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Lee A, Lee SI, Shin Y, Lee J. The Reliability and Validity of the Korean Version of Autism Spectrum Quotient (AQ) Children's Version. J Autism Dev Disord 2024:10.1007/s10803-024-06572-3. [PMID: 39377897 DOI: 10.1007/s10803-024-06572-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2024] [Indexed: 10/09/2024]
Abstract
There is no validated screening measure for children with high-functioning autism spectrum disorder (ASD) in Korea. The purpose of the present study was (1) to examine the reliability and validity of the Korean version of the Autism Spectrum-Child (K-AQ-Child); (2) to find the optimal cut-off value of the K- AQ-Child in the Korean population. A total of 144 children aged 4-11 years (male 80.6%, mean age = 7.05 ± 1.75) were recruited in this study, with 72 in the high-functioning ASD group and 72 in the non-clinical Control group. The Cronbach's alpha coefficient of the K-AQ-child was 0.962, showing excellent internal consistency. For discriminant validity, the ASD group scored significantly higher than the Control group on the total score and all the scores of the subdomains of the K-AQ-Child after controlling for sex. Significant positive correlation between total scores of the K-AQ-Child and the K-SCQ was found. The optimal cut-off value of 58.5 yielded a sensitivity of 0.931 and specificity of 0.986. K-AQ-Child is a valid and reliable measure to quantify autistic traits and identify the high-risk individuals for further diagnostic evaluation in intellectually capable children aged 4-11 years. It would be useful for both clinical practice and research purposes. Clinical Trial Registration The trial was registered at the Clinical Research Information Service (CRIS) of Republic of Korea (Registration Number: KCT0008907).
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Affiliation(s)
- Areum Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Soonchunhyang University College of Medicine, Asan, Republic of Korea
| | - Yunmi Shin
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jeewon Lee
- Department of Psychiatry, Soonchunhyang University College of Medicine, Asan, Republic of Korea.
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2
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Torralbas-Ortega J, Valls-Ibáñez V, Roca J, Campoy-Guerrero C, Sastre-Rus M, García-Expósito J. Sexual Affectivity in Autism Spectrum Disorder: Bibliometric Profile of Scientific Production. ARCHIVES OF SEXUAL BEHAVIOR 2024:10.1007/s10508-024-02996-1. [PMID: 39269514 DOI: 10.1007/s10508-024-02996-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/15/2024]
Abstract
The aim of the present study was to describe the scientific production on sexuality and affectivity of autistic people. The inclusion criteria were articles published in all languages from the year 2000 to 2023, excluding reviews, proceedings, and other works not considered original. The search was performed in the Web of Science Core Collection and RStudio was utilized to analyze the records, with the "Bibliometrix 4.1.0" package and the VOSviewer software. A total of 314 articles were included, from the USA, Australia, and parts of Europe. The production peak was found in the year 2020, the most cited articles referred to the children's population, and the most important journals were specialized on the subject. As for the thematic content, 29 keywords emerged that were grouped into three clusters. In the first group, children associated with vulnerability and victimization were underlined, in which multifocal interventions were needed to prevent risk; in the second, we found adolescents and the need for sex education that is adapted and comprehensive; and lastly, adults who must be able to perform an adequate transition that eases the adaptation of neurodivergent individuals.
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Affiliation(s)
- Jordi Torralbas-Ortega
- Hospital de La Santa Creu i Sant Pau, Barcelona, Spain
- Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | | | - Judith Roca
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig St. 25198, Lleida, Spain.
- Nursing, Sustainability and Innovation Research Group (GREISI), Health Education, Lleida, Spain.
| | - Carme Campoy-Guerrero
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig St. 25198, Lleida, Spain
- African Societies Study Group, Lleida, Spain
| | - Meritxell Sastre-Rus
- Hospital de La Santa Creu i Sant Pau, Barcelona, Spain
- Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Judith García-Expósito
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig St. 25198, Lleida, Spain
- Bachelor of Nursing, University of Andorra, Sant Julià de Lòria, Andorra
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3
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Westby C, Chen KM, Cheng L, Jithavech P, Maroonroge S. Autism in Taiwan and Thailand: Influences of Culture. Neuropsychiatr Dis Treat 2024; 20:1523-1538. [PMID: 39113831 PMCID: PMC11303671 DOI: 10.2147/ndt.s462864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/11/2024] [Indexed: 08/10/2024] Open
Abstract
The prevalence of autism is increasing worldwide. The majority of autism research and development of autism assessments and interventions has been conducted in Western cultures. The prevalence of autism is reportedly lower in Asian versus Western cultures, but this is likely due to lack of personnel and uniform criteria for diagnosing autism. This article describes how two Asian cultures, Taiwan and Thailand, are dealing with the increasing identification of autistic children. National universal healthcare in both Taiwan and Thailand provides a mechanism for assessment and diagnosis of young children, but a lack of a sufficient number of trained professionals limits the availability of intervention services. A focus of research in these cultures has been on parents' experiences and coping with the stigma and stress of having an autistic child. Cultural values associated with Confucianism and Buddhism influence attitudes toward persons with disability and how parents of autistic children experience and cope with stigma and stress. Both areas have national laws that provide a range of educational opportunities for autistic children, including inclusion into general education classrooms. Special education and general education teachers, however, have little specific training in autism. Speech and language services are rarely offered in public school programs. Available speech and language services are limited to consultation with teachers a few times a year. In general, parents of autistic children are supportive of inclusion programs, but teachers and parents of both autistic and typically developing children express concerns about the ability to implement such programs in ways that are beneficial to all children.
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Affiliation(s)
- Carol Westby
- Bilingual Multicultural Services, Albuquerque, NM, USA
| | - Kai-Mei Chen
- Muen Speech-Language Clinic, Taichung City, Taiwan
| | - Lilly Cheng
- Chinese Cultural Center, San Diego State University, San Diego, CA, USA
| | - Ponjit Jithavech
- Department of Communication Sciences and Disorders, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sumalai Maroonroge
- Communication Sciences and Disorders, Texas A&M International University, Laredo, TX, USA
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4
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Paolizzi E, Perzolli S, Bentenuto A, Bertamini G, Venuti P. Characterization of dyadic interaction features between fathers and mothers playing with their autistic children. Acta Psychol (Amst) 2024; 248:104411. [PMID: 39032270 DOI: 10.1016/j.actpsy.2024.104411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 07/15/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Socio-communicative difficulties are a core symptom of autism that deeply impact interaction with others. Despite that, research on bidirectional caregiver-child interaction variables has been notably scant and predominantly focused on autistic children's interactive differences and the consequences on parenting behaviors. AIM The study aimed to assess parent-child interaction in the context of autism through observational validated instruments that consider qualitative and structural features in a complementary way to obtain a comprehensive characterization of the exchange within the dyad. METHODS AND PROCEDURES This study involved 56 paired parent-child dyads of 28 autistic children (mean age = 38.60 months, sd = 9.50) playing with their mothers and their fathers for 10 min. The video-recorded sessions were coded through the Emotional Availability Scales (EAS) and the Interpersonal Synchrony (IS) coding system. OUTCOMES AND RESULTS Fathers and mothers do not show significant differences in ISexcept for mother widenings, which are more frequent and successful, and in Emotional Availability. Further, dyads present moderate levels of Emotional Availability, indicating that parents may struggle with structuring, sensitivity, and interactive abilities with their autistic children, which in turn present low levels of responsiveness and involvement. Further, we explored an association between IS and EA characteristics. CONCLUSION AND IMPLICATIONS This study suggests the need for interventions to target interaction considering both caregivers, ultimately targeting both interaction structure and affect features. Research that includes fathers fosters strategies for individualization and treatment optimization.
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Affiliation(s)
- Eleonora Paolizzi
- Laboratory of Observation, Diagnosis, and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy.
| | - Silvia Perzolli
- Laboratory of Observation, Diagnosis, and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy.
| | - Arianna Bentenuto
- Laboratory of Observation, Diagnosis, and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy.
| | - Giulio Bertamini
- Laboratory of Observation, Diagnosis, and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy; Department of Child and Adolescent Psychiatry, Pitie-Salpetriere University Hospital, Sorbonne University, 75013 Paris, France.
| | - Paola Venuti
- Laboratory of Observation, Diagnosis, and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy.
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Covello M, Pelella MR, Bennett A, Gerdes M, Guthrie W, Wallis KE, Wong ZM, Miller JS, Truong DM. Missing Ethnicity and Language Information in Healthcare Records of Patients from the Asian Diaspora. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02059-0. [PMID: 38969925 DOI: 10.1007/s40615-024-02059-0] [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: 04/23/2024] [Revised: 06/10/2024] [Accepted: 06/17/2024] [Indexed: 07/07/2024]
Abstract
The electronic health record (EHR) should contain information to support culturally responsive care and research; however, the widely used default "Asian" demographic variable in most US social systems (including EHRs) lacks information to describe the diverse experience within the Asian diaspora (e.g., ethnicities, languages). This has a downstream effect on research, identifying disparities, and addressing health equity. We were particularly interested in EHRs of autistic patients from the Asian diaspora, since the presence of a developmental diagnosis might call for culturally responsive care around understanding causes, treatments, and services to support good outcomes. The aim of this study is to determine the degree to which information about Asian ethnicity, languages, and culture is documented and accessible in the EHR, and whether it is differentially available for patients with or without autism. Using electronic and manual medical chart review, all autistic and "Asian" children (group 1; n = 52) were compared to a randomly selected comparison sample of non-autistic and "Asian" children (group 2; n = 50). Across both groups, manual chart review identified more specific approximations of racial/ethnic backgrounds in 54.5% of patients, 56% for languages spoken, and that interpretation service use was underestimated by 13 percentage points. Our preliminary results highlight that culturally responsive information was inconsistent, missing, or located in progress notes rather than a central location where it could be accessed by providers. Recommendations about the inclusion of Asian ethnicity and language data are provided to potentially enhance cultural responsiveness and support better outcomes for families with an autistic child.
