education, Université de Genève, Geneva, Switzerland
- *Correspondence: Paulina Buffle,
| | - Edouard Gentaz
- Department of Psychology and Education, Université de Genève, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Giacomo Vivanti
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| |
Collapse
|
4
|
Diamond G, Badir E, Almog S, Badir G, Jaoussy L, Akawi A, Jaber L. Characteristic Neuro-Linguistic Styles in Young Arabic Speaking Children Diagnosed with ASD. Child Neurol Open 2022; 9:2329048X221080271. [PMID: 35340453 PMCID: PMC8951048 DOI: 10.1177/2329048x221080271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/15/2022] [Accepted: 01/26/2022] [Indexed: 11/21/2022] Open
Abstract
Evaluations of all Arabic speaking children age 3–9.0 years with significant
speech delays or impairments, referred to a community based, child development
center in the public health care system during a 5-year period were
reviewed. Use of an inordinate degree of words and expressions in Fossha version of
classical Arabic, mainly used in the media, children's literature and formalized
venues, as well as in English, was highly associated with ASD, especially among
those who were both more intelligent (IQ> 70), as well as older (greater than
4 years), (Pearson 7.29, Fisher 2-tailed test, p = 0.015). The use of "out of context" speech embedded in ordinary Arabic vernacular was
associated with a higher degree of speech stereotypy (p < 0.001) among
children with ASD, and unrelated statistically to the number of hours of screen
viewing time, jargoning or associative speech. Idiosyncratic speech choices reflect neuro-linguistic mechanisms in social
communication- impaired youngsters.
Collapse
Affiliation(s)
- Gary Diamond
- Alyn Hospital for Children’s Rehabilitation, Jerusalem
- Clalit Dan Petah Tiqva Region, Kfar Kassem center
- Tel Aviv University, Tel Aviv, Israel
| | - Eman Badir
- Clalit Dan Petah Tiqva Region, Kfar Kassem center
| | - Shelly Almog
- Clalit Dan Petah Tiqva Region, Kfar Kassem center
| | - Gumma Badir
- Clalit Dan Petah Tiqva Region, Kfar Kassem center
| | | | - Ashraf Akawi
- Clalit Dan Petah Tiqva Region, Kfar Kassem center
| | | |
Collapse
|
5
|
Gabra RH, Hashem DF, Ahmed GK. The possible relation between stigma, parent psychiatric symptoms, quality of life and the disease burden in families of children with autism spectrum disorder in Egypt: a multicentre study. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00426-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Abstract
Background
Most autism spectrum disorder (ASD) interventions evaluated child outcomes and ignoring the role of parent and family factors on both the immediate- and long-term effects of therapy. The purpose of this study was to determine the relationship between stigma, parent mental health problems, and quality of life and burden in families of children with ASD in Egypt and its risk factors. Seventy parents of ASD children were recruited from two child intervention centers. Participants were divided into two groups based on burden scale: caregivers of moderate burden (n = 27) and caregivers of severe burden (n = 43). All parents were evaluated for demographic data, zarit Burden Interview, socioeconomic scale, symptom checklist–90 (SCL90), Explanatory Model Interview Catalogue Community Stigma Scale (EMIC-CSS), and the World Health Organization Quality of Life–BREF (WHOQOL-BREF).
Results
Half of the parents reported significant stigma, particularly caregivers with a severe burden. Caregivers with severe burden had more depression and about twice the frequency of sensitivity and somatization problems, lower QoL (20%) as compared with caregivers with moderate burden. Parents with ASD had many associate factors such as work, male autistic children and their caregiver, age of children and parents, the severity of the condition, and disease duration with burden, stigma, QoL, and mental health problems.
Conclusions
This study linked the interrelationships between increased burden and stigma, impaired quality of life, and parental mental health problems; the presence of one of these variables was found to increase the risk of other variables.
Collapse
|
6
|
Shawahna R, Jaber M, Yahya N, Jawadeh F, Rawajbeh S. Are medical students in Palestine adequately trained to care for individuals with autism spectrum disorders? A multicenter cross-sectional study of their familiarity, knowledge, confidence, and willingness to learn. BMC MEDICAL EDUCATION 2021; 21:424. [PMID: 34376162 PMCID: PMC8356397 DOI: 10.1186/s12909-021-02865-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Medical students are the future workforce of physicians in primary, secondary, tertiary, and highly specialized care centers. The present study was undertaken to assess familiarity, knowledge, confidence, of medical students with regard to autism spectrum disorders (ASDs). METHODS This multicenter study was conducted in a cross-sectional design among medical students in the 3 main universities in Palestine. In addition to the sociodemographic and academic details, the questionnaire measured familiarity (8-items), knowledge (12-items), confidence and willingness to learn (5-items) with regard to ASDs. RESULTS The questionnaire was completed by309 medical students (response rate = 77.3 %). The median familiarity, knowledge, and confidence scores were 50 % (42.5 %, 57.5 %), 50 % (41.7 %, 66.7 %), and 60.0 % (54.0 %, 68.0 %), respectively. There was a positive moderate correlation between familiarity and knowledge scores (Spearman's rho = 0.29, p-value < 0.001) and familiarity and confidence scores (Spearman's rho = 0.34, p-value < 0.001). Medical students who have received a course on autism were 3.08-fold (95 % C.I. of 1.78-5.31) more likely to score ≥ 50 % on the familiarity items compared to those who did not receive a course. The medical students who were in their clinical academic stage, who received a course on ASDs, and those who interacted with individuals with ASDs were 2.36-fold (95 % C.I. of 1.34-4.18), 2.66-fold (95 % C.I. of 1.52-4.65), and 2.59-fold (95 % C.I. of 1.44-4.63) more likely to score ≥ 50 % on the knowledge items. Medical students who reported high satisfaction with their social life were 2.84-fold (95 % C.I. of 1.15-7.00) more likely to score ≥ 50 % on the confidence items. CONCLUSIONS The present study identified considerable awareness and knowledge gaps among medical students with regard to ASDs. Medical students in this study reported low confidence in their ability to provide healthcare services to individuals with ASDs. Appropriately designed educational interventions might improve familiarity, knowledge, and confidence of medical students. More studies are still needed to investigate if such interventions can improve healthcare services for individuals with ASDs.
Collapse
Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, New Campus, Building: 19, Office: 1340, Nablus, Palestine.
- An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| | - Mohammad Jaber
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- An-Najah National University Hospital, An-Najah National University, Nablus, Palestine
| | - Nourhan Yahya
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Firdaous Jawadeh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Shahd Rawajbeh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|
7
|
Daniels NF, Coughlan B, Duschinsky R. How UK health care professionals conceptualise parental experiences of the diagnostic process for autism spectrum disorder: A qualitative study. SAGE Open Med 2021; 9:20503121211031310. [PMID: 34349995 PMCID: PMC8287381 DOI: 10.1177/20503121211031310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/16/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Much of the literature on diagnostic experiences of autism focuses on parental perspectives. Few studies have explored how health care professionals conceptualise parental experiences of the diagnostic process. The current study examines clinical perspectives of the diagnostic process with a focus on the perceived impact of assessment on families. METHODS Qualitative interviews were conducted with 25 health care professionals from various National Health Service child and adolescent mental health services and general practices in the United Kingdom. Interviews were transcribed verbatim and data were analysed using a thematic approach. RESULTS Two main themes were identified: (1) stress and the autism spectrum disorder diagnostic process and (2) expectations of the diagnostic pathway. The main sources of stress perceived by the health care professionals related to diagnostic delay and ambiguity around the diagnostic process, with parents facing significant hurdles in understanding their child's behaviour. Many health care professionals also reported a struggle to navigate differing expectations of the diagnostic process between parents and clinicians, as well as managing objectivity in the face of significant distress. Parent internalised stigma and guilt was a key component of the health care professional's perception of sources of stress around the diagnostic process. CONCLUSION The vast majority of clinicians recognised the diagnostic pathway as a significant source of stress for parents, with many hurdles and battles to finalise the process.
Collapse
Affiliation(s)
| | - Barry Coughlan
- Department of Public Health and Primary
Care, University of Cambridge, Cambridge, UK
| | - Robbie Duschinsky
- Department of Public Health and Primary
Care, University of Cambridge, Cambridge, UK
| |
Collapse
|
8
|
Perceptions of Autism Spectrum Disorder (ASD) Etiology among Parents of Children with ASD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136774. [PMID: 34202481 PMCID: PMC8297016 DOI: 10.3390/ijerph18136774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022]
Abstract
Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and restricted or repetitive behaviors. Parental perceptions of the etiology of their child’s ASD can affect provider–client relationships, bonding between parents and their children, and the prognosis, treatment, and management of children with ASD. Thus, this study sought to examine the perceptions of ASD etiology of parents of children with ASD. Methods: Forty-two parents of children diagnosed with ASD were recruited across Texas. Semi-structured interviews were conducted individually. All interviews were recorded and later transcribed verbatim for content analysis utilizing NVivo 12.0 (QSR International, Doncaster, Australia). Results: The content analysis identified the following themes regarding parental perceptions of ASD etiology: Genetic factors (40.5%), environmental factors (31.0%), problems that occurred during pregnancy or delivery (23.8%), vaccinations (16.7%), other health problems (7.1%), parental age at the time of pregnancy (4.8%), and spiritual or religious factors (2.4%). Conclusions: The parental perceptions of ASD etiology were diverse, but several views, such as vaccinations and spiritual or religious factors, were not based on scientific evidence. Health professionals and researchers can use these findings to develop and provide targeted education to parents who have children with ASD. Our findings also support policymakers in developing campaigns designed to increase parental ASD awareness and knowledge.
