Knowledge, attitudes, and perceptions of autism spectrum disorder in a stratified sampling of preschool teachers in China

Parental Perception of the Importance of Friendship and Other Educational Outcomes in Children with Autism Spectrum Disorder in China

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.

Preschool teachers' knowledge, beliefs, and self-efficacy concerning autism: A parallel mixed-methods study of an intervention to improve autism identification

LAY ABSTRACT

Preschool teachers can play a critical role in early detection of autism. Equipping preschool teachers with prerequisite knowledge and skills would allow them to identify children with probable autism and referral to diagnostic services. This study aimed to investigate the impact of an educational module (EMiASD) that prepared preschool teachers to identify autism symptoms. The sample included 144 preschool teachers, of which 120 were stratified and randomly assigned to an intervention arm receiving training in EMiASD (n = 60) or a comparison arm receiving standard training (n = 60) using a parallel mixed-methods design. Responses to open-ended questions about video case studies revealed improvement in the identification of autism symptoms in preschool teachers in the intervention arm, in contrast to preschool teachers in the comparison arm. Moreover, significant changes in knowledge, belief, and self-efficacy about autism favoured EMiASD. Overall, these results demonstrate the influence of EMiASD in the Yemeni cultural context.

Interplay between Tradition and Modernity: Stress and Coping Experiences among Parents of Children with Autism in Beijing, China

In traditional Chinese culture, specific beliefs and values can influence parents' experiences of stress and coping while raising children with autism. However, as China undergoes rapid social changes amid globalization, are these cultural influences still significant for today's parents of young children with autism? This study delves into this question through 12 in-depth interviews with parents of children with autism in Beijing. Content analysis indicated that while influences from traditional culture remain, modern parents often diverge from them. They adopt Western views on autism to mitigate stigma, establish boundaries with grandparents to ensure effective early interventions, address imbalanced professional dynamics, adjust authoritarian parenting styles, and broaden their social networks. A mix of traditional and contemporary parenting characterizes their experiences. The discussion elaborates on the findings, emphasizing the importance of family support.

Current Dimensions of Applied Behavior Analysis in Mainland China: A Review of 20 Years of Research

In the West, the field of applied behavior analysis (ABA) evolved over 7 decades from the experimental analysis of behavior. In this evolutionary process, seven dimensions of ABA emerged: applied, behavioral, analytic, technological, conceptual, effective, and generality. In contrast, ABA was introduced into mainland China only about 20 years ago as a direct result of the rise in autism diagnosis in that country, and only since then has it become an area of research there. The purpose of this study is to critically evaluate ABA research published in China by focusing on its seven dimensions. The results of our review reveal that the level of acceptance of and interest in the seven ABA dimensions varies across the studies sampled. Recommendations for the future development of ABA research in China are offered.

Assessment of Parental Knowledge, Awareness, and Perception About Autism Spectrum Disorders in Aseer Region, Southwestern Saudi Arabia

Background

Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects young children in social relatedness and communication besides other characteristics. A community's awareness and early intervention services in diagnosing and treating autistic children are essential for preventing the expected complications, eg language delay, social interaction, and intellectual ability.

Aim

To assess the parent's knowledge and perceptions regarding autism and its associated clinical features and effects.

Methodology

A cross-sectional study was conducted targeting all available parents aged 18 years or more living in Aseer region. Data were collected using a self-reported questionnaire from randomly selected parents who attended outpatient clinics at Abha Maternity and Children Hospital and Aseer Central Hospital. Parents' knowledge regarding autism was assessed covering general knowledge, clinical features, social effects, consequences, and curability.

Results

A total of 477 parents participated. Parents' ages ranged from 18 to 85 years. 261 (54.7%) parents were male and 216 (45.3%) were females. Nearly 65.6% of parents were university graduates and 28.3% had a secondary level of education. About 50.9% of the parents know that genetics play a major role in causing autism, 69.6% think that most children with autism have special talents or abilities, 64.2% know that delayed language development is one of the main symptoms of autism, 61.2% also know that repetitive movements of the hands and head are a common symptom of autism. About 36.9% of parents think that diagnosing a child with autism will lead to discrimination against the child, 33.3% of parents think that autism is a rare condition in this country compared to the West.

Conclusion

The study showed that parents had poor knowledge levels regarding autism and its related clinical features, especially male parents with low levels of education. On the other hand, their perception of the disease and its frequency in the study area was satisfactory.