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Affiliation(s)
- Maxine Covello
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Maggie Rose Pelella
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amanda Bennett
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Marsha Gerdes
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Whitney Guthrie
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kate E Wallis
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Zoe M Wong
- Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - Judith S Miller
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Dieu M Truong
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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6
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Baloyi O, Jarvis MA, Chironda G, Mbeje P, Ngcobo SJ, Gqaleni T, Mhlongo EM, Ngcobo WB, Brysiewicz P. Experiences of families with children diagnosed with Autism Spectrum Disorder in World Health Organization Afro-Regions: A scoping review. Nurs Health Sci 2024; 26:e13123. [PMID: 38692580 DOI: 10.1111/nhs.13123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/13/2024] [Accepted: 04/09/2024] [Indexed: 05/03/2024]
Abstract
A scoping review on Autism Spectrum Disorder (ASD) and its impact on the families of affected children was undertaken due to insufficient information available on the diverse experiences impacting their lives. Using the Joanna Briggs Institute methodology, eligibility criteria were guided by Population (families), Concept (family experiences), and Context (African region). English-language articles were sought from a variety of databases and search engines. The publication date of the identified articles ranged from 2003 to 2021 with most published in 2020 (n = 10), and the majority using qualitative methodologies (n = 51). Most family members involved were parents (n = 51) and their ages ranged from 18 to 75 years. The families experienced various challenges related to their child with regard to education, healthcare, and the broader community including lack of support. Family coping strategies included believing in God, attending counseling sessions, adapting, and accepting the situation. Healthcare professionals should be prepared and positioned to educate families and siblings on various aspects of ASD. There is a need for active, continued research on families within most countries of World Health Organization Afro-region.
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Affiliation(s)
- Olivia Baloyi
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Mary Ann Jarvis
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Geldine Chironda
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Pretty Mbeje
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Silingene Joyce Ngcobo
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Thusile Gqaleni
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Euphemia Mbali Mhlongo
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Winnie Baphumelele Ngcobo
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Petra Brysiewicz
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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7
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Terol AK, Meadan H, Gómez LR, Magaña S. Cultural adaptation of an intervention for caregivers of young autistic children: Community members' perspectives. FAMILY PROCESS 2024; 63:691-710. [PMID: 38605389 DOI: 10.1111/famp.12999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/08/2024] [Accepted: 03/27/2024] [Indexed: 04/13/2024]
Abstract
Caregivers of autistic children in low-to-middle-income countries experience many barriers to access resources to support their child's development. Caregiver training is considered an evidence-based practice and may be a cost-effective way to support caregivers of autistic children in such settings. This study focuses on the cultural adaptation of Parents Taking Action (PTA; Magaña et al., Family Process, 56, 57-74, 2017) to support caregivers of autistic children in Paraguay. We conducted focus groups and individual interviews with 28 caregivers, autistic individuals, and professionals in Paraguay to understand caregivers' needs and to explore needed cultural adaptations of PTA to achieve contextual fit. Participants identified caregivers' need for accurate and reliable information, strategies to support children's growth, and emotional support and strategies to manage stress. Additionally, participants provided recommendations for adapting PTA considering the dimensions within the Cultural Adaptation Checklist (Lee et al., International Journal of Developmental Disabilities, 2023). This study is the first step in the iterative process of culturally adapting an intervention and the process described in this study may be appropriate for culturally adapting other interventions.
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Affiliation(s)
- Adriana Kaori Terol
- Department of Special Education, University of Illinois Urbana Champaign, Champaign, Illinois, USA
| | - Hedda Meadan
- Department of Special Education, University of Illinois Urbana Champaign, Champaign, Illinois, USA
| | - Laura R Gómez
- School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, Florida, USA
| | - Sandy Magaña
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA
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8
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Leng LL, Huang S, Zhou LG. Perceived discrimination among caregivers of children with disabilities in China: Unraveling the effects of social determinants. Soc Sci Med 2024; 351:116991. [PMID: 38833767 DOI: 10.1016/j.socscimed.2024.116991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/05/2024] [Accepted: 05/15/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE Although discrimination has gained increasing attention in research and practice intervention for family caregivers of children with disabilities, little is known about the social determinants that associate with the perceived discrimination among caregivers, especially in non-Western contexts. This study aims to examine the socio-familial and child-level determinants of perceived discrimination among family caregivers of children with disabilities in China. METHOD This study drew from a population-based cross-sectional survey in Shenzhen, China. Proportional quota sampling was conducted to get data from 2500 family caregivers of children with disabilities in rehabilitation service centers (response rate = 94.9%, n = 2373), accounting for 25% of the total population of children with disabilities receiving service in Shenzhen. Latent profile analysis was conducted to categorize three perceived discrimination groups among caregivers (i.e., severe perceived discrimination group, moderate perceived discrimination group, and low perceived discrimination group). The multinomial logistic regression models were conducted to test the association between these social determinants and perceived discrimination. RESULTS Most caregivers (82.9%) reported moderate or severe levels of perceived discrimination. Caregivers of children with moderate and severe impairments and children with mental and multiple disabilities were more vulnerable to perceiving severe social discrimination. Socio-familial characteristics, particularly the intersectionality between gender and employment, influence caregivers' perceived discrimination. CONCLUSION Caregivers of children with disabilities experience pervasive social discrimination in contemporary urban China. Our study demonstrates that the social construction of disablism and the affiliate discrimination against family caregivers of children with disabilities is complex and multidimensional and depends upon the children's disability and the caregivers' socio-demographic characteristics.
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Affiliation(s)
- Ling Li Leng
- The Department of Sociology, Zhejiang University, Hangzhou, China.
| | - Shixin Huang
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong.
| | - Lin Gang Zhou
- Center for Disability Studies, Shenzhen University, Shenzhen, China.
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9
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Ma Z, Fu W, Gu P, Siting H, Liujing Y, Zhou W. Parental Perception of the Importance of Friendship and Other Educational Outcomes in Children with Autism Spectrum Disorder in China. J Autism Dev Disord 2024; 54:2012-2025. [PMID: 36961612 DOI: 10.1007/s10803-023-05954-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/25/2023]
Abstract
This study examined parental perception of the importance of friendship and five other educational outcomes from 101 Chinese parents of children with autism spectrum disorders between the ages of 3 and 12 years. Results showed Chinese parents considered friendship less important than social skills, emotional development, and physical skills and motor development. Unlike the results from previous studies, Chinese parents ranked friendship as the second least important outcome. Children's age rather than educational setting impacted parental perceptions. The findings suggested cultural contexts may have influenced parental perceptions of the importance of different educational outcomes, and future research on the influence of cultural contexts is warranted.
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Affiliation(s)
- Zijie Ma
- Department of Special Education, University of Kansas, Lawrence, USA
| | - Wangqian Fu
- Faculty of Education, Beijing Normal University, Beijing, China
| | - Peidi Gu
- College of Education for the Future, Beijing Normal University, Zhuhai, China.
| | - He Siting
- College of Education for the Future, Beijing Normal University, Zhuhai, China
| | - Yang Liujing
- College of Education for the Future, Beijing Normal University, Zhuhai, China
| | - Wei Zhou
- Faculty of Education, Beijing Normal University, Beijing, China
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Wong CM, Aljunied M, Chan DKL, Cheong JMY, Chew B, Chin CH, Choo SHT, Chua AHL, Foo MTS, Goh TJ, Khader M, Khoo SKM, Koh HC, Lian WB, Lim HH, Poon KKL, Sim ZL, Sung M, Tan PC, Yong S, Zhang G, Aishworiya R. 2023 clinical practice guidelines on autism spectrum disorder in children and adolescents in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2024; 53:541-552. [PMID: 38920181 DOI: 10.47102/annals-acadmedsg.2023307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Introduction Autism is a neurodevelopmental condition that is increasing in prevalence worldwide. There has been an exponential increase in autism-related research since 2010, when the first Singapore Clinical Practice Guidelines (CPG) on autism was published. Understanding of autism has since evolved to adopt a lifespan approach beyond that of a childhood condition. The aim of this CPG was to provide an updated set of recommendations for children and adolescents to aid clinical practice for professionals. Method A multidisciplinary workgroup that comprised representatives from various sectors worked on this CPG. Clinical questions were organised into 10 different sections, each with its own subgroup of members. Seventeen existing international guidelines were evaluated using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE-II) framework, of which 4 met criteria to act as references. Literature review across multiple databases was conducted between January 2011 to 2023; Grading of Recommendations, Assessment, Development and Evaluation (GRADE-like) methodology was used to synthesise evidence. Recommendation statements were derived, following Delphi-style consensus surveys among the workgroup. The draft guidelines underwent external review and public consultation before being formalised. Results Recommendation and good practice statements pertaining to care of children and adolescents on the autism spectrum across 10 different sections were developed. Evidence matrices complement these recommendations and detail relevant evidence behind each recommendation statement. Conclusion It is intended for these guidelines to promote effective management and healthcare services for children and adolescents on the autism spectrum, by reinforcing good and evidence-based clinical practice within our national context.