Collapse
|
9
|
Makino A, Hartman L, King G, Wong PY, Penner M. Parent Experiences of Autism Spectrum Disorder Diagnosis: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00237-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractThe purpose of this review was to identify the quantity, breadth, and methodological characteristics of literature examining parent perspectives of autism spectrum disorder diagnosis, synthesize key research findings, and highlight gaps in the current literature. A systematic search was conducted for the period January 1994–February 2020. One hundred and twenty-two articles underwent data extraction. The majority of studies took place in Europe and North America in high-income countries. Over half of the studies used qualitative methodology. Four key components of the diagnostic experience were identified: journey to assessment, assessment process, delivery of the diagnosis and feedback session, and provision of information, resources, and support. Themes of parental emotions and parental satisfaction with the diagnostic process were also found.
Collapse
|
10
|
Stewart SL, Celebre A, Iantosca JA, Poss JW. Autism Spectrum Screening Checklist (ASSC): The Development of a Scale to Identify High-Risk Individuals Within the Children's Mental Health System. Front Psychiatry 2021; 12:709491. [PMID: 34552515 PMCID: PMC8451328 DOI: 10.3389/fpsyt.2021.709491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/10/2021] [Indexed: 11/30/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a complex childhood onset neurodevelopmental disorder that has become the fastest growing developmental disability. Due to the increased demand for diagnostic assessments and subsequent increased wait times, standardized screening as part of regular clinical practice is needed. More specifically, there is an important need for the development of a more streamlined screening tool within an existing assessment system to identify those at greatest risk of having ASD. The current study utilized data from ~17,000 assessments obtained within the province of Ontario, based on the interRAI Child and Youth Mental Health (ChYMH) and Child and Youth Mental Health and Developmental Disability (ChYMH-DD), to develop a scale to identify children who have a higher likelihood of having autism. The scale was then tested on a trial population with data from the interRAI Early Years instrument. Further analyses examined the predictive validity of the scale. The Autism Spectrum Screening Checklist (ASSC) was found to be a good predictor of ASD with a sensitivity of 0.73 and specificity of 0.62, at the recommended cut-point of 2+. The results were consistent across several age ranges, specifically from 2 to 21 years of age. The ASSC scale provides an initial screen to help identify children and youth at heightened risk for autism within larger populations being assessed as part of routine practice. The main goal for the development and implementation of the ASSC scale is to harness the power of the existing interRAI assessment system to provide a more efficient, effective screening and referral process. This will ultimately help improve patient outcomes through needs-based care.
Collapse
Affiliation(s)
| | - Angela Celebre
- Faculty of Education, Western University, London, ON, Canada
| | - Jo Ann Iantosca
- Faculty of Applied Arts and Health Sciences, Seneca College, Toronto, ON, Canada
| | - Jeffrey W Poss
- Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada
| |
Collapse
|
11
|
Taresh SM, Ahmad NA, Roslan S, Ma’rof AM. Preschool Teachers' Beliefs towards Children with Autism Spectrum Disorder (ASD) in Yemen. CHILDREN-BASEL 2020; 7:children7100170. [PMID: 33036166 PMCID: PMC7601273 DOI: 10.3390/children7100170] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 01/01/2023]
Abstract
It is perplexing that some preschool teachers not only advise parents who have children with autism spectrum disorder (ASD) to go to religious healers, but also attribute such neurological disorders to the curse of the “evil eye” or vaccines. Although it is now the twentieth century, this behavior simply reflects the concerns of over-protective teachers and the cultural misperceptions about the actual definition of ASD. In Yemen, the term “ASD”, with its wide range of symptoms, is still ambiguous among preschool teachers. Thus, in a rather insightful piece for the education community, this study has attempted to look beneath the surface of the beliefs (religious belief–social belief–personal belief) of Yemeni preschool teachers regarding ASD. Based on the data collected from 213 teachers (20–30\31–40-~≥40 age) in the Taiz district, this study found that misconceptions specific to autism spectrum disorder were strongly evidenced among teachers who taught preschoolers. Due to personal ignorance and growing superstitions, these teachers tend to believe the society’s perceptions of ASD, thus resulting in the ignorance of scientific views. However, the mass media can increase this group’s awareness of ASD by continually assessing the inaccurate views on ASD, and correcting them. And by influencing the teachers to take a more conceptual scientific approach in serving their special needs students, furthermore, by informing preschool teachers of children’s rights in normal life in the future through providing children with an optimal chance of development by early intervention.
Collapse
Affiliation(s)
- Sahar Mohammed Taresh
- Department of Foundation of Education, Faculty of Educational Studies, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia; (S.M.T.); (S.R.); (A.M.M.)
- Department of Kindergarten, Faculty of Education, Taiz University, Taiz, Yemen
| | - Nor Aniza Ahmad
- Department of Foundation of Education, Faculty of Educational Studies, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia; (S.M.T.); (S.R.); (A.M.M.)
- Correspondence:
| | - Samsilah Roslan
- Department of Foundation of Education, Faculty of Educational Studies, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia; (S.M.T.); (S.R.); (A.M.M.)
| | - Aini Marina Ma’rof
- Department of Foundation of Education, Faculty of Educational Studies, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia; (S.M.T.); (S.R.); (A.M.M.)
| |
Collapse
|
12
|
Rah SS, Hong SB, Yoon JY. Screening Effects of the National Health Screening Program on Developmental Disorders. J Autism Dev Disord 2020; 51:2461-2474. [PMID: 32989511 DOI: 10.1007/s10803-020-04712-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
As the prevalence of developmental disorders (DDs) has increased, many OECD countries provide a national screening examination for early detection and intervention for DDs. This study examined effects of the National Health Screening Program in Korea. 65,334 children (39%) were DD-screened and 35,466 children (21%) received a false negative among the 167,050 study subjects. The DD-screened rate had increased from 3208 (27.2%) in 2008 to 8471 (47.3%) in 2012, then decreased to 5544 (29.8%) in 2017. Changes in the false negative rates increased from 2.7% in 2008 to 23.8% in 2017 were one of the most influential factors in these fluctuations. The DD-screened rate was influenced by demo-geographic and economic factors as well as by age-related characteristics of the subconditions.
Collapse
Affiliation(s)
- Sung Sil Rah
- College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Soon-Beom Hong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Ju Young Yoon
- Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| |
Collapse
|
13
|
Samadi SA. Parental Beliefs and Feelings about Autism Spectrum Disorder in Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E828. [PMID: 32013060 PMCID: PMC7038212 DOI: 10.3390/ijerph17030828] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 01/20/2020] [Accepted: 01/23/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study provides information on beliefs that parents of children with autism hold in Iran. The main focus is on their beliefs about the cause and the way that this condition is explained based on the first signs that made them be concerned for their children. METHOD To attain the aims of this study, 43 parents of children with ASD (27 mothers and 16 fathers) were recruited and interviewed in two sessions in their home. A mixed method approach was used to understand Iranian parents' reaction to receive diagnosis for their children. RESULTS Based on findings for the identification, description, and treatment of ASD in Iran, it is argued that since Iranian parents had their special justification regarding their experience with ASD, early child development and interventions must be understood within cultural context. Culturally informed research on ASD is vital to boost awareness of the importance of understanding parental concerns and their need for educational and psychological services in countries in which autism is less known, undiagnosed, misdiagnosed, or even stigmatized. Understanding the difference in ASD meaning across cultures urges stakeholders such as service providers and policymakers to accept and appreciate cultural and individual diversities in the present century.
Collapse
Affiliation(s)
- Sayyed Ali Samadi
- Institute of Nursing and Health Research, Ulster University, BT521SA Coleraine, Ireland
| |
Collapse
|
14
|
Sahni LC, Boom JA, Mire SS, Berry LN, Dowell LR, Minard CG, Cunningham RM, Goin-Kochel RP. Vaccine Hesitancy and Illness Perceptions: Comparing Parents of Children with Autism Spectrum Disorder to other Parent Groups. CHILDRENS HEALTH CARE 2020; 49:385-402. [PMID: 33716379 DOI: 10.1080/02739615.2020.1740883] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Fears persist despite compelling evidence refuting associations between vaccines and autism spectrum disorder (ASD). We compared vaccine hesitancy (VH) and beliefs about illness causes among parents of children in four groups: ASD, non-ASD developmental disorders, rheumatologic conditions, and the general pediatric population. VH was 19.9% overall; parents of children with ASD reported highest VH rates (29.5%) and more frequently attributed ASD to toxins in vaccines (28.9% vs. 15.7%, p=0.004). The odds of VH were increased among parents who attributed their child's condition to diet or eating habits (aOR 4.2; 95% CI: 1.6, 11.2) and toxins found in vaccines (aOR 20, 95% CI: 7.1, 55.9). Parents who attributed the condition to chance or bad luck were less likely to be vaccine hesitant (aOR 0.1; 95% CI: 0.03, 0.5).
