Parent Education and Training for autism spectrum disorders: Scoping the evidence

Empowering families of children with autism spectrum disorder through education and training is best practice. A wide range of Parent Education and Training programmes are delivered around the globe, but there is limited knowledge about the characteristics of these programmes, or about the research methods and outcomes used to evaluate them, particularly in countries outside the United States. We, therefore, performed a scoping review of all peer-reviewed Parent Education and Training publications outside the United States. A search was conducted between March and May 2017. Four reviewers extracted data and performed a mixed-methods quality appraisal of publications. Thirty-seven publications representing 32 unique programmes were identified. Publications described a highly diverse range of Parent Education and Training programmes across 20 countries and all continents except South America. The majority were group-based, but varied significantly in goals, modalities and duration. The majority of studies (86.4%) reported positive outcomes in relation to the core study objectives and only two studies reported some negative findings. Quality appraisal rated only 27% of studies to have met all the methodological quality criteria. Implementation factors such as manualisation, fidelity and cost were commented on infrequently. In spite of the clear need for Parent Education and Training programmes, our findings show that the research evidence-base in autism spectrum disorder outside the United States is relatively small, non-representative and in need of methodological quality improvements.

Extension for Community Healthcare Outcomes Uruguay: A New Strategy to Promote Best Primary Care Practice for Autism

Introduction. In Uruguay, the special care required for children with neurodevelopmental disorders presents difficulties including lack of access to specialists and rehabilitation services. Project ECHO (Extension for Community Healthcare Outcomes) connects primary care clinicians from remote areas to specialists to enable them to treat complex conditions through ongoing education and mentoring. Objective. To share the experience of the ECHO Autism program during the first 2 years of implementation. Methods. Analysis of ECHO Autism clinics from June 2015 to June 2017 including clinical cases presented participants' self-perception of changes in skills and competences. Results. Twenty clinical cases were presented: mean age 4.5 years; 15 were males; and 17 with medical and psychiatric comorbidities. After ECHO Autism implementation, a statistically significant improvement in participants' self-perception of skills and competences was observed. Conclusions. ECHO Autism in Uruguay is a meaningful approach to autism care and offers improved access to best practice care.

Invisible work of using and monitoring knowledge by parents (end-users) of children with chronic conditions

BACKGROUND

Parents who care for young children with chronic conditions are knowledge users. Their efforts, time, and energy to source, consider and monitor information add to the 'invisible' work of parents in making decisions about care, school transitions, and interventions. Little is known or understood about the work of parents as knowledge users.

OBJECTIVE

To understand the knowledge use patterns and how these patterns may be monitored in parents caring for their young children with cerebral palsy (CP).

METHODS

An embedded case study methodology was used. In-depth qualitative interviews and visual mapping were employed to collect and analyze data based on the experiences of three mothers of young children with CP.

RESULTS

Knowledge use in parents caring for their young children with CP is multi-factorial, complex and temporal. Findings resulted in a provisional model elaborating on the ways knowledge is used by parents and how it may be monitored.

CONCLUSIONS

The visual mapping of pathways and actions of parents as end users makes the processes of knowledge use more visible and open to be valued as well as appreciated by others. The provisional model has implications for knowledge mobilization as a strategy in childhood rehabilitation and the facilitation of knowledge use in the lives of families with children with chronic health conditions.

Impact of Diagnostic Practices on the Self-Reported Health of Mothers of Recently Diagnosed Children with ASD

Objectives: Obtaining a diagnosis of an Autism Spectrum Disorder (ASD) for a child is a pivotal point in developing the treatment plan for the child but can also be regarded as highly stressful by parents. The current study examined the impact of different aspects of the diagnosis process on the self-reported mental health of mothers of children undergoing a diagnosis for ASD in a cross-sectional cohort design. Methods: One-hundred-fifty-eight mothers of consequently diagnosed children with ASD participated. The severity of the children’s ASD and their intellectual functioning was assessed within twelve months of the diagnosis, and the mothers completed a psychometric assessment battery including the Hospital Anxiety and Depression Scale, General Health Questionnaire, and Questionnaire on Resources and Stress. Results: The actual time from first reporting a problem to obtaining a diagnosis, and the speed of the diagnostic process from first to last appointment, were both negatively related to patenting stress. In contrast, mothers’ perceptions of the speed and helpfulness of the process were negatively related to levels of anxiety and depression. The number of professionals involved in the process and the perceived coherence of the diagnosis were also negatively related to aspects of mothers’ functioning. Conclusions: Care is needed to help mothers through the diagnostic process with regard to their own functioning. Providing information and help sources throughout the process, while keeping the number of professionals involved to a minimum, may improve the parent perception of the process and reduce the negative impacts of the diagnosis on the family as a whole.

Profile and predictors of service needs for families of children with autism spectrum disorders

Purpose:

Increasing demand for autism services is straining service systems. Tailoring services to best meet families’ needs could improve their quality of life and decrease burden on the system. We explored overall, best, and worst met service needs, and predictors of those needs, for families of children with autism spectrum disorders.

Methods:

Parents of 143 children with autism spectrum disorders (2–18 years) completed a survey including demographic and descriptive information, the Family Needs Survey–Revised, and an open-ended question about service needs. Descriptive statistics characterize the sample and determine the degree to which items were identified and met as needs. Predictors of total and unmet needs were modeled with regression or generalized linear model. Qualitative responses were thematically analyzed.

Results:

The most frequently identified overall and unmet service needs were information on services, family support, and respite care. The funding and quality of professional support available were viewed positively. Decreased child’s age and income and being an older mother predicted more total needs. Having an older child or mother, lower income, and disruptive behaviors predicted more total unmet needs, yet only disruptive behaviors predicted proportional unmet need. Child’s language or intellectual abilities did not predict needs.

Conclusion:

Findings can help professionals, funders, and policy-makers tailor services to best meet families’ needs.

Autism in Vietnam: the case for the development and evaluation of an information book to be distributed at the time of diagnosis

Autism is not generally well understood by the community in the West or in Asia. A diagnosis of autism is distressing for all families. When families receive the diagnosis they are often not able to fully appreciate what it means or process the information given to them. Booklets exist in English that contain relevant autism related information but few have been evaluated. In Vietnam, parents do not have ready access to autism related information. This paper makes the case for offering a Vietnamese language information resource/booklet for parents to be distributed at the beginning of the diagnostic process and evaluating its usefulness. In developed countries autism has been recognised since the 1940s (Kanner, 1943). More recently it is being increasingly recognised in children with average and above intelligence. In Vietnam, a Western view of autism is just developing. Consequently community resources are undeveloped. The community, in general, and health services for children, in particular, have a rudimentary understanding of autism. This paper discusses a Western understanding of autism, autism in Vietnam, and suggests one possible strategy for addressing the educational needs around autism in Vietnam.