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Affiliation(s)
- Chui Mae Wong
- Department of Child Development, KK Women's and Children's Hospital, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Singapore
| | - Mariam Aljunied
- Special Educational Needs Division, Ministry of Education, Singapore
| | - Daisy Kwai Lin Chan
- Department of Child Development, KK Women's and Children's Hospital, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Singapore
- Department of Neonatal and Developmental Medicine, Singapore General Hospital
| | - Janice Mun Yi Cheong
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore
| | | | - Chee Hon Chin
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore
| | - Sylvia Henn Tean Choo
- Department of Child Development, KK Women's and Children's Hospital, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Singapore
| | | | | | - Tze Jui Goh
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore
| | | | | | - Hwan Cui Koh
- Department of Child Development, KK Women's and Children's Hospital, Singapore
| | - Wee Bin Lian
- SpecialKids Child Health & Development Clinic, Singapore
| | | | | | | | - Min Sung
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore
| | - Peng Chian Tan
- National Institute of Education, Nanyang Technological University, Singapore
| | - Sarah Yong
- Specialised Assistive Technology Centre, SPD, Singapore
| | - Guiyue Zhang
- Child Development Unit, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore
| | - Ramkumar Aishworiya
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Child Development Unit, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore
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11
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Genovesi E, Yao YI, Mitchell E, Arad M, Diamant V, Panju A, Hanlon C, Tekola B, Hoekstra RA. Mapping awareness-raising and capacity-building materials on developmental disabilities for non-specialists: a review of the academic and grey literature. Int J Ment Health Syst 2024; 18:10. [PMID: 38402178 PMCID: PMC10893740 DOI: 10.1186/s13033-024-00627-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 02/01/2024] [Indexed: 02/26/2024] Open
Abstract
Most children with developmental disabilities (DD), such as intellectual disabilities and autism, live in low- and middle-income countries (LMICs), where services are usually limited. Various governmental, non-governmental and research organisations in LMICs have developed awareness-raising campaigns and training and education resources on DD in childhood relevant to LMICs. This study aimed to comprehensively search and review freely available materials in the academic and grey literature, aimed at awareness raising, training and education on DD among non-specialist professionals and community members in LMICs. We consulted 183 experts, conducted key-word searches in five academic databases, four grey-literature databases and seventeen customised Google search engines. Following initial screening, we manually searched relevant systematic reviews and lists of resources and conducted forwards and backwards citation checks of included articles. We identified 7327 articles and resources after deduplication. We then used a rigorous multi-step screening process to select 78 training resources on DD relevant to LMICs, of which 43 aimed at informing and/or raising awareness DD, 16 highlighted specific strategies for staff in health settings and 19 in education settings. Our mapping analysis revealed that a wealth of materials is available for both global and local use, including comics, children's books, flyers, posters, fact sheets, blogs, videos, websites pages, social media channels, handbooks and self-education guides, and training programmes or sessions. Twelve resources were developed for cross-continental or global use in LMICs, 19 were developed for and/or used in Africa, 23 in Asia, 24 in Latin America. Most resources were developed within the context where they were intended to be used. Identified gaps included a limited range of resources on intellectual disabilities, manuals for actively delivering training to staff in education settings and resources targeted at eastern European LMICs: future intervention development and adaptation efforts should address such gaps, to ensure capacity building materials exist for a sufficient variety of DD, settings and geographical areas. Beyond identifying these gaps, the value of the review lies in the compilation of summary tables of information on all freely available resources found, to support their selection and use in wider contexts. Information on the resource content, country of original development and copyright is provided to facilitate resource sharing and uptake.
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Affiliation(s)
- Elisa Genovesi
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Addison House, Guy's Campus, London, SE11UL, UK.
| | - Yuan Ishtar Yao
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Addison House, Guy's Campus, London, SE11UL, UK
| | - Emily Mitchell
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Addison House, Guy's Campus, London, SE11UL, UK
| | - Michal Arad
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Addison House, Guy's Campus, London, SE11UL, UK
| | - Victoria Diamant
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Addison House, Guy's Campus, London, SE11UL, UK
| | - Areej Panju
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Addison House, Guy's Campus, London, SE11UL, UK
| | - Charlotte Hanlon
- Centre for Global Mental Health, Department of Health Services and Population Research and WHO Collaborating Centre for Mental Health Research and Training, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE58AB, UK
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bethlehem Tekola
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Addison House, Guy's Campus, London, SE11UL, UK
| | - Rosa A Hoekstra
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Addison House, Guy's Campus, London, SE11UL, UK
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Pang RCC, Ho MSH, Wong PWC. A Review of the Literature on the Multiple Forms of Stigmatization of Caregivers of Children with Autism Among Ethnic Minority Groups. J Racial Ethn Health Disparities 2024; 11:545-559. [PMID: 36877377 DOI: 10.1007/s40615-023-01540-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 03/07/2023]
Abstract
Multiple forms of stigmatization are experienced by caregivers of children with autism among ethnic minority (EM) groups in various countries. Such forms of stigmatization can lead to delayed assessment and services for mental health among children and caregivers. This review identified the research literature on the types of stigmatization experienced by caregivers of children with autism with an EM background. A total of 19 studies published after 2010 (i.e., 12 from the USA, 2 from the UK, 1 from Canada, and 1 from New Zealand) of caregivers of 20 ethnicities were identified and reviewed, and their reporting qualities systematically also assessed. Four main themes: (1) self-stigma, (2) social stigma, (3) stigma towards EM parents of children on the autism spectrum, and (4) service utilization stigma, and nine sub-themes were identified. The discrimination experienced by caregivers were extracted, synthesized, and further discussed. While the reporting quality of the studies included is good, the depth of the understanding of this under-researched yet important phenomenon is very limited. The multiple forms of stigmatization experiences are complex, and it may be difficult to disentangle whether the causes of stigmatization were autism and/or EM related, and the types of stigmatization can vary enormously among different ethnic groups in different societies. More quantitative studies are needed to quantify the impacts of multiple forms of stigmatization on families of children with autism in EM groups so that more socially inclusive support for caregivers with an EM background in host countries can be developed.
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Affiliation(s)
| | - Mimi S H Ho
- Department of Special Education and Counselling, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, Hong Kong
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Tawankanjanachot N, Truesdale M, Orachon P, Kidd L. Social skills interventions for Thai adolescents with Autism Spectrum Disorder (ASD): a qualitative study of the perceptions and experiences of Thai adolescents, their caregivers and healthcare professionals. Int J Ment Health Syst 2024; 18:1. [PMID: 38167087 PMCID: PMC10763348 DOI: 10.1186/s13033-023-00617-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Social skills interventions (SSIs) are effective for enhancing social skills and decreasing mental health problems in adolescents with autism spectrum disorder (ASD). However, these interventions have been designed and their effectiveness has been established in Western countries. Lack of culturally acceptable SSIs for Asian nations is a possible barrier to implementing effective and tailored interventions that address the unique requirements of ASD individuals across countries and cultures. This study aims to explore the needs and preferences of adolescents with ASD, their caregivers, and healthcare professionals (HPs) in Thailand regarding the components, delivery formats, and cultural adaptation required for an outpatient-based social skills intervention. METHODS Qualitative data was collected via three focus groups of HPs (n = 20) and 24 paired interviews with adolescents with ASD and their caregivers from a child psychiatric hospital in Thailand. Purposive sampling was employed, and thematic analysis was used to analyse the data. RESULTS Nine themes emerged from the data generated by HPs, and seven from adolescents with ASD and their caregivers. SSIs for Thai adolescents with ASD and their caregivers should emphasise specific social skills training and assess the abilities of adolescents as required. Incorporating various learning strategies is important. Parental involvement is essential and provides knowledge of an adolescent's symptoms and coaching skills, which are best used to support their adolescents. Cultural considerations include the need for social knowledge of Thai culture, promoting assertiveness and praising parents' abilities, implementing a programme in time to not interrupt academic achievement, and renaming a programme from social skills intervention to social communication intervention. Barriers to implementing a programme included HPs' need for specialised training and education and decreased workload. Also, the caregivers' and adolescents' stigma reduced attendance in a programme. Increased extra compensation and relocation days off are provided as policy support for staff who deliver the intervention. CONCLUSION The results suggest that SSIs for Thai adolescents with ASD should be tailored to meet the needs for specific knowledge, skills, and parental collaboration as coaches for their adolescents. Additionally, it should incorporate Thai culture. It is necessary to consider staff knowledge, workload, and stigma in order to reduce barriers to implementation in practice.
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Affiliation(s)
- Nadlada Tawankanjanachot
- School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, 57-61 Oakfield Avenue, Glasgow, G12 9LL, UK.