Collapse
Affiliation(s)
- Leila C Sahni
- Immunization Project, Texas Children's Hospital, Houston, TX
| | - Julie A Boom
- Immunization Project, Texas Children's Hospital, Houston, TX.,Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Sarah S Mire
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
| | - Leandra N Berry
- Department of Pediatrics, Baylor College of Medicine, Houston, TX.,Autism Center, Texas Children's Hospital, Houston, TX
| | - Lauren R Dowell
- Department of Pediatrics, Baylor College of Medicine, Houston, TX.,Autism Center, Texas Children's Hospital, Houston, TX
| | - Charles G Minard
- Dan L. Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX
| | | | - Robin P Goin-Kochel
- Department of Pediatrics, Baylor College of Medicine, Houston, TX.,Autism Center, Texas Children's Hospital, Houston, TX
| |
Collapse
|
15
|
Kiely B, Vettam S, Adesman A. Correlates of genetic attributions among parents of children in the USA with developmental disabilities. APPLICATION OF CLINICAL GENETICS 2019; 12:55-61. [PMID: 31043799 PMCID: PMC6469480 DOI: 10.2147/tacg.s164757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction As technologies for identifying causal genetic variants in children with autism spectrum disorders (ASD) and other developmental conditions continue to advance, there is a need to understand the factors that influence parental beliefs about the causes of their child’s disabilities. This study assessed the correlates of etiologic attributions among US parents of children with ASD, intellectual disability (ID), and/or developmental delay (DD). Methods Data were obtained from the Centers for Disease Control and Prevention’s nationally representative Survey of Pathways to Diagnosis and Services. Respondents were classified according to whether their child had ASD without ID or DD (ASD-only), ASD with ID and/or DD (ASD+ID/DD), or ID and/or DD without ASD (ID/DD-only). Respondents rated the extent to which they believed that genetics/heredity and environmental exposures (prenatal and/or postnatal) had contributed to their child’s condition. Logistic regression analyses and chi-square tests were used to assess the relationship between parental beliefs and child characteristics. Results The parents of children with comorbid ASD and ID/DD were found to be significantly less likely than those in the other condition groups to attribute their child’s condition to genetics. Within the ASD+ID/DD group, parental endorsement of genetics was lower among those who reported a history of language regression (p=0.006). Conclusion Further research is needed to evaluate the impact of parental genetic attributions on medical decision-making.
Collapse
Affiliation(s)
- Bridget Kiely
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY, USA,
| | - Sujit Vettam
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY, USA,
| | - Andrew Adesman
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY, USA,
| |
Collapse
|
16
|
Al Khateeb JM, Kaczmarek L, Al Hadidi MS. Parents’ perceptions of raising children with autism spectrum disorders in the United States and Arab countries: A comparative review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1645-1654. [DOI: 10.1177/1362361319833929] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Four databases were searched to identify studies published by Arab researchers on parents’ perceptions of autism spectrum disorder and studies conducted by US researchers and published in systematic reviews of this topic. The electronic search resulted in 14 studies published by Arab researchers and 55 studies published by US researchers. The results showed that autism spectrum disorder has many of the same effects on Arab and American families. Six major areas were identified in the results. Financial difficulties associated with raising children with autism spectrum disorder were mentioned more in Arab studies than in US studies. Arab studies had more emphasis on gender than US studies. The results related to quality of life of parents of children with autism spectrum disorder in Arab studies were equivocal. US studies included comparisons with families without a child with autism spectrum disorder, and addressed factors that were associated with quality of life indicators. More health, educational, and social services were available in United States than in Arab countries, but some frustration was reported by US parents in obtaining appropriate services in some studies. A higher percentage of Arab studies mentioned the role of religious faith than US studies. Finally, social stigma was evidenced in both cultures, but not much research was available.
Collapse
|
17
|
Chaidez V, Fernandez y Garcia E, Wang LW, Angkustsiri K, Krakowiak P, Hertz-Picciotto I, Hansen RL. Comparison of maternal beliefs about causes of autism spectrum disorder and association with utilization of services and treatments. Child Care Health Dev 2018; 44:916-925. [PMID: 30136409 PMCID: PMC6447086 DOI: 10.1111/cch.12612] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 06/27/2018] [Accepted: 07/23/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND This study aimed to describe parental perceptions of the causes of autism spectrum disorder (ASD) in an ethnically diverse sample and explore whether these perceptions relate to treatment choices. METHODS The sample consisted of White (n = 224), Hispanic (n = 85), and Asian (n = 21) mothers of a child with ASD. A mixed methods approach was used in this secondary analysis focusing on parental perceptions about the causes of ASD and the relationship of these to utilization of services and treatment. RESULTS Environmental and genetic factors were most often believed to be the cause or one of the causes of ASD by mothers across all ethnic groups studied. Asian mothers were more likely to cite multiple causes. Environmental causes were associated with receiving 20 or more hours of autism-related services per week, whereas belief in environmental exposures and vaccines and medications as causes were associated with complementary-alternative medicine (CAM) use. CONCLUSION Our findings suggest that ethnic differences in autism causal beliefs and treatment choices may exist. Future research should be conducted to specifically confirm the findings, to understand parental motivation behind their service and treatment choices, and to gain more insight into the types, usage, and sources of CAM treatments. Clinicians can use parental autism causal beliefs in discussions about treatment recommendations.
Collapse
Affiliation(s)
- Virginia Chaidez
- Present address,Department of Public Health Sciences, University of California, Davis School of Medicine, Davis, California
| | - Erik Fernandez y Garcia
- Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, California
| | - Lulu W Wang
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California Davis Health System, Sacramento, California.,Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, California
| | - Kathleen Angkustsiri
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California Davis Health System, Sacramento, California.,Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, California
| | - Paula Krakowiak
- Department of Public Health Sciences, University of California, Davis School of Medicine, Davis, California,Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California Davis Health System, Sacramento, California
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, Davis School of Medicine, Davis, California,Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California Davis Health System, Sacramento, California
| | - Robin L Hansen
- Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California Davis Health System, Sacramento, California.,Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, California
| |
Collapse
|
18
|
Castillo A, Gilger JW. Adult perceptions of children with dyslexia in the USA. ANNALS OF DYSLEXIA 2018; 68:203-217. [PMID: 30094715 DOI: 10.1007/s11881-018-0163-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 06/29/2018] [Indexed: 06/08/2023]
Abstract
This study examined adult perceptions of dyslexia among US adults. Participants (n = 623) answered survey questions pertaining to characteristics, views, and possible causes of DYS. Exploratory factor analysis revealed five distinct factors: (1) psychosocial causes, (2) external causes, (3) biological causes, (4) consequences, and (5) controllability. Three-way ANOVA's were conducted to determine the effects of ethnicity, gender, and parental status on how DYS was perceived. The results revealed ethnic, gender, and parental status differences. Males endorsed psychosocial causes and external causes more often than females. Those who self-identified as Asian viewed DYS as more controllable in comparison to Whites. Results also revealed a three-way interaction regarding controllability. Understanding the public's perceptions about developmental disorders helps distinguish true from erroneous beliefs, and understanding differences that may exist in particular groups can help implement targeted actions to improve awareness, care, and interventions for families.