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Maria Truesdale
- School of Health and Wellbeing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 0XH, UK
| | - Pornpun Orachon
- Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health, Ministry of Public Health, Samut Prakan, 10270, Thailand
| | - Lisa Kidd
- School of Health & Life Sciences, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, G4 OBA, UK
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Zeng S, Sardar A, Beckstein A, Mohamed NH, Shen R, Xiu Y. Developing a new questionnaire of positive contributions to Chinese families by children with autism spectrum disorder. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2024; 9:23969415231221520. [PMID: 38187822 PMCID: PMC10768583 DOI: 10.1177/23969415231221520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background and Aims A literature review of both Eastern and Western literature regarding families of children with autism spectrum disorder (ASD) revealed limited empirical research that examines ASD in China. Furthermore, most research in this area comes from a deficit model and there is a lack of research that comes from a strengths background. No previous study in China has looked at the positive contributions of children with ASD to their families. The present study came from a strengths-based perspective and aimed to develop a new questionnaire to evaluate the positive contributions made to families by children who have ASD in China and are raised by their respective families. It considered the severity level of the children's disorder and the impact this had on the parents. Besides examining the children's impairment levels, the study also examined positive contributions and their relationship with socio-demographic elements such as family income and employment status of the parents, which also seem to be related to the positive contributions experienced by the parents. Methods First, based on the literature review, an initial qualitative interview protocol was developed and administered to 10 parents of children with ASD. Then, based on the analyses of the interviews, a quantitative questionnaire was developed to assess the positive contributions of children with ASD to their families. The questionnaire was then administered to 156 parents of children with ASD. The internal structure of the questionnaire was analyzed by factor analysis. The questionnaire's reliability and validity were also examined. The data were then analyzed with multiple correlation comparisons and an independent sample T-test. Results Six factors emerged for families of children with ASD. The results showed that the cumulative explanatory variance of the six dimensions of the questionnaire was 65.42%. The Cronbach's coefficient of each dimension was between 0.7 and 0.9, and the combined Cronbach's coefficient of the total questionnaire was 0.945. This study found that the overall average positive contribution to families by children with ASD was 3.32, which is at a medium level, and all six dimensions were at a medium-to-high level. This study also found that the family's monthly income contributed to the overall positive contribution, intimacy and happiness, and gaining more special knowledge through experience dimensions. Furthermore, it was found that moderate severity of ASD, high income, and parental employment were all associated with more positive contributions. Conclusion This new questionnaire appears to have good reliability and validity and seems suitable for assessing the positive contributions to families by children with ASD in China. Implications The present study may be helpful for the parents of children with ASD and will likely help them focus on the strengths of their children rather than their shortcomings. The study might also benefit counselors and researchers who would be able to use the new questionnaire to evaluate the positive contributions made to families by children who have ASD.
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Affiliation(s)
- Shulan Zeng
- College of Education Science, Chongqing Normal University, Chongqing, China
| | - Afsheen Sardar
- College of Education Science, Chongqing Normal University, Chongqing, China
| | - Amoneeta Beckstein
- College of Education Science, Chongqing Normal University, Chongqing, China
| | | | - Renhong Shen
- College of Education Science, Chongqing Normal University, Chongqing, China
| | - Yunhui Xiu
- College of Education Science, Chongqing Normal University, Chongqing, China
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15
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Smith J, Rabba AS, Cong L, Datta P, Dresens E, Hall G, Heyworth M, Lawson W, Lee P, Lilley R, Syeda N, Ma E, Wang J, Wang R, Yeow CT, Pellicano E. "They Were Saying That I Was a Typical Chinese Mum" : Chinese Parents' Experiences of Parent-Teacher Partnerships for Their Autistic Children. J Autism Dev Disord 2023; 53:4888-4900. [PMID: 36149615 PMCID: PMC9510549 DOI: 10.1007/s10803-022-05748-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 11/20/2022]
Abstract
Effective parent-teacher partnerships improve outcomes for autistic students. Yet, we know little about what effective partnerships look like for parents of autistic children from different backgrounds. We conducted interviews with 17 Chinese parents of autistic children attending Australian kindergartens/schools to understand their experiences. Parents appreciated the acceptance, opportunities and supports they received in Australia. They had high expectations of children; expectations not often shared by educators. Parents were respectful of teachers' expertise and polite and undemanding in interactions. Nevertheless, parents were frustrated by inconsistent teaching quality and inadequate communication. Navigating systems was also challenging and parents faced discrimination from teachers and their community. Recommendations include fostering open home-school communication, proactively seeking parents' expertise about children and explicitly scaffolding parents' self-advocacy.
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Affiliation(s)
- Jodie Smith
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia.
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Aspasia Stacey Rabba
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Melbourne, Australia
| | - Lin Cong
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Poulomee Datta
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | | | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
- Reframing Autism, Sydney, Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | | | - Rozanna Lilley
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | | | - Emily Ma
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Julia Wang
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Rena Wang
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Chong Tze Yeow
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Chua SY, Abd Rahman FN, Ratnasingam S. Problem behaviours and caregiver burden among children with Autism Spectrum Disorder in Kuching, Sarawak. Front Psychiatry 2023; 14:1244164. [PMID: 37965356 PMCID: PMC10642943 DOI: 10.3389/fpsyt.2023.1244164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/04/2023] [Indexed: 11/16/2023] Open
Abstract
Objective Caregivers of children with Autism Spectrum Disorder (ASD) often experience emotional and psychological distress, as well as disruptions to family life and employment due to the challenges of caring for children with ASD. This study examines the relationship between problem behaviours and caregiver burden among children with ASD. Method A cross-sectional study using convenience sampling recruited 230 caregivers of children with ASD aged 4 to 18 years from selected autism centres in Kuching, Sarawak. The caregivers completed the Aberrant Behaviour Checklist-2 and the Zarit Burden Interview. Results Univariate analysis revealed a significant difference in caregiver burden for children with ASD receiving medications (p = 0.013), registered with the Social Welfare Department (p = 0.036), and having siblings with ASD (p = 0.046). About 40% of the children exhibited at least one domain of problem behaviour. More than half of the caregivers (53.9%) experienced burden, with the majority experiencing mild burden. Positive associations were seen between irritability (r = 0.458, p < 0.01), social withdrawal (r = 0.439, p < 0.01), stereotypic behaviour (r = 0.392, p < 0.01), hyperactivity/non-compliance (r = 0.467, p < 0.01), and caregiver burden. Child factors, including the duration of problem behaviour (r = 0.182, p = 0.007), medication use (eta = 0.187, p = 0.005), Social Welfare Department registration (eta = 0.138, p = 0.036), and the presence of siblings with ASD (eta = 0.130, p = 0.046) were associated with caregiver burden. Multiple linear regression showed that hyperactivity/noncompliance significantly predicted caregiver burden. Conclusion Specific problem behaviours in children with ASD were associated with caregiver burden. These results highlight the need for interventions for the child with ASD and their caregivers.
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Affiliation(s)
- Shi Yi Chua
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Psychiatry and Mental Health, Hospital Umum Sarawak, Kuching, Sarawak, Malaysia
| | - Fairuz Nazri Abd Rahman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Child and Adolescent Psychiatric Unit, UKM Specialist Children’s Hospital, Kuala Lumpur, Malaysia
| | - Selvasingam Ratnasingam
- Department of Psychiatry and Mental Health, Hospital Umum Sarawak, Kuching, Sarawak, Malaysia
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Xia C, Wei T, Tang Q, Zheng H, Chen G, Lu J. Depression and Associated Factors among Family Caregivers of Children with Disabilities: Analysis of Intergenerational Differences. Healthcare (Basel) 2023; 11:2693. [PMID: 37830730 PMCID: PMC10572526 DOI: 10.3390/healthcare11192693] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 10/14/2023] Open
Abstract
Family caregivers of children with disabilities might face high risks of depression, whereas the existing literature focused more on parents neglecting grandparents. This study investigated 380 parents and 108 grandparents of children with disabilities to identify depression and associated factors. Descriptive statistics, Chi-square test, Mann-Whitney U test, and multivariable logistic regression were performed to describe the participants' characteristics and risks of depression and identify significant factors. Results showed that parents (35.5%) had higher risks of depression than grandparents (32.4%), but statistical differences were not found. Children's sleep problems (AOR = 1.751, 95%CI = 1.019, 3.008), harmonious family relationships (AOR = 0.694, 95%CI = 0.569, 0.846), and better barrier-free construction (AOR = 0.742, 95%CI = 0.568, 0.970) were significantly associated with depression among parents. As for grandparents, higher education (AOR = 4.108, 95%CI = 1.526, 11.057) and caring for children who experience frequent mood swings (AOR = 2.242, 95%CI = 1.161, 4.329) were associated with higher risks of depression. Further, house ownership (AOR = 0.167, 95%CI = 0.031, 0.887), higher family cohesion (AOR = 0.545, 95%CI = 0.297, 1.000), and better barrier-free construction (AOR = 0.401, 95%CI = 0.185, 0.869) were associated with lower odds of depression. Therefore, both parents and grandparents of children with disabilities had high risks of depression and thus required urgent attention. Healthcare providers and policymakers should develop and implement interventions considering intergenerational differences to reach optimal efficiency.
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Affiliation(s)
- Cong Xia
- School of Health Management, Anhui Medical University, Hefei 230032, China;
| | - Ting Wei
- School of Public Health, Fudan University, Shanghai 200032, China; (T.W.); (Q.T.); (H.Z.)
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Qi Tang
- School of Public Health, Fudan University, Shanghai 200032, China; (T.W.); (Q.T.); (H.Z.)
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Hongying Zheng
- School of Public Health, Fudan University, Shanghai 200032, China; (T.W.); (Q.T.); (H.Z.)
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Gang Chen
- School of Public Health, Fudan University, Shanghai 200032, China; (T.W.); (Q.T.); (H.Z.)
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Jun Lu
- School of Public Health, Fudan University, Shanghai 200032, China; (T.W.); (Q.T.); (H.Z.)
- China Research Center on Disability, Fudan University, Shanghai 200032, China
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18
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Dai YG, Carter AS. Characterizing Accommodations by Parents of Young Children with Autism: A Mixed Methods Analysis. J Autism Dev Disord 2023; 53:3380-3393. [PMID: 35764771 DOI: 10.1007/s10803-022-05652-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 11/27/2022]
Abstract
Symptoms of autism influence families' participation in daily activities, but few studies have broadly explored the types of accommodations caregivers make to their family's routines after their child is diagnosed with autism. The current study used a mixed-methods approach to characterize the rate and types of accommodations made by 171 families and the child and family characteristics that predicted accommodations. Most families (91%) endorsed making accommodations in the past year. Lower income, older child age, marginalized racial/ethnic identity, and higher levels of child problem behavior predicted accommodations in a greater number of domains. Thematic analysis illuminated the types of accommodations caregivers made and their motivation for making these lifestyle adjustments. Findings have important implications for parent-mediated interventions and policy.
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Affiliation(s)
- Yael G Dai
- Department of Psychology, University of Massachusetts Boston, 100 Morrissey Boulevard, 02125, Boston, MA, USA.
| | - Alice S Carter
- Department of Psychology, University of Massachusetts Boston, 100 Morrissey Boulevard, 02125, Boston, MA, USA
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Newell V, Phillips L, Jones C, Townsend E, Richards C, Cassidy S. A systematic review and meta-analysis of suicidality in autistic and possibly autistic people without co-occurring intellectual disability. Mol Autism 2023; 14:12. [PMID: 36922899 PMCID: PMC10018918 DOI: 10.1186/s13229-023-00544-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Suicidality is highly prevalent in autistic people without co-occurring intellectual disabilities, and high autistic traits are found in adults who have attempted suicide. However, prevalence rates for both autistic and possibly autistic people have not been synthesised meta-analytically. AIMS To (1) calculate pooled prevalence estimates of suicidality in autistic people and possibly autistic people without co-occurring intellectual disability; (2) evaluate the influence of participant and study level characteristics on heterogeneity; and (3) determine the quality of evidence. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. PsycINFO, Embase, MEDLINE and Web of Science were systematically searched from 1992 to January 25, 2022. Empirical quantitative studies reporting prevalence of suicidal ideation, suicide plans, or suicide attempts and behaviours were considered for inclusion. Random effects models were used to estimate pooled prevalence of each suicidality outcome with 95% confidence intervals. Heterogeneity was explored using sensitivity and moderator analyses. RESULTS Data from 48,186 autistic and possibly autistic participants in 36 primary studies were meta-analysed. Pooled prevalence of suicidal ideation was 34.2% (95% CI 27.9-40.5), suicide plans 21.9% (13.4-30.4), and suicidal attempts and behaviours 24.3% (18.9-29.6). High levels of heterogeneity (I2 > 75) were observed in all three analyses. Estimates did not differ between autistic or possibly autistic samples. Geographical location (p = 0.005), transgender or gender non-conforming samples (p < 0.001) and type of report (p < 0.001) significantly moderated suicidal ideation, whereas age group (p = 0.001) and measure of suicidality (p = 0.001) significantly moderated suicide plans. There was a significant association between the proportion of male participants and prevalence of suicide plans, with a decrease in the proportion of males for every unit change of suicide plan prevalence (p = 0.013). No variables were found to moderate estimates of suicide attempts and behaviours. CONCLUSIONS The results confirm suicidality is highly prevalent in both autistic and possibly autistic people without co-occurring intellectual disability and highlights potential moderators. Possibly autistic individuals require more attention in clinical and research considerations going forward to further understand and prevent suicide in both groups.
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Affiliation(s)
- Victoria Newell
- School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
| | - Lucy Phillips
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK
| | - Chris Jones
- School of Psychology, University of Birmingham, 52 Pritchatts Road, Birmingham, B15 2TT, UK
| | - Ellen Townsend
- School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, 52 Pritchatts Road, Birmingham, B15 2TT, UK
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
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Trinh NB, Phan NDT, Bui AT, Phan HT, Nguyen LTT, Nguyen LHT, Do KN, Dang AK. Nutritional status and eating behavior of children with autism spectrum disorders in Vietnam: A case-control study. Nutr Health 2023:2601060231152278. [PMID: 36706790 DOI: 10.1177/02601060231152278] [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: 01/29/2023]
Abstract
Background: Atypical eating behaviors and feeding issues are common in children with autism spectrum disorder (ASD). Aim: This study aims to evaluate the nutritional status and eating behavior of the ASD and typically developing groups. Methods: A case-control study was conducted from January to April 2019 in Nghe An, Vietnam. A total of 93 children in each group participated in the study with their main caregivers. We applied the Children's Eating Behavior Inventory (CEBI) to evaluate the eating behaviors of children. Results: Overweight and obesity in ASD children accounted for 41.9%. The CEBI score and %CEBI of the ASD group was higher than that of the control group (104.0 ± 14.2 and 91.3 ± 8.3; 24.1 ± 21.4 and 5.0 ± 11.8, respectively). Most of the adverse mealtime behaviors of ASD children focused on excessive duration (52.7%), distraction (40.9%), and food refusal (39.8%). In total 88.2% of caregivers had to comfort their ASD children at every meal, followed by threatening, scolding, or punishing children if they refused to eat (57.0%). Conclusion: Being overweight/obese and having eating behavior difficulties were prevalent among ASD children in Vietnam. Safer alternatives, such as lifestyle measures and seeking help from a nutritional therapist, can help ASD children reduce weight and modify their erroneous feeding habits.
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Affiliation(s)
- Ngoc Bao Trinh
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | | | - An Tuong Bui
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | - Hai Thanh Phan
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | - Lieu Thu Thi Nguyen
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | - Lan Huong Thi Nguyen
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Nam Do
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | - Anh Kim Dang
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
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Smith J, Rabba AS, Ali A, Datta P, Dresens E, Faragaab N, Hall G, Heyworth M, Ige K, Lawson W, Lilley R, Syeda N, Pellicano E. 'Somali parents feel like they're on the outer': Somali mothers' experiences of parent-teacher relationships for their autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023:13623613221146077. [PMID: 36680459 DOI: 10.1177/13623613221146077] [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: 01/22/2023]
Abstract
LAY ABSTRACT Good relationships between parents and schools can improve autistic children's school success. There are many reasons why families from different cultural backgrounds find it harder to develop good relationships with schools, such as language barriers, discrimination and unfamiliarity with education systems. We know little about what 'good relationships' look like for these families. Here, we worked with a team of autistic and non-autistic researchers as well as an Advisory Group of Somali parents to conduct interviews with 15 Somali mothers of kindergarten and school-age autistic children. We asked mothers about their experiences of their child's education, communication with teachers and what a good relationship with schools would look like. We also asked how they felt the Somali community understood autism. We looked for common things that mothers said. We found that mothers were very proud of their children. They had high expectations, particularly about what children could do by themselves. Mothers found it frustrating that teachers had low expectations, that schools were not good at communicating with them and that autism-specific skills and experience were uncommon in schools. They also reported racist attitudes towards their children. Mothers experienced stigma and lacked resources, but support was gained from their daughters and their religion. Mothers themselves were proactively increasing community awareness and knowledge about autism in the hope that they and their autistic children would be valued and better supported. Our work has implications for how teachers and schools can work together with Somali parents to forge better futures for autistic children.
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Affiliation(s)
- Jodie Smith
- Macquarie University, Australia.,La Trobe University, Australia
| | | | | | | | | | - Nadia Faragaab
- Macquarie University, Australia.,Positive Partnerships, Australia
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22
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Sim SS, Bourke-Taylor HM, Yu ML, Fossey E, Tirlea L. Cross-Cultural Validation of the Chinese Version of the Health Promoting Activities Scale. Am J Occup Ther 2022; 76:23979. [PMID: 36548000 DOI: 10.5014/ajot.2022.049434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE The Health Promoting Activities Scale (HPAS) measures the frequency of participation in health-promoting activities of mothers of children with disabilities. Translation of the HPAS into Chinese and validation of the Chinese version will enable its use with Chinese-speaking mothers of children with disabilities. OBJECTIVE To translate the HPAS into Chinese and assess its construct validity in relation to measures of well-being, mental health, and activity satisfaction. DESIGN Cross-cultural validation. SETTING Community. PARTICIPANTS Eight bilingual Chinese speakers were involved in the translation. Ethnic Chinese mothers of children with disabilities living in Australia, Singapore, or Taiwan (N = 89) were recruited via purposive snowball sampling. Participants self-selected to complete the Chinese e-survey. OUTCOMES AND MEASURES Translation was guided by recommended frameworks. The Chinese versions of the Warwick-Edinburgh Mental Well-being Scale (WEMWS), Personal Well-being Index (PWI), and Kessler Psychological Distress Scale-10 (K10) were used to determine construct validity. Internal reliability was investigated. RESULTS The Chinese version of the HPAS correlated significantly with satisfaction ratings (r = .45, p < .001; n = 87), WEMWS Total score (r = .61, p < .001; n = 85), PWI mean score (r = .44, p < .001; n = 84), and K10 total score (r = -.33, p = .002; n = 81). Internal reliability was moderate (Cronbach's α = .74). CONCLUSIONS AND RELEVANCE The Chinese version of the HPAS was found to be cross-culturally equivalent to the original HPAS and psychometrically sound for use with Chinese-speaking mothers of children with disabilities. What This Article Adds: This study provides an example of the cross-cultural validation process. The Chinese version of the HPAS is psychometrically sound and could be used as an outcome measure of Chinese mothers' participation in health-promoting activities.