Collapse
Affiliation(s)
- Anabel Castillo
- Psychological Sciences & the Consortium for Research on Atypical Development and Learning, University of California, Merced, 5200 N. Lake Rd, Merced, CA, 92583, USA.
| | - Jeffrey W Gilger
- Psychological Sciences & the Consortium for Research on Atypical Development and Learning, University of California, Merced, 5200 N. Lake Rd, Merced, CA, 92583, USA
| |
Collapse
|
19
|
Zerbo O, Modaressi S, Goddard K, Lewis E, Fireman BH, Daley MF, Irving SA, Jackson LA, Donahue JG, Qian L, Getahun D, DeStefano F, McNeil MM, Klein NP. Vaccination Patterns in Children After Autism Spectrum Disorder Diagnosis and in Their Younger Siblings. JAMA Pediatr 2018; 172:469-475. [PMID: 29582071 PMCID: PMC5875314 DOI: 10.1001/jamapediatrics.2018.0082] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE In recent years, rates of vaccination have been declining. Whether this phenomenon disproportionately affects children with autism spectrum disorder (ASD) or their younger siblings is unknown. OBJECTIVES To investigate if children after receiving an ASD diagnosis obtain their remaining scheduled vaccines according to the Advisory Committee on Immunization Practices (ACIP) recommendations and to compare the vaccination patterns of younger siblings of children with ASD with the vaccination patterns of younger siblings of children without ASD. DESIGN, SETTING, AND PARTICIPANTS This investigation was a retrospective matched cohort study. The setting was 6 integrated health care delivery systems across the United States within the Vaccine Safety Datalink. Participants were children born between January 1, 1995, and September 30, 2010, and their younger siblings born between January 1, 1997, and September 30, 2014. The end of follow-up was September 30, 2015. EXPOSURES Recommended childhood vaccines between ages 1 month and 12 years. MAIN OUTCOME AND MEASURE The proportion of children who received all of their vaccine doses according to ACIP recommendations. RESULTS The study included 3729 children with ASD (676 [18.1%] female), 592 907 children without ASD, and their respective younger siblings. Among children without ASD, 250 193 (42.2%) were female. For vaccines recommended between ages 4 and 6 years, children with ASD were significantly less likely to be fully vaccinated compared with children without ASD (adjusted rate ratio, 0.87; 95% CI, 0.85-0.88). Within each age category, vaccination rates were significantly lower among younger siblings of children with ASD compared with younger siblings of children without ASD. The adjusted rate ratios varied from 0.86 for siblings younger than 1 year to 0.96 for those 11 to 12 years old. Parents who had a child with ASD were more likely to refuse at least 1 recommended vaccine for that child's younger sibling and to limit the number of vaccines administered during the younger sibling's first year of life. CONCLUSIONS AND RELEVANCE Children with ASD and their younger siblings were undervaccinated compared with the general population. The results of this study suggest that children with ASD and their younger siblings are at increased risk of vaccine-preventable diseases.
Collapse
Affiliation(s)
- Ousseny Zerbo
- Kaiser Permanente Vaccine Study Center, Oakland, California
| | | | | | - Edwin Lewis
- Kaiser Permanente Vaccine Study Center, Oakland, California
| | | | - Matthew F. Daley
- Institute for Health Research, Kaiser Permanente Colorado, Denver
| | | | | | - James G. Donahue
- Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin
| | - Lei Qian
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Darios Getahun
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Frank DeStefano
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michael M. McNeil
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | |
Collapse
|
20
|
Thai parental perception of the etiology of autism spectrum disorders with an emphasis on genetics. ASIAN BIOMED 2018. [DOI: 10.2478/abm-2010-0100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract
Background: More than 90% of cases of autism spectrum disorders (ASDs) are idiopathic and are multi-factorial inheritant in etiology. Although parental perceptions of ASDs etiologies including genetics have been investigated well in western countries, there is no study regarding Asian parental perspectives on the genetic etiology of ASDs. Objectives: Examine what Thai parents perceived to be the etiology of ASDs with particular focus on the role of genetics, and analyze the correlation between demographics of parents and the perception of genetics as an etiology of ASDs. Methods: Children diagnosed with an ASD at Ramathibodi Hospital were recruited, and 328 questionnaires were mailed to their parents between February 1 and March 31, 2008. Based on 252 answers received, the perception of genetics as an etiology of ASDs was evaluated using univariate and multivariate analysis. Results: Among 252 parents, 44.0% cited genetics, 52% cited other prenatal and perinatal factors such as stress and chemical exposure during pregnancy, 33% cited postnatal factors such as child rearing, child’s viewing of television, and playing computer game as etiologies of ASDs. Parents’ education, positive family history of ASDs, and positive family history of speech delay were all significantly associated with the perception of genetics as an etiology of ASDs. Conclusions: Less than half of Thai parents cited genetics as an etiology of ASDs. This finding alerts medical professionals to spend more time and effort to educate and counsel parents.
Collapse
|
21
|
Lappé M, Lau L, Dudovitz RN, Nelson BB, Karp EA, Kuo AA. The Diagnostic Odyssey of Autism Spectrum Disorder. Pediatrics 2018; 141:S272-S279. [PMID: 29610407 PMCID: PMC5972532 DOI: 10.1542/peds.2016-4300c] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by challenges in social communication and interaction and restricted or repetitive behavior, interests, or activities. Although ASD symptoms generally manifest in early childhood, many individuals experience delays accessing an autism diagnosis and related services. In this study, we identify the individual, social, and structural factors that influence parents' experiences of children's ASD diagnosis. METHODS Parents of 25 children with autism participated in 60- to 90-minute semistructured in-person interviews. Interviews were recorded and transcribed verbatim. Transcripts were analyzed using the method of grounded theory. This inductive method allowed analysts to identify key themes related to participants' experiences of children's ASD diagnosis. RESULTS The process of ASD diagnosis reflects an odyssey that includes 3 key phases: the prediagnosis phase, in which "Making Sense of Child Difference" is a primary characteristic of participants' experiences; the during-diagnosis phase, when "Navigating Diagnosis" suggests systematic barriers that influence the timing of ASD diagnosis; and the postdiagnosis phase, when participants' experiences of "Connecting to Services" point to the important role that personal efforts play in gaining access to care. CONCLUSIONS In this study, we highlight individual, social, and structural factors that influence parent experiences before, during, and after their child's autism diagnosis. Our findings indicate the need for more consistent and continuous support for autistic individuals and their families during the diagnostic odyssey, as well as resources that better represent the diversity of experiences and symptoms associated with autism across the life course.
Collapse
Affiliation(s)
- Martine Lappé
- Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic and Behavioral Genetics, Columbia University, New York, New York;
| | - Lynette Lau
- Department of Medicine, David Geffen School of Medicine at UCLA and UCLA Mattel Children’s Hospital, Los Angeles, California,Department of Pediatrics and Children’s Discovery & Innovation Institute, David Geffen School of Medicine at UCLA and UCLA Mattel Children’s Hospital, Los Angeles, California
| | - Rebecca N. Dudovitz
- Department of Pediatrics and Children’s Discovery & Innovation Institute, David Geffen School of Medicine at UCLA and UCLA Mattel Children’s Hospital, Los Angeles, California
| | - Bergen B. Nelson
- Children’s Hospital of Richmond, Virginia Commonwealth University, Richmond, Virginia
| | - Elizabeth A. Karp
- Department of Psychology, University of Washington, Seattle, Washington
| | - Alice A. Kuo
- Department of Medicine, David Geffen School of Medicine at UCLA and UCLA Mattel Children’s Hospital, Los Angeles, California,Department of Pediatrics and Children’s Discovery & Innovation Institute, David Geffen School of Medicine at UCLA and UCLA Mattel Children’s Hospital, Los Angeles, California
| |
Collapse
|
22
|
Hoang N, Cytrynbaum C, Scherer SW. Communicating complex genomic information: A counselling approach derived from research experience with Autism Spectrum Disorder. PATIENT EDUCATION AND COUNSELING 2018; 101:352-361. [PMID: 28803755 DOI: 10.1016/j.pec.2017.07.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/17/2017] [Accepted: 07/24/2017] [Indexed: 06/07/2023]
Abstract
Individuals with Autism Spectrum Disorder (ASD) share characteristics (impairments in socialization and communication, and repetitive interests and behaviour), but differ in their developmental course, pattern of symptoms, and cognitive and language abilities. The development of standardized phenotyping has revealed ASD to clinically be vastly heterogeneous, ranging from milder presentations to more severe forms associated with profound intellectual disability. Some 100 genes have now been implicated in the etiology of ASD, and advances in genome-wide testing continue to yield new data at an unprecedented rate. As the translation of this data is incorporated into clinical care, genetic professionals/counsellors, as well as other health care providers, will benefit from guidelines and tools to effectively communicate such genomic information. Here, we present a model to facilitate communication regarding the complexities of ASD, where clinical and genetic heterogeneity, as well as overlapping neurological conditions are inherent. We outline an approach for counselling families about their genomic results grounded in our direct experience from counselling families participating in an ASD research study, and supported by rationale from the literature.
Collapse
Affiliation(s)
- Ny Hoang
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Canada; Autism Research Unit, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada; Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada.
| | - Cheryl Cytrynbaum
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada; Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada.
| | - Stephen W Scherer
- Department of Molecular Genetics, University of Toronto, Toronto, Canada; Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada; The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Canada; McLaughlin Centre, University of Toronto, Toronto, Canada.
| |
Collapse
|
23
|
Sun IYI, Varanda CA, Fernandes FD. Stimulation of Executive Functions as Part of the Language Intervention Process in Children with Autism Spectrum Disorder. Folia Phoniatr Logop 2017; 69:78-83. [PMID: 29248909 DOI: 10.1159/000479586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 07/18/2017] [Indexed: 11/19/2022] Open
Abstract
AIMS Identifying effective methods for stimulating language and communication of children with autism spectrum disorder (ASD) is fundamental to the effective use of available resources to support these children. This pilot study was designed to explore the potential benefits of a program of stimulation of executive functions (SEF) on the functional aspects of language and communication through the assessment of the functional communicative profile and social-cognitive performance. METHODS Twenty children, aged 5-12 years, with a diagnosis of ASD participated in the study. Two stimulation programs were offered over a 10- to 12-week period as part of the regular services offered to these children through a University's speech and language therapy outpatient clinic in São Paulo, Brazil. Children either received SEF intervention in their home implemented by their parent/s, with close monitoring by the speech-language pathologist (SLP) (group 1), or they received SEF by the SLP during regular speech-language therapy individual sessions (group 2). RESULTS The findings suggested that there were differences between the children's pre- and posttest performance. Significantly different performances were observed in the areas of occupation of communication space, proportion of communicative interactivity, and social-cognitive performance. CONCLUSION The inclusion of activities to stimulate executive function abilities in language intervention for children with ASD warrants further investigation.
Collapse
Affiliation(s)
- Ingrid Ya I Sun
- Department of Physical Therapy, Speech-Language Pathology and Audiology, and Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Cristina Andrade Varanda
- Department of Physical Therapy, Speech-Language Pathology and Audiology, and Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), São Paulo, Brazil.,Universidade Paulista (UNIP), Santos, Brazil
| | - Fernanda Dreux Fernandes
- Department of Physical Therapy, Speech-Language Pathology and Audiology, and Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), São Paulo, Brazil
| |
Collapse
|
24
|
Semensato MR, Bosa CA. Crenças Indicativas de Resiliência Parental no Contexto do Autismo. PSICOLOGIA: TEORIA E PESQUISA 2017. [DOI: 10.1590/0102.3772e33416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO A resiliência parental refere-se a uma parentalidade sensível e cuidadosa diante de situações críticas, como em processos diagnósticos de autismo envolvendo os filhos. Trata-se de um processo que permite aos pais desenvolver uma relação protetora frente às necessidades dos filhos e às do próprio casal, bem como elaborar o diagnóstico recebido. No atual estudo, investigaram-se indicativos de resiliência parental através da análise de conteúdo de seis entrevistas com casais cujo filho apresenta autismo. Os resultados revelaram que (a) a busca e a atribuição de sentido ao comportamento do filho e ao próprio termo autismo e (b) a capacidade de desenvolver um empoderamento nessa vivência, foram indicativos de resiliência parental importantes no processo de elaboração do diagnóstico de autismo do filho.
Collapse
|
25
|
Filliter JH, Dodds L, MacDonald N, Shea S, Dubé E, Smith IM, Campbell LA. The next vaccine-autism question: Are school-aged youth with autism spectrum disorder undervaccinated and, if so, why? Paediatr Child Health 2017; 22:285-287. [PMID: 29479236 DOI: 10.1093/pch/pxx083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Over the past two decades, the words 'autism' and 'vaccination' have often been linked and mired in controversy. In this commentary, we raise a different question about autism spectrum disorder (ASD) and vaccines: Are school-aged youth with ASD undervaccinated and, if so, why? There are several reasons why youth with ASD might be undervaccinated, including: belief in a vaccine-ASD link, challenges faced by youth with ASD when seeking health care and vaccine hesitancy factors that affect the general population. Possible undervaccination in this group is concerning given the prevalence of ASD and the key role of vaccinations in preventing infectious diseases. More research is needed to establish definitively whether youth with ASD are undervaccinated and to understand facilitators and barriers to vaccination for this population. This would help public health officials to develop and implement targeted policy and practice changes to increase vaccination uptake in youth with ASD, thereby increasing immunization equity.
Collapse
Affiliation(s)
- Jillian H Filliter
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia.,Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia.,IWK Health Centre, Halifax, Nova Scotia
| | - Linda Dodds
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia.,IWK Health Centre, Halifax, Nova Scotia.,Department of Obstetrics & Gynecology, Dalhousie University, Halifax, Nova Scotia
| | - Noni MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia.,IWK Health Centre, Halifax, Nova Scotia
| | - Sarah Shea
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia.,IWK Health Centre, Halifax, Nova Scotia
| | - Eve Dubé
- Institut national de santé publique du Québec, Québec, Québec.,Département d'Anthropologie, Université Laval, Québec, Québec
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia.,Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia.,IWK Health Centre, Halifax, Nova Scotia
| | - Leslie Anne Campbell
- IWK Health Centre, Halifax, Nova Scotia.,Department of Community Health & Epidemiology, Dalhousie University, Halifax, Nova Scotia
| |
Collapse
|
26
|
Martínez-Cayuelas E, Ibáñez-Micó S, Ceán-Cabrera L, Domingo-Jiménez R, Alarcón-Martínez H, Martínez-Salcedo E. Level of training in autistic spectrum disorders among hospital paediatricians. An Pediatr (Barc) 2017. [DOI: 10.1016/j.anpede.2016.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
27
|
GPs' confidence in caring for their patients on the autism spectrum: an online self-report study. Br J Gen Pract 2017; 67:e445-e452. [PMID: 28483821 DOI: 10.3399/bjgp17x690449] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 10/10/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In the UK, GPs play a key role in the identification and management of children, young people, and adults on the autism spectrum, but there is a paucity of research on GPs' perceptions of working with these patients. AIM To understand GPs' perceived self-efficacy in identifying and managing their patients on the autism spectrum, and the factors affecting this. DESIGN AND SETTING An online self-report survey was developed for completion by GPs across the UK. METHOD A total of 304 GPs in the UK took part. The survey collected responses on participants' background, training, and experience, both as a GP and with regard to autism, and included a 22-item knowledge of autism questionnaire, a 14-item self-efficacy scale targeting GPs' perceived confidence in identifying and managing their autistic patients, and an open question eliciting participants' experiences of working with autistic people. RESULTS In total, 39.5% (n = 120) of GP participants reported never having received formal training in autism. Despite demonstrating good knowledge of its key features, participants reported limited confidence in their abilities to identify and manage autistic patients, with many citing a number of barriers that overwhelmingly focused on perceived failings of the current healthcare system (such as a lack of clarity around referral pathways). CONCLUSION There is an urgent need for improved local specialist service provision alongside clearer referral pathways for diagnosis to improve both GPs' confidence in caring for their autistic patients and the healthcare experiences of autistic patients and their families. Local clinical commissioning groups are best served to assist GPs in ensuring that they can reliably detect the condition and make appropriate provisions for support.
Collapse
|
28
|
Chao KY, Chang HL, Chin WC, Li HM, Chen SH. How Taiwanese parents of children with autism spectrum disorder experience the process of obtaining a diagnosis: A descriptive phenomenological analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 22:388-400. [PMID: 28205453 DOI: 10.1177/1362361316680915] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An autism spectrum disorder can result in considerable stress and confusion for parents as they attempt to understand their child's problems and obtain a diagnosis. Few studies have explored the parental experience in the context of Chinese culture. The purpose of this study was to understand the experiences of parents in Taiwan of children diagnosed with autism spectrum disorder. In total, 15 parents, 1 father and 14 mothers, were recruited by purposive sampling. This qualitative study used semi-structured interviews and descriptive phenomenological analysis. The findings indicated that parents of children diagnosed with autism spectrum disorder underwent five coping experiences during the diagnostic process: (1) uncertainty and difficulty understanding their child's behaviour, which occurred during the pre-diagnosis phase; (2) obligation to obtain professional services; (3) anxious searching for a second opinion, which occurred during the diagnosis phase; (4) acceptance and fortitude and (5) further adjustment during the post-diagnosis phase. Our findings add to our understanding of how parents experience the diagnostic process, which could improve medical professionals' counselling and support for parents at the stage of obtaining a diagnosis for their children.
Collapse
Affiliation(s)
- Kuo-Yu Chao
- 1 Chang Gung University of Science and Technology, Taiwan.,2 Chang Gung Memorial Hospital (Linkou Branch), Taiwan
| | | | - Wei-Chih Chin
- 2 Chang Gung Memorial Hospital (Linkou Branch), Taiwan.,4 Chang Gung Memorial Hospital (Taoyuan Branch), Taiwan
| | - Hsin-Mei Li
- 1 Chang Gung University of Science and Technology, Taiwan
| | - Sue-Hsien Chen
- 1 Chang Gung University of Science and Technology, Taiwan.,5 Chang Gung Memorial Hospital (Keelung Branch), Taiwan
| |
Collapse
|
29
|
Ludlow AK, Brown R, Schulz J. A qualitative exploration of the daily experiences and challenges faced by parents and caregivers of children with Tourette’s syndrome. J Health Psychol 2016; 23:1790-1799. [DOI: 10.1177/1359105316669878] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Few studies address the daily challenges faced by parents of children diagnosed with Tourette’s syndrome. This article reports on a qualitative interview study with 15 parents exploring their experiences, the challenges they face and the support mechanisms they have found to be most helpful. Thematic analysis identified four core categories which represented shared experiences of the participants: coping with children’s challenging behaviours, misconceptions and lack of understanding of professionals and the lay public, negative experiences of their children’s education and lack of support and services for families with Tourette’s syndrome. The findings highlight the challenges of parenting a child with Tourette’s syndrome, particularly with respect to family life and the child’s schooling.