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Affiliation(s)
- So Sin Sim
- So Sin Sim, MSocSc, BSc (OT), is Lecturer, Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia;
| | - Helen M Bourke-Taylor
- Helen M. Bourke-Taylor, PhD, MSc (OT), is Associate Professor, Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
| | - Mong-Lin Yu
- Mong-lin Yu, PhD, MOT, BSc (OT), is Senior Lecturer, Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
| | - Ellie Fossey
- Ellie Fossey, PhD, MSc (Health Psychol), DipCOT (UK), is Professor, Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
| | - Loredana Tirlea
- Loredana Tirlea, PhD, BSocSc (Psychology), is Lecturer, Department of Health Sciences and Biostatistics, School of Health Science, Swinburne University of Technology, Hawthorn, Victoria, Australia
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23
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Wong TSM, Shorey S. Experiences of peer support amongst parents of children with neurodevelopmental disorders: A qualitative systematic review. J Pediatr Nurs 2022; 67:e92-e99. [PMID: 36115753 DOI: 10.1016/j.pedn.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/30/2022] [Accepted: 09/02/2022] [Indexed: 11/24/2022]
Abstract
PROBLEM Peer support is a form of social support that can address the complexities of support needs and challenges of parenting children with Neurodevelopmental Disorders (NDDs). However, there is paucity of research on the roles and influences of peer support experienced amongst parents of neurodivergent children. This qualitative systematic review therefore aimed to consolidate and synthesize the experiences of peer support amongst parents caring for neurodivergent children. ELIGIBILITY CRITERIA Articles were selected if they reported primary qualitative findings on the experiences of peer-support amongst parents of children diagnosed with at least one NDD as classified by DSM-5. SAMPLE Eleven articles were finalised and included in the review. RESULTS Four themes emerged: (1) reasons for seeking peer support, (2) different roles of peer support, (3) contributing elements of successful peer support, and (4) barriers against facilitating peer support. The findings of this review revealed that peer support was a valuable social support resource that met the complex support needs of parents. It enabled parents to provide quality care for their children whilst living with quality of life for themselves. CONCLUSIONS Peer support could be a valuable resource for parents of neurodivergent children as it could potentially enhance quality of life for parents while providing quality care for their children with complex needs. IMPLICATIONS Healthcare providers should integrate peer support as an adjunct resource of social support to help ease caregiver burdens of parents with neurodivergent children.
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Affiliation(s)
- Tiffany Shi Min Wong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore.
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24
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Kaba D, Hasanlı J, Efe A, Yavuz-Çolak M, Akın-Sarı B. Predictors of burnout and distress in parents of children with autism spectrum disorder during COVID-19 home confinement. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2022.2119974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Duygu Kaba
- Child and Adolescent Psychiatry Department, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Jamal Hasanlı
- Psychiatry Department, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Ayşegül Efe
- Child and Adolescent Psychiatry Department, Sami Ulus Maternity and Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Meriç Yavuz-Çolak
- Biostatistics Department, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Burcu Akın-Sarı
- Child and Adolescent Psychiatry Department, Başkent University Faculty of Medicine, Ankara, Turkey
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25
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Chaudhary D, Bhat B, Shields GE, Davies LM, Green J, Verghis T, Roy R, Kumar D, Kakra M, Vajaratkar V, Lall G, Pandey S, Johri S, Shakeel S, Patel V, Juneja M, Gulati S, Divan G. Development of a cost of illness inventory questionnaire for children with autism spectrum disorder in South Asia. BMC Health Serv Res 2022; 22:1137. [PMID: 36076224 PMCID: PMC9461098 DOI: 10.1186/s12913-022-08508-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The economic burden of autism is substantial and includes a range of costs, including healthcare, education, productivity losses, informal care and respite care, among others. In India, approximately, 2 million children aged 2-9 years have autism. Given the likely substantial burden of illness and the need to identify effective and cost-effective interventions, this research aimed to produce a comprehensive cost of illness inventory (COII) suitable for children with autism in South Asia (India) to support future research. METHODS A structured and iterative design process was followed to create the COII, including literature reviews, interviews with caregivers, pilot testing and translation. Across the development of the COII, thirty-two families were involved in the design and piloting of the tool. The COII was forward translated (from English to Hindi) and back translated. Each stage of the process of development of the COII resulted in the further refinement of the tool. RESULTS Domains covered in the final COII include education, childcare, relocation, healthcare contacts (outpatient, inpatient, medical emergencies, investigations and medication), religious retreats and rituals, specialist equipment, workshops and training, special diet, support and care, certification, occupational adjustments and government rebates/schemes. Administration and completion of the COII determined it to be feasible to complete in 35 minutes by qualified and trained researchers. The final COII is hosted by REDCap Cloud and is a bilingual instrument (Hindi and English). CONCLUSIONS The COII was developed using experiences gathered from an iterative process in a metropolitan area within the context of one low- and middle-income country (LMIC) setting, India. Compared to COII tools used for children with autism in high-income country settings, additional domains were required, such as complimentary medication (e.g. religious retreats and homeopathy). The COII will allow future research to quantify the cost of illness of autism in India from a broad perspective and will support relevant economic evaluations. Understanding the process of developing the questionnaire will help researchers working in LMICs needing to adapt the current COII or developing similar questionnaires.
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Affiliation(s)
- Divya Chaudhary
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Bhargav Bhat
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | | | | | | | - Tara Verghis
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Reetabrata Roy
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Divya Kumar
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Minal Kakra
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | | | - Gitanjali Lall
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Sonakshi Pandey
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Sanchita Johri
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Saani Shakeel
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
| | - Monica Juneja
- Maulana Azad Medical College and Assoc. Lok Nayak Hospital (MAMC), New Delhi, India
| | | | - Gauri Divan
- Sangath, House No 451 (168), Bhatkar Waddo, Socorro, Porvorim, Bardez, Goa, 403501, India.
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26
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Xu Y, Chen F, Mirza M, Magaña S. Culturally adapting a parent psychoeducational intervention for Chinese immigrant families of young children with autism spectrum disorder. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022. [DOI: 10.1111/jppi.12432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yue Xu
- Department of Health Sciences Education University of Illinois College of Medicine Rockford Illinois USA
| | - Feifei Chen
- Illinois Leadership Education in Neurodevelopmental Disorder Fellow Chicago Illinois USA
| | - Mansha Mirza
- Department of Disability and Human Development University of Illinois at Chicago Chicago Illinois USA
- Department of Occupational Therapy University of Illinois at Chicago Chicago Illinois USA
| | - Sandy Magaña
- Steve Hicks School of Social work University of Texas at Austin Austin Texas USA
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27
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Seidel B, De Azevedo Mazza V, Louyse Schuertz A, Trevisan Nobrega Martins Ruthes VB, Macedo LC. Percepção do profissional da Estratégia Saúde da Família no cuidado à criança com deficiência. AVANCES EN ENFERMERÍA 2022. [DOI: 10.15446/av.enferm.v40n2.91505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Objetivo: compreender a percepção dos profissionais da Estratégia Saúde da Família sobre o cuidado às crianças com deficiências.
Materiais e método: estudo exploratório descritivo com abordagem qualitativa. A coleta de dados ocorreu no primeiro semestre de 2019. Realizaram-se entrevistas não estruturadas, com questões orientadoras referentes à percepção dos profissionais quanto ao cuidado realizado às crianças com deficiências com 33 profissionais de seis equipes de saúde, de um município da região Sul do Brasil. Utilizou-se a análise categorial temática com o auxílio do software WebQDA®.
Resultados: as categorias temáticas finais identificadas neste estudo são sobre o cuidado às crianças com deficiências na Estratégia Saúde da Família, as quais foram divididas em potencialidades e fragilidades. Com relação às potencialidades, identificaram-se a rede de atenção, dando suporte aos encaminhamentos necessários, os atendimentos realizados com priorização e equidade e a consideração da importância das famílias nos cuidados; nas fragilidades, ressaltaram-se as limitações dos serviços, que dificultam ou até impossibilitam os atendimentos, como falta de profissionais, insumos e ambiência adequada, falta de protocolos direcionando os atendimentos, falta de capacitação e desconhecimento dos direitos desse público, o que prejudica o cuidado prestado a essas crianças.
Conclusões: compreender a percepção dos profissionais que estão na assistência dessas crianças possibilita identificar as lacunas dos serviços e proporciona a valorização do pessoal de saúde; em consequência disso, favorece o direcionamento adequado de recursos, beneficiando o cuidado para as famílias de crianças com deficiência.