Collapse
|
30
|
Zuckerman KE, Lindly OJ, Sinche B. Parent Beliefs About the Causes of Learning and Developmental Problems Among Children With Autism Spectrum Disorder: Results From a National Survey. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 121:432-47. [PMID: 27611353 PMCID: PMC5575795 DOI: 10.1352/1944-7558-121.5.432] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This study aimed to assess variation in parent beliefs about causes of learning and developmental problems in U.S. children with autism spectrum disorder, using data from a nationally representative survey. Results showed that beliefs about a genetic/hereditary cause of learning/developmental problems were most common, but nearly as many parents believed in exposure causes. Forty present of parents had no definite causal beliefs. On multivariate analysis, parents who were non-White, publicly insured or poor were more likely than other parents to endorse exposure causes, or less likely to endorse genetic causes, compared to other parents. Further research should assess how these beliefs modify health care quality or services use.
Collapse
Affiliation(s)
- Katharine E Zuckerman
- Katharine E. Zuckerman, Divison of General Pediatrics, Doernbecher Children's Hospital and Oregon Health & Science University; Olivia J. Lindly, Oregon State University, College of Public Health and Human Sciences; and Brianna Sinche, Division of General Pediatrics, Doernbecher Children's Hospital and Oregon Health & Science University
| | - Olivia J Lindly
- Katharine E. Zuckerman, Divison of General Pediatrics, Doernbecher Children's Hospital and Oregon Health & Science University; Olivia J. Lindly, Oregon State University, College of Public Health and Human Sciences; and Brianna Sinche, Division of General Pediatrics, Doernbecher Children's Hospital and Oregon Health & Science University
| | - Brianna Sinche
- Katharine E. Zuckerman, Divison of General Pediatrics, Doernbecher Children's Hospital and Oregon Health & Science University; Olivia J. Lindly, Oregon State University, College of Public Health and Human Sciences; and Brianna Sinche, Division of General Pediatrics, Doernbecher Children's Hospital and Oregon Health & Science University
| |
Collapse
|
31
|
[Level of training in autistic spectrum disorders among hospital paediatricians]. An Pediatr (Barc) 2016; 86:329-336. [PMID: 27325257 DOI: 10.1016/j.anpedi.2016.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/06/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Training in autistic spectrum disorders is crucial in order to achieve an early diagnosis. However, the number of papers describing this training is limited. This study describes this level of knowledge among paediatricians from tertiary care hospitals in different regions of Spain and detects areas that need improvement. MATERIAL AND METHOD A total of one hundred and fifty-seven (157) paediatricians working in tertiary healthcare hospitals located in three different regions in Spain consented to complete an online questionnaire divided in three sections (socio-demographic, knowledge about childhood autism, and opinion). Data were analysed using SPSS version 15. RESULTS The total mean score of participating paediatricians in the questionnaire was 20.34 (± 2.43 SD) out of a total possible score of 23. Approximately two-thirds (65%) of paediatricians scored more or equal to the mean score. The knowledge gap was found to be higher with symptoms of repetitive behaviour patterns, concept of autism, and comorbidity, with no statistical significance. There were no differences in paediatrician scores within different socio-demographic groups. Just under two-thirds (64%) of paediatricians subscribed to the opinion that their own knowledge about autism is limited, and there is a significant lack of knowledge about facilities in every region. CONCLUSIONS There is a sufficient level of knowledge about autism among paediatricians in tertiary healthcare, although a lack of awareness about the management of these patients, with poor coordination between the different specialists that are involved in their treatment. Efforts should focus on achieving a better coordination between these specialists, and update the knowledge gaps identified.
Collapse
|
32
|
Practices and outcomes of self-treatment with helminths based on physicians' observations. J Helminthol 2016; 91:267-277. [DOI: 10.1017/s0022149x16000316] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractThe successful use of helminths as therapeutic agents to resolve inflammatory disease was first recorded 40 years ago. Subsequent work in animal models and in humans has demonstrated that the organisms might effectively treat a wide range of inflammatory diseases, including allergies, autoimmune disorders and inflammation-associated neuropsychiatric disorders. However, available information regarding the therapeutic uses and effects of helminths in humans is limited. This study probes the practices and experiences of individuals ‘self-treating’ with helminths through the eyes of their physicians. Five physicians monitoring more than 700 self-treating patients were interviewed. The results strongly support previous indications that helminth therapy can effectively treat a wide range of allergies, autoimmune conditions and neuropsychiatric disorders, such as major depression and anxiety disorders. Approximately 57% of the self-treating patients observed by physicians in the study had autism. Physicians reported that the majority of patients with autism and inflammation-associated co-morbidities responded favourably to therapy with either of the two most popular organisms currently used by self-treaters, Hymenolepis diminuta and Trichuris suis. However, approximately 1% of paediatric patients experienced severe gastrointestinal pains with the use of H. diminuta, although the symptoms were resolved with an anti-helminthic drug. Further, exposure to helminths apparently did not affect the impaired comprehension of social situations that is the hallmark of autism. These observations point toward potential starting points for clinical trials, and provide further support for the importance of such trials and for concerted efforts aimed at probing the potential of helminths, and perhaps other biologicals, for therapeutic use.
Collapse
|
33
|
Höfer J, Hoffmann F, Bachmann C. Use of complementary and alternative medicine in children and adolescents with autism spectrum disorder: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:387-402. [DOI: 10.1177/1362361316646559] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Despite limited evidence, complementary and alternative medicine treatments are popular in autism spectrum disorder. The aim of this review was to summarize the available evidence on complementary and alternative medicine use frequency in autism spectrum disorder. A systematic search of three electronic databases was performed. All research studies in English or German reporting data on the frequency of complementary and alternative medicine use in individuals with autism spectrum disorder were included. Two independent reviewers searched the literature, extracted information on study design and results, and assessed study quality using an established quality assessment tool. Twenty studies with a total of 9540 participants were included. The prevalence of any complementary and alternative medicine use ranged from 28% to 95% (median: 54%). Special diets or dietary supplements (including vitamins) were the most frequent complementary and alternative medicine treatments, ranking first in 75% of studies. There was some evidence for a higher prevalence of complementary and alternative medicine use in autism spectrum disorder compared to other psychiatric disorders and the general population. Approximately half of children and adolescents with autism spectrum disorder use complementary and alternative medicine. Doctors should be aware of this and should discuss complementary and alternative medicine use with patients and their carers, especially as the evidence is mixed and some complementary and alternative medicine treatments are potentially harmful.
Collapse
Affiliation(s)
| | | | - Christian Bachmann
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| |
Collapse
|
34
|
Benevides TW, Carretta HJ, Mandell DS. Differences in Perceived Need for Medical, Therapeutic, and Family Support Services Among Children With ASD. Pediatrics 2016; 137 Suppl 2:S176-85. [PMID: 26908473 DOI: 10.1542/peds.2015-2851p] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Identifying racial and ethnic differences in perceived need for treatment among families of children with autism spectrum disorder (ASD) will improve understanding of disparities in care seeking. We described racial and ethnic differences in perceived need for services that children with ASD and their families frequently use. METHODS We conducted bivariate analyses of racial and ethnic categories and perceived need for 6 common services used by children with ASD as found in the 2005 to 2006 (n = 2123) and the 2009 to 2010 (n = 3055) National Survey of Children With Special Health Care Needs data sets. Multivariate logistic regressions within concatenated data sets were conducted to examine associations between racial and ethnic category and perceived service needs while controlling for predisposing, enabling, and child factors. RESULTS Compared with caregivers of white non-Hispanic children with ASD, caregivers of Hispanic children reported less need for prescription medications in adjusted multivariate analyses. Caregivers of black non-Hispanic children with ASD reported less need for prescription medications and for child and family mental health services than caregivers of white non-Hispanic children. Both English-speaking Hispanic caregivers and black non-Hispanic caregivers reported greater need for occupational, speech, and physical therapy than white non-Hispanic caregivers. No racial or ethnic differences were found in perceived need for specialty medical care or respite care. CONCLUSIONS Caregivers of children with ASD from different racial and ethnic backgrounds may differentially perceive need for different types of care. Their perceptions may in turn affect how they prioritize and seek care, independent of their child's specific needs.