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28
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Sibeoni J, Massoutier L, Valette M, Manolios E, Verneuil L, Speranza M, Revah-Levy A. The sensory experiences of autistic people: A metasynthesis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1032-1045. [PMID: 35362340 DOI: 10.1177/13623613221081188] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Sensory atypicalities are very common among autistic people and are integrated in several theories and explanatory models of autism. Qualitative studies have explored these singular sensory experiences from the perspectives of autistic people themselves. This article gathers all these qualitative studies and provides original findings regarding the everyday sensory experience of autistic people, that is, around four dimensions - physical, emotional, relational and social - experienced holistically, as inseparable, and not hierarchically or in terms of cause and effect. Adopting this holistic view could improve the adaptation of the sensory environment in health care facilities and the training of professionals around this specific issue.
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Affiliation(s)
- Jordan Sibeoni
- Argenteuil Hospital Centre, France.,Université de Paris, France
| | - Laura Massoutier
- Université de Paris, France.,Centre Hospitalier de Gonesse, France
| | | | - Emilie Manolios
- Université de Paris, France.,Hôpital Européen Georges Pompidou, France
| | - Laurence Verneuil
- Université de Paris, France.,GHU Paris Psychiatrie & Neurosciences, France
| | - Mario Speranza
- Centre Hospitalier de Versailles, France.,Université Paris-Saclay, France
| | - Anne Revah-Levy
- Argenteuil Hospital Centre, France.,Université de Paris, France
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29
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Bhavnani S, Lockwood Estrin G, Arora R, Kumar D, Kakra M, Vajaratkar V, Juneja M, Gulati S, Patel V, Green J, Divan G. "I was Confused … and Still am" Barriers Impacting the Help-Seeking Pathway for an Autism Diagnosis in Urban North India: A Mixed Methods Study. J Autism Dev Disord 2022; 52:1778-1788. [PMID: 34014464 PMCID: PMC8938390 DOI: 10.1007/s10803-021-05047-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 12/27/2022]
Abstract
Timely recognition of autism in children is integral to improve developmental outcomes. This study used mixed-methods (84 case-registers and 20 in-depth interviews with caregivers of children with a diagnosis of autism) to explore the extent to which the nature of parental concerns and prior knowledge of developmental disorders impact the time between symptom recognition and autism diagnosis, and the contextual family, societal and health-system related factors that impede the autism help-seeking pathway. Lack of awareness of age-appropriate child developmental milestones, apparent amongst the community and health professionals, contributed to a 1.5-year delay between parental concerns and autism diagnosis. Recommendations to shorten this help-seeking pathway include harnessing the potential of non-specialist workers to increase awareness and enable developmental monitoring of young children through scalable tools.
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Affiliation(s)
- Supriya Bhavnani
- Child Development Group, Sangath, House 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India.
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Gurgaon, 122002, India.
| | - Georgia Lockwood Estrin
- Centre for Brain and Cognitive Development, Birkbeck, University of London, Malet Street, WC1E 7HX, London, UK
| | - Rashi Arora
- Child Development Group, Sangath, House 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Divya Kumar
- Child Development Group, Sangath, House 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Minal Kakra
- Child Development Group, Sangath, House 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
| | - Vivek Vajaratkar
- Department of Orthopaedic Surgery, Goa Medical College, Bambolim, Goa, 403202, India
| | - Monica Juneja
- Maulana Azad Medical College, Balmiki Basti, New Delhi, India, 110002
| | - Sheffali Gulati
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Vikram Patel
- Child Development Group, Sangath, House 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02115, USA
- Department of Global Health and Population, Harvard T H Chan School of Public Health, 655 Huntington Ave, Boston, MA, 02115, USA
| | - Jonathan Green
- Royal Manchester Children's Hospital, University of Manchester and Manchester Academic Health Sciences Centre, Oxford Rd, Manchester, M13 9PL, UK
| | - Gauri Divan
- Child Development Group, Sangath, House 451 Bhatkar Waddo, Succor, Bardez, Goa, 403501, India
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30
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Truong DM, Barth AM, Mire SS, Ayala ML, Ramclam AN, Tan SXL, McKee SL. Cultural considerations for conducting autism assessment with Asian American and Pacific Islander students. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Dieu M. Truong
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Alexandra M. Barth
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Sarah S. Mire
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Mycah L. Ayala
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Ashley N. Ramclam
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Samantha X. L. Tan
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
| | - Shannon L. McKee
- Department of Psychological, Health, and Learning Sciences University of Houston Houston Texas USA
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31
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Stress, anxiety and depression in parents of children with autism spectrum disorders in Kazakhstan: prevalence and associated factors. Glob Ment Health (Camb) 2022; 9:472-482. [PMID: 36618742 PMCID: PMC9806964 DOI: 10.1017/gmh.2022.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Studies worldwide reported increased levels of stress among parents of children with autism due to the unique caregiving challenges. While research has shown that parents' and autistic child's demographics and behavioral characteristics are associated with psychological distress among caregivers of children with autism, very few studies have investigated the impact of the caregiver's unmet needs on various aspects of the perceived family burden. METHODS This cross-sectional study examined the prevalence of stress, anxiety and depressive symptoms among a wide range of 146 parents with different sociodemographic characteristics, social support and unmet needs who care for children with autism spectrum disorder. These parents were recruited from autism non-governmental organizations and the National Children's Rehabilitation Center in Astana, Kazakhstan, a post-Soviet country in Central Asia. Multiple linear regression analyses were utilized to examine the relationship of parental psychological distress variables with social support, unmet needs and parental and child sociodemographic characteristics. RESULTS Significantly higher levels of stress and depression were reported among parents who perceived their needs as being unmet or extremely unmet as addressed by societal acceptance as compared to parents who reported adequate levels of needs met by social acceptance. Employed parents and parents with a higher level of perceived friends' support had less symptoms of stress, anxiety, and depression. CONCLUSIONS Increasing public awareness about autism and providing early detection and interventions for distressed caregivers of children with autism may be helpful in improving healthy functioning of parents and the entire family.
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32
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Li F, Xu M, Wu D, Tang Y, Zhang L, Liu X, Zhou L, Li F, Jiang L. From child social impairment to parenting stress in mothers of children with ASD: The role of parental self-efficacy and social support. Front Psychiatry 2022; 13:1005748. [PMID: 36147986 PMCID: PMC9485583 DOI: 10.3389/fpsyt.2022.1005748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Children with autism spectrum disorder (ASD) can exhibit persistent deficits in social communication, causing their mothers to experience elevated parenting stress during the childrearing process. Some internal and external psychosocial resources may mediate or moderate the mother-child relationship, though the underlying mechanisms remain unclear. This study aimed to explore the predictors of parenting stress in mothers of children with ASD and elucidate the mechanisms underlying the relationship between child social impairment and parenting stress. METHODS A cross-sectional study was conducted between October 2020 and March 2022 in Shanghai, China. Mothers of children with ASD completed a survey investigating child social impairment, parenting stress, parental self-efficacy, and social support. RESULTS A total of 185 mothers of children with ASD were included in the final analysis. 70.27 percent of mothers experienced a clinically significant level of parenting stress. Child social impairment (r = 0.46, P < 0.001), parental self-efficacy (r = -0.58, P < 0.001), and social support (r = -0.35, P < 0.001) were significantly correlated with parenting stress. Parental self-efficacy completely mediated the relationship between child social impairment and parenting stress (B = 0.51, P < 0.001), after controlling for socioeconomic status (SES) correlated with parenting stress. There was no significant moderating effect of social support between child social impairment and parenting stress (B = 0.01, P = 0.09). CONCLUSION Future early intervention programs that focused on child's social communication skills and empowered mothers with related strategies through group-based parent training programs may help reduce parenting stress.
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Affiliation(s)
- Fēi Li
- Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingyu Xu
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danping Wu
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Tang
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Faculty of Education, Yunnan Normal University, Kunming, China
| | - Lingli Zhang
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Liu
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Zhou
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Psychology and Neuroscience of Cognition Research Unit, University of Liege, Liège, Belgium
| | - Fei Li
- Department of Developmental and Behavioral Pediatric and Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liping Jiang
- Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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33
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Lee V, Albaum C, Tablon Modica P, Ahmad F, Gorter JW, Khanlou N, McMorris C, Lai J, Harrison C, Hedley T, Johnston P, Putterman C, Spoelstra M, Weiss JA. The impact of COVID-19 on the mental health and wellbeing of caregivers of autistic children and youth: A scoping review. Autism Res 2021; 14:2477-2494. [PMID: 34591373 PMCID: PMC8646541 DOI: 10.1002/aur.2616] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/25/2021] [Accepted: 09/10/2021] [Indexed: 12/30/2022]
Abstract
Caregivers and families of autistic people have experienced stress and increase in demands due to the COVID-19 pandemic that may have long-term negative consequences for both their own and their children's mental health. A scoping review was conducted to identify pandemic related demands experienced by caregivers and families of autistic children and youth. The review also consolidated information on coping strategies and parenting-related guidelines that have emerged to help parents meet these demands. Search strategies were approved by a research librarian and were conducted in peer-reviewed and gray literature databases between May 2020 and February 2021. Additional resources were solicited through author networks and social media. All articles were published between December 2019 and February 2021. Article summaries were charted, and a thematic analysis was conducted with confirmation of findings with our knowledge users. Twenty-three published articles and 14 pieces of gray literature were included in the review. The majority of articles characterized and highlighted the increase in demands on caregivers of autistic children and youth during the pandemic globally. Both quantitative and qualitative studies suggest that parents have experienced an increase in stress and mental health-related symptoms during lockdown measures. Findings suggest that families are employing coping strategies, but there no evidence-based supports were identified. The review highlighted the potential long-term impact of prolonged exposure to increasing demands on the mental health and wellbeing of caregivers and families of autistic people, and pointed to a need for the rapid development and evaluation of flexible and timely support programs. LAY SUMMARY: Caregivers and families of autistic children and youth have faced increased demands due to pandemic-related lockdown measures. We reviewed the literature to outline sources of stress, links to their influence on caregiver mental health, and if support programs have emerged to help them. Our findings suggest a number of demands have increased caregivers' risk to mental health challenges, and their potential impact on family wellbeing. Ongoing development of evidence-based supports of all families of autistic children and youth are needed.