Collapse
Affiliation(s)
- Teal W Benevides
- Department of Occupational Therapy, College of Health Professions, Thomas Jefferson University, Philadelphia, Pennsylvania;
| | - Henry J Carretta
- Florida State University, Department of Family Medicine & Rural Health Division of Health Affairs, College of Medicine, Tallahassee, Florida; and
| | - David S Mandell
- Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
35
|
Zwaigenbaum L, Bauman ML, Fein D, Pierce K, Buie T, Davis PA, Newschaffer C, Robins DL, Wetherby A, Choueiri R, Kasari C, Stone WL, Yirmiya N, Estes A, Hansen RL, McPartland JC, Natowicz MR, Carter A, Granpeesheh D, Mailloux Z, Smith Roley S, Wagner S. Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research. Pediatrics 2015; 136 Suppl 1:S41-59. [PMID: 26430169 PMCID: PMC9923900 DOI: 10.1542/peds.2014-3667d] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This article reviews current evidence for autism spectrum disorder (ASD) screening based on peer-reviewed articles published to December 2013. Screening provides a standardized process to ensure that children are systematically monitored for early signs of ASD to promote earlier diagnosis. The current review indicates that screening in children aged 18 to 24 months can assist in early detection, consistent with current American Academy of Pediatrics' recommendations. We identify ASD-specific and broadband screening tools that have been evaluated in large community samples which show particular promise in terms of accurate classification and clinical utility. We also suggest strategies to help overcome challenges to implementing ASD screening in community practice, as well as priorities for future research.
Collapse
Affiliation(s)
- Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada;
| | - Margaret L. Bauman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Deborah Fein
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Karen Pierce
- Department of Neurosciences, University of California San Diego, La Jolla, California
| | - Timothy Buie
- Harvard Medical School and Massachusetts General Hospital for Children, Boston, Massachusetts
| | | | - Craig Newschaffer
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Diana L. Robins
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Amy Wetherby
- Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, Florida
| | - Roula Choueiri
- Division of Developmental and Behavioral Pediatrics, University of Massachusetts Memorial Children’s Medical Center, Worcester, Massachusetts
| | - Connie Kasari
- Graduate School of Education & Information Studies, University of California Los Angeles, Los Angeles, California
| | | | - Nurit Yirmiya
- Department of Psychology, Hebrew University of Jerusalem Mount Scopus, Jerusalem, Israel
| | - Annette Estes
- Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Robin L. Hansen
- Department of Pediatrics, University of California Davis MIND Institute, Sacramento, California
| | | | | | - Alice Carter
- Department of Psychology, University of Massachusetts, Boston, Massachusetts
| | | | - Zoe Mailloux
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Susanne Smith Roley
- USC Mrs T.H. Chan Division of Occupational Science and Occupational Therapy, Los Angeles, California; and
| | - Sheldon Wagner
- Behavioral Development & Educational Services, New Bedford, Massachusetts
| |
Collapse
|
36
|
Zerbo O, Massolo ML, Qian Y, Croen LA. A Study of Physician Knowledge and Experience with Autism in Adults in a Large Integrated Healthcare System. J Autism Dev Disord 2015; 45:4002-14. [DOI: 10.1007/s10803-015-2579-2] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
37
|
Fischbach RL, Harris MJ, Ballan MS, Fischbach GD, Link BG. Is there concordance in attitudes and beliefs between parents and scientists about autism spectrum disorder? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 20:353-63. [PMID: 26014839 DOI: 10.1177/1362361315585310] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
There is no reported investigation comparing concordance in attitudes and beliefs about autism spectrum disorder between parents of children with autism spectrum disorder and scientists who research autism spectrum disorder. To investigate the level of concordance between these groups on causes of autism, priorities of research, perceived stigma, and disclosure of genetic test results, telephone interviews were conducted. Parents (n = 502) were recruited from the Simons Simplex Collection, and research scientists (n = 60) were recruited from investigators funded by the Simons Foundation. Response rates were notable (parents 91%, scientists 80%). Parents and scientists differed significantly regarding beliefs of the likely major cause of autism (p = 0.007) and priorities for further research (p < 0.001). Scientists believed in genetic causes while many parents believed in vaccines as the cause of autism. Parents (37%) were more likely to hesitate vaccinating their child (p < 0.001). In contrast, there was strong concordance regarding extent of perceived stigma (95% vs 92%) and preferences for disclosure of genetic test results, including incidental findings. While scientists believed communication important, paradoxically fewer than half reported it important for scientists to communicate directly with parents. Better communication between parents and scientists should improve mutual understanding and ultimately the health and well-being of children with autism spectrum disorder and their families.
Collapse
Affiliation(s)
- Ruth L Fischbach
- Columbia University College of Physicians and Surgeons, USA Columbia University Mailman School of Public Health, USA
| | - Mark J Harris
- Columbia University College of Physicians and Surgeons, USA
| | | | - Gerald D Fischbach
- Columbia University College of Physicians and Surgeons, USA Simons Foundation, USA
| | - Bruce G Link
- Columbia University Mailman School of Public Health, USA New York State Psychiatric Institute, USA
| |
Collapse
|
38
|
Lake JK, Vogan V, Sawyer A, Weiss JA, Lunsky Y. Psychotropic medication use among adolescents and young adults with an autism spectrum disorder: parent views about medication use and healthcare services. J Child Adolesc Psychopharmacol 2015; 25:260-8. [PMID: 25803636 DOI: 10.1089/cap.2014.0106] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Psychotropic medications are frequently used to treat mental health and behavioral issues in adolescents and adults with an autism spectrum disorder (ASD). Although parents of individuals with ASD frequently take on medication management for their child, there is limited literature on parent perspectives of their child's medication use or their views about the healthcare services they receive, particularly in adulthood. The current study examined and compared parents of adolescents and of young adults with ASD regarding their child's psychotropic medication use and their views about healthcare services. METHODS One hundred parents of adolescents and young adults with ASD (ages 12-30 years) completed an online survey about their experience with their child's healthcare services and medication use. RESULTS Parents of young adults were less likely to use nonpharmacological services before using a psychotropic medication than were parents of adolescents. Parents of young adults were also less likely to believe that their prescribing healthcare provider had adequate expertise in ASD, and were less satisfied with how their prescriber monitored their child's medication use. CONCLUSION Findings highlight the need to build capacity among healthcare providers supporting individuals with ASD as they transition into adulthood. There is also a need for improved medication monitoring and increased awareness of the different mental health challenges that individuals with ASD encounter as they age.
Collapse
Affiliation(s)
- Johanna K Lake
- 1 Centre for Addiction and Mental Health, Dual Diagnosis Service , Toronto, Ontario, Canada
| | | | | | | | | |
Collapse
|
39
|
Crane L, Chester JW, Goddard L, Henry LA, Hill E. Experiences of autism diagnosis: A survey of over 1000 parents in the United Kingdom. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 20:153-62. [DOI: 10.1177/1362361315573636] [Citation(s) in RCA: 245] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A sample of 1047 parents completed an online survey about their experiences and opinions regarding the process of attaining a diagnosis of autism spectrum disorder for their children. The results revealed that parents usually waited a year from when they first had concerns about their child’s development before they sought professional help. On average, there was a delay of around 3.5 years from the point at which parents first approached a health professional with their concerns to the confirmation of an autism spectrum disorder diagnosis. Just over half of the parents surveyed were dissatisfied with the diagnostic process as a whole. Several factors predicted parents’ overall levels of satisfaction with the diagnostic process, including the time taken to receive a diagnosis, satisfaction with the information provided at diagnosis, the manner of the diagnosing professional, the stress associated with the diagnostic process and satisfaction with post-diagnostic support. Post-diagnosis, the support (if any) that was provided to parents was deemed unsatisfactory, and this was highlighted as an area of particular concern among parents.
Collapse
|
40
|
Lilienfeld SO, Marshall J, Todd JT, Shane HC. The persistence of fad interventions in the face of negative scientific evidence: Facilitated communication for autism as a case example. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/17489539.2014.976332] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
41
|
Diagnosis of pervasive developmental disorders: when and how? An area-based study about health care providers. World J Pediatr 2015; 11:48-53. [PMID: 25447633 DOI: 10.1007/s12519-014-0533-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 11/22/2013] [Indexed: 10/24/2022]
Abstract
BACKGROUND Pervasive developmental disorders (PDDs) can be very difficult to diagnose in children and to communicate such a diagnosis to their parents. Families of children with PDD learn of their child's diagnosis long after the first symptoms are noted in the child's behavior. METHODS An area-based survey was conducted to assess all social and health care providers taking care of patients with PDDs in the Veneto Region (North-East Italy). RESULTS Only 28% of health care providers arrived at a definite diagnosis when the child was in his/her first year of age, 51% when the child was 2-3 years old and 21% from age of 4 years and up. On average, the latency between the time of the diagnosis and its communication to the family was 6.9 months. However, a number of families did not ever have a diagnosis communicated to them. Sometimes, 68% of the providers did not communicate a PDDs diagnosis to patient's families, and 4% of them quite commonly. CONCLUSION The well-known delay in making a diagnosis of PDDs has two distinct components: one relating to the difficulty of confirming a diagnosis of PDDs, the other, hitherto unrecognized, relating to the family being notified.