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Affiliation(s)
- Vivian Lee
- Department of PsychologyCarleton UniversityOttawaCanada
| | - Carly Albaum
- Department of PsychologyYork UniversityTorontoCanada
| | | | - Farah Ahmad
- School of Health Policy and ManagementYork UniversityTorontoCanada
| | | | | | - Carly McMorris
- Werklund School of EducationUniversity of CalgaryCalgaryCanada
| | - Jonathan Lai
- Canadian Autism Spectrum Disorder AllianceCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
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Bordes Edgar V, Meneses V, Shaw D, Romero RA, Salinas CM, Kissel A. Clinical utility of the ECLECTIC framework in providing culturally-informed autism spectrum disorder evaluations: a pediatric case-based approach. Clin Neuropsychol 2021; 36:1148-1171. [PMID: 34126862 DOI: 10.1080/13854046.2021.1936187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Social cognition does not exist within a vacuum. One's culture and surrounding social environment influence 1) development of social skills and behaviors, and 2) society's expectations regarding "normal" behavior versus behaviors consistent with the diagnosis of Autism Spectrum Disorder (ASD). Use of a comprehensive cultural framework such as Fujii's ECLECTIC model undergirds valid ASD testing by enhancing clinician awareness of potential biases during clinical decision-making and by supporting culturally relevant recommendations. Method: Four diverse pediatric patients presenting for concerns of ASD are described. Neuropsychological test data and salient cultural considerations are presented within the ECLECTIC framework. Results: The cases illustrate relevant cultural factors critical to the ASD assessment for youth with wide diversity (Southeast Asian, Deaf, Black, Hispanic/Latinx, and Chinese cultures) and varied contextual factors (adoption, underlying Down syndrome). The ECLETIC model better allows integration of salient factors such as cognition, family dynamics, behaviors, educational services, and language dominance. Conclusions: Unrecognized ethnocentric biases may shadow the complexities and nuances involved in ASD assessment across cultures. Such errors are minimized using a comprehensive cultural framework to guide equitable neuropsychological services. The ECLECTIC model's emphasis on cultural and contextual factors results in more accurate findings and more individualized planning for the patient. Recommendations for clinical application are provided.
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Affiliation(s)
- Veronica Bordes Edgar
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Children's Medical Center, Dallas, TX, USA
| | - Veronica Meneses
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Pediatric Developmental Disabilities, Scottish Rite Hospital for Children, Dallas, TX, USA
| | - Daphna Shaw
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Children's Medical Center, Dallas, TX, USA
| | - Regilda Anne Romero
- Department of Psychiatry, University of Florida, Gainesville, FL, USA.,Center for Autism and Neurodevelopment, University of Florida Health, Jacksonville, FL, USA
| | - Christine M Salinas
- Neuropsychology Concierge®, Indialantic, FL, USA.,Niños Health, Indialantic, FL, USA
| | - Abigail Kissel
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Children's Medical Center, Dallas, TX, USA
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Goh JX, Aishworiya R, Ho RCM, Wang W, He HG. A qualitative study exploring experiences and support needs of parents of children with autism spectrum disorder in Singapore. J Clin Nurs 2021; 30:3268-3280. [PMID: 33969552 DOI: 10.1111/jocn.15836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVE To explore the experiences and support needs of parents of children with recently diagnosed autism spectrum disorder (ASD) in Singapore. BACKGROUND Raising a child with ASD is challenging for parents, especially in the initial period following the diagnosis. Limited studies have focused on parents' perspectives. DESIGN A qualitative descriptive design study. METHODS Thirteen parents were recruited from a developmental and behavioural paediatric outpatient clinic of a tertiary hospital in Singapore from October-December 2018. Adult parents, who were primary caregivers of 2-10-year-old children diagnosed with ASD in the preceding 3 months to 2 years, were recruited. Semi-structured individual face-to-face interviews were conducted based on an interview guide. Thematic analysis was used to analyse the data. Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist was used for reporting. RESULTS Common themes were analysed using constant comparative method to generate results. Four themes emerged after 13 interviews: (1) adjusting psychologically, (2) changing lifestyle, (3) contending with hurdles to services and (4) needing informational, tangible and emotional support. CONCLUSIONS Findings suggested a need for more formal support networks, targeted resource platforms and accessibility of services to help support parents better after receiving a diagnosis of ASD in their child. RELEVANCE TO CLINICAL PRACTICE Enhancing current healthcare and social policies to improve the provision of standardised and targeted information to parents, establishing formal support networks, facilitating access to childcare services, and involving domestic helpers/nannies as dedicated caregivers and trainers could better support parents.
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Affiliation(s)
- Jing Xuan Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Nursing, National University Hospital, Singapore, Singapore
| | - Ramkumar Aishworiya
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger Chun Man Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
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Divan G, Bhavnani S, Leadbitter K, Ellis C, Dasgupta J, Abubakar A, Elsabbagh M, Hamdani SU, Servili C, Patel V, Green J. Annual Research Review: Achieving universal health coverage for young children with autism spectrum disorder in low- and middle-income countries: a review of reviews. J Child Psychol Psychiatry 2021; 62:514-535. [PMID: 33905120 DOI: 10.1111/jcpp.13404] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Autism presents with similar prevalence and core impairments in diverse populations. We conducted a scoping review of reviews to determine key barriers and innovative strategies which can contribute to attaining universal health coverage (UHC), from early detection to effective interventions for autism in low- and middle-income countries (LAMIC). METHODS A systematic literature search of review articles was conducted. Reviews relevant to the study research question were included if they incorporated papers from LAMIC and focused on children (<eight years old) with autism or their caregivers. The database search was supplemented with bibliographic search of included articles and key informant suggestions. Data were extracted and mapped onto a Theory of Change model toward achieving UHC for autism in LAMIC. RESULTS We identified 31 articles which reviewed data from over fifty countries across Africa, Latin America, Middle East, and Asia and addressed barriers across one or more of four inter-related domains: (a) the social context and family experience for a child with autism; (b) barriers to detection and diagnosis; (c) access to appropriate evidence-based intervention; and (d) social policy and legislation. Key barriers identified included: lack of appropriate tools for detection and diagnosis; low awareness and experienced stigma impacting demand for autism care; and the prevalence of specialist models for diagnosis and treatment which are not scalable in LAMIC. CONCLUSIONS We present a Theory of Change model which describe the strategies and resources needed to realize UHC for children with autism in LAMIC. We highlight the importance of harnessing existing evidence to best effect, using task sharing and adapted intervention strategies, community participation, and technology innovation. Scaling up these innovations will require open access to appropriate detection and intervention tools, systematic approaches to building and sustaining skills in frontline providers to support detection and deliver interventions embedded within a stepped care architecture, and community awareness of child development milestones.
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Affiliation(s)
- Gauri Divan
- Child Development Group, Sangath, Bardez, Goa, India
| | | | - Kathy Leadbitter
- Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | - Ceri Ellis
- Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | | | - Amina Abubakar
- Institute of Human Development, Aga Khan University, Nairobi, Kenya
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Syed Usman Hamdani
- Human Development Research Foundation, Punjab, Pakistan.,University of Liverpool, Liverpool, UK
| | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Jonathan Green
- Child and Adolescent Psychiatry, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK.,Royal Manchester Children's Hospital, Manchester, UK
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37
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Attitudes and Perceptions of Muslim Parents Toward Their Children with Autism: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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38
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Bilaver LA, Sobotka SA, Mandell DS. Understanding Racial and Ethnic Disparities in Autism-Related Service Use Among Medicaid-Enrolled Children. J Autism Dev Disord 2020; 51:3341-3355. [PMID: 33219917 DOI: 10.1007/s10803-020-04797-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 01/30/2023]
Abstract
Racial and ethnic disparities in the use of nine common autism-related services among Medicaid-enrolled children with autism spectrum disorder (ASD) were examined, distinguishing between school and other community-based outpatient settings. Using 2012 Medicaid Analytic Extract data, we identified 117,848 continuously enrolled children with ASD. Several racial and ethnic disparities were found, varying by geography. Black, Asian, and Native American/Pacific Islanders received fewer outpatient services compared with white children, but there was no disparity for Latinx children. Black and Asian children received more school-based services than white children. Disparities in case management/care coordination services were largest and present in each minority group. Geographic variation in receipt of services suggests targets for policy intervention to improve access for minorities with ASD.
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Affiliation(s)
- Lucy A Bilaver
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, 633 N St. Clair, 20th floor, Chicago, IL, 60611, USA.
| | - Sarah A Sobotka
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, 950 East 61st Street, Suite 207, Chicago, IL, 60637, USA
| | - David S Mandell
- Department of Psychiatry, Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA
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