Collapse
|
42
|
Chen LS, Li C, Wang CH, Amuta A, Li M, Huang TY, Dhar SU, Talwar D, Jung E. Autism spectrum disorders: perceptions of genetic etiology and recurrence risk among Taiwanese parents of affected children. Clin Genet 2014; 88:129-34. [PMID: 25267333 DOI: 10.1111/cge.12514] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/11/2014] [Accepted: 09/26/2014] [Indexed: 11/29/2022]
Abstract
In Taiwan, autism spectrum disorders (ASDs) are an emerging public health concern. The ongoing scientific progress for understanding the genetic etiology of ASD makes it increasingly important to examine how parents of children with ASD perceive the causes and recurrence risk of having another child with ASD. These perceptions may influence their family planning, attitudes toward genetic services, and willingness to take their children for ASD genetic testing. However, previous studies addressing this issue were conducted primarily in Western countries. As culture might shape an individual's views of genetic/genomic disorders, this first-of-its-kind study examined the perceptions of the genetic etiology for ASD and the recurrence risk among Taiwanese parents of children affected with ASD. In-depth, semi-structured interviews were conducted among 39 parents having at least one child with ASD. Although the majority of participants believed that ASD has a genetic link, less than half perceived genetic factors as the cause of their own child's ASD. Moreover, most participants articulated their recurrence risk incorrectly. Some parents were concerned about their doctors' limited genomic competencies. To provide parents with better education, counseling, and support for making reproductive decisions, ASD-related genomic education among Taiwanese physicians is needed.
Collapse
Affiliation(s)
- L S Chen
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - C Li
- Department of Foreign Languages, WeiFang Medical University, Shandong, China
| | - C H Wang
- Department of Special Education, National HsinChu University of Education, HsinChu, Taiwan
| | - A Amuta
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - M Li
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - T Y Huang
- Department of Special Education, National HsinChu University of Education, HsinChu, Taiwan
| | - S U Dhar
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - D Talwar
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - E Jung
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| |
Collapse
|
43
|
Parent Reports of Treatments and Interventions Used With Children With Autism Spectrum Disorders (ASD): A Review of the Literature. ACTA ACUST UNITED AC 2014. [DOI: 10.1017/jse.2014.4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
With the increasing number of treatment and intervention options for parents of children with autism spectrum disorders (ASD) in recent years, the number and types of interventions that parents are choosing to use has become of interest. In the present paper, the authors review 41 articles (describing 42 studies) presenting quantitative data on intervention choices of parents of children with ASD. Speech therapy was the most commonly reported intervention for both current and lifetime use. Across the studies, parents were reported to be using a variety of interventions, from those with strong empirical support, such as applied behaviour analysis (ABA), to others that lacked such support, such as dietary interventions. Some differences in the data presented across studies may be attributed to the range of different methodologies used to collect the data. Recommendations for future research, including those related to collecting treatment usage data more consistently, are discussed.
Collapse
|
44
|
Zhao ZQ, Jia SW, Hu S, Sun W. Evaluating the effectiveness of electro-acupuncture as a treatment for childhood autism using single photon emission computed tomography. Chin J Integr Med 2013; 20:19-23. [PMID: 24374754 DOI: 10.1007/s11655-014-1680-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To explore the effectiveness of electro-acupuncture (EA) in the treatment of childhood autism (CA) and evaluate its effectiveness using single photon emission computed tomography (SPECT). METHODS A total of 55 CA patients (4.52±2.73 years) were enrolled in this study. All patients received EA treatments and were examined by SPECT before and after treatments. RESULTS Following treatment, the intracerebral multiple focal radioactivity distribution defect areas of CA patients were observed to be partially filled. Specifically, significant differences in the ratios of regional cerebral blood flow and global cerebral blood flow before (Fb) and after (Fe) EA treatment in different lesions were observed (in the left prefrontal cortex, t=5.01, P<0.01; in the right prefrontal cortex, t=2.32, P<0.05; in the left temporal lobe, t=4.54, P<0.01; in the right temporal lobe, t=2.90, P<0.05; in the left Broca's area, t=5.82, P<0.01). After EA treatment, the patients exhibited symptomatic relief. CONCLUSION EA is useful to treat CA and SPECT can be used to evaluate the effectiveness of this treatment.
Collapse
Affiliation(s)
- Zheng-qin Zhao
- Department of Nuclear Medicine, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, 518036, China
| | | | | | | |
Collapse
|
45
|
Autism genetic testing: a qualitative study of awareness, attitudes, and experiences among parents of children with autism spectrum disorders. Genet Med 2013; 15:274-81. [DOI: 10.1038/gim.2012.145] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
46
|
O'Reilly M, Cook L, Karim K. Complementary or controversial care? The opinions of professionals on complementary and alternative interventions for Autistic Spectrum Disorder. Clin Child Psychol Psychiatry 2012; 17:602-15. [PMID: 22371629 DOI: 10.1177/1359104511435340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The use of complementary and alternative interventions is growing and gaining popularity, both in the UK and internationally, with significant financial and emotional implications. Complementary and alternative interventions are often utilised by parents of children with Autistic Spectrum Disorders and research has investigated parental beliefs. There is, however, limited understanding regarding what professionals believe about the use of alternative treatments. In this paper we explore the opinions of a range of different professionals about alternative treatments and found that while some have an open-minded opinion, there was a tendency to hold beliefs that these treatments are ineffective, that they give false hope and have potential to harm the child. We discuss the implications for this in terms of the importance of an open dialogue between professionals and families and consider the importance of this in relation to the popularity of these interventions.
Collapse
|
47
|
Wang J, Zhou X, Xia W, Sun C, Wu L, Wang J. Autism awareness and attitudes towards treatment in caregivers of children aged 3-6 years in Harbin, China. Soc Psychiatry Psychiatr Epidemiol 2012; 47:1301-8. [PMID: 22009414 DOI: 10.1007/s00127-011-0438-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 10/04/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To (1) estimate the proportion of people in the community who could correctly recognize autism spectrum disorders (ASD); (2) describe the attitudes towards various treatments for ASD; and (3) identify factors associated with ASD recognition. METHODS A population-based cross-sectional survey was conducted in Harbin, China (n = 4,947). We estimated the proportions of participants who were at different levels of knowledge about ASD and of their attitudes towards mental health service use. Multivariate logistic regression modeling was used to identify factors associated with the recognition of ASD. RESULTS Overall, 2,786 (57.8%) of the respondents could recognize the ASD. Recognition of autism depended on gender, residing areas, age and educational levels. With respect to the attitudes towards mental health service use for ASD, 4,007 respondents (84.6%) chose to visit a health organization for treatment; 2,470 (68.2%) made the choice of consulting a psychotherapist. CONCLUSIONS There is a large room for improvement in awareness about ASD and treatment in the Chinese communities. Insufficient knowledge about ASD and inappropriate attitudes towards mental health service use may impede the efforts of early identification and intervention. Health education and promotion are needed to improve people's knowledge about ASD and available mental health services.
Collapse
Affiliation(s)
- Jia Wang
- Department of Children's and Adolescent Health, Public Health College of Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, People's Republic of China
| | | | | | | | | | | |
Collapse
|
48
|
Dolphin-Assisted Therapy: Claims versus Evidence. AUTISM RESEARCH AND TREATMENT 2012; 2012:839792. [PMID: 22928101 PMCID: PMC3420785 DOI: 10.1155/2012/839792] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 06/24/2012] [Indexed: 11/18/2022]
Abstract
The purpose of this paper is to review and critique studies that have been conducted on dolphin-assisted therapy for children with various disorders. Studies have been released claiming swimming with dolphins is therapeutic and beneficial for children with autism, attention deficit hyperactivity disorder, physical disabilities, and other psychological disorders. The majority of the studies conducted supporting the effectiveness of dolphin-assisted therapy have been found to have major methodological concerns making it impossible to draw valid conclusions. Readers will be informed of the history of, theory behind, and variations of dolphin-assisted therapy along with a review and critique of studies published which purportedly support its use.
Collapse
|
49
|
Bazzano A, Zeldin A, Schuster E, Barrett C, Lehrer D. Vaccine-related beliefs and practices of parents of children with autism spectrum disorders. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 117:233-242. [PMID: 22716265 DOI: 10.1352/1944-7558-117.3.233] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although the assertion of a link between vaccines and autism has been scientifically rejected, the theory continues to be popular and may influence the attitudes of parents of children with autism spectrum disorders. The authors sought to assess how often parents change or discontinue their child's vaccine schedule after autism spectrum disorder diagnosis and whether beliefs about the etiology of autism affect their decision to do so. The authors surveyed 197 (43%) of 460 eligible parents of children under 18 years of age with autism spectrum disorders who were enrolled in a state-funded agency that provides services to those with developmental disabilities in western Los Angeles County. Half of the parents discontinued or changed vaccination practices, and this was associated with a belief that vaccines contributed to autism spectrum disorders, indicating a potential subset of undervaccinated children. Educational tools should be designed to assist physicians when talking to parents of children with autism spectrum disorders about vaccination.
Collapse
Affiliation(s)
- Alicia Bazzano
- UCLA Fielding School of Public Health, Department of Health Services, Los Angeles, CA 90095-1772, USA.
| | | | | | | | | |
Collapse
|
50
|
Gurrieri F. Working up autism: The practical role of medical genetics. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2012; 160C:104-10. [DOI: 10.1002/ajmg.c.31326] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|