The Jordanian Population's Knowledge, Attitudes, and Willingness to Help People with Autism: A Cross-Sectional Study

Objective

To assess the knowledge and attitudes of the general public in Jordan towards autism. In addition, we aimed to assess their awareness of various treatment options for autism, and their attentiveness and willingness to assist.

Methods

A cross-sectional survey was conducted in Jordan for the period between April and May 2022 using an online questionnaire developed based on a literature review. A total of 833 individuals in Amman city completed the questionnaires assessing participant demographics, knowledge of and attitude towards ADS, awareness of management options, perception, and ability to help. Using logistic regression, the odds ratios (ORs) and 95% confidence intervals (CIs) for those who are more likely to be informed about autism were determined.

Results

The participants' overall understanding of autism spectrum disorder was poor, with a mean score of 6.2 (SD: 3.1) out of 17, or 36.5%. The participants showed a moderately positive attitude towards autism, with an average agreement of 60.9% for government support for ADS children. The items about management options auditory integration training therapy had the highest level (50.1%). Additionally, the participants showed a moderate to high level of attention and ability to help people with autism. The majority confirmed that they see the need to implement changes in public facilities to meet the needs of autistic patients (71.8%). When compared to others, females, aged below 30, single, with family income less than 500 JD, holding a bachelor's degree, and working outside the healthcare field had a higher likelihood of knowing more about the autism spectrum condition (p ≤ 0.05).

Conclusion

Our research illustrates the lack of awareness and knowledge among the Jordanian population regarding autism. To fill this gap, educational awareness programs should be conducted to promote Jordanian knowledge regarding autism and find ways in which communities, organisations, and governments can support so as to allow for early diagnoses and an appropriate treatment plan and therapy for autistic children.

Knowledge, attitudes, and associated factors of caregivers towards children with autism spectrum disorder in East Coast Peninsular Malaysia

Background

Caregivers are directly involved in managing the daily basic needs of children with autism spectrum disorder (ASD). The knowledge and attitudes of these caregivers are important to achieving success in their roles. Thus, this study aimed to determine what constitutes good knowledge, attitudes, and associated factors among caregivers toward children with ASD.

Methods

A cross-sectional study was conducted among 128 caregivers of children with ASD in Kota Bharu, Kelantan from May to August 2020, using convenience sampling. Validated questionnaires were used to assess the knowledge and attitudes toward children with ASD. The data were analyzed using SPSS version 24. Descriptive statistics and simple and multiple logistic regression analyses were then performed.

Results

The response rate was 100%. The proportion of good knowledge and attitudes toward children with ASD among caregivers was 85.1% and 88.3%, respectively. Factors significantly associated with good knowledge were being female (OR (95% CI) 2.79 [0.99-7.90]) and ASD children being non-first-born children (OR (95% CI) 0.41 [0.15-1.12]). Factors significantly associated with good attitudes were age of 30 years and older (OR (95% CI) 0.13 [0.03-0.62]) and caregiver having other children with other types of learning difficulties (OR (95% CI) 0.15 [0.04, 0.52]).

Conclusions

The proportion of caregivers with good knowledge of ASD and good attitudes toward children with ASD was high. The caregiver's age and sex, the position of the ASD child among the siblings, and the presence of other types of learning disorders in the family need to be considered when managing children with ASD.

Factors affecting knowledge of autism spectrum disorder among pediatric residents in eastern China: a cross-sectional study

BACKGROUND

There is a global increase in the prevalence of autism spectrum disorder (ASD). Early identification of ASD in children and intervention are key aspects in the management of ASD. However, early identification is partly dependent on knowledge on ASD among pediatricians. This study analyzed the extent of ASD knowledge and its underlying factors among pediatric residents in eastern China, to provide a reference for medical education reforms.

METHODS

The study employed the Knowledge about Childhood Autism among Health Workers questionnaire. A total of 138 pediatric residents participated in the survey. Descriptive statistics were used to describe demographic characteristics and the four domains of the questionnaire. Univariate analysis was employed to assess impacts of the demographic characteristics on the questionnaire scores. On the other hand, multivariate regression analysis was used to analyze the correlation between the participants' demographic characteristics and the questionnaire scores.

RESULTS

The average ASD cognitive score of 138 respondents was 13.38 ± 4.48. The ASD cognitive scores in female pediatric residents were higher compared to that in males (p < 0.05). Residents who had obtained professional doctor qualification certificate were more than those without professional doctor qualification certificate (p < 0.05). The ASD knowledge in the group which did not have rotation in both departments was lower than in the group which had rotation in both departments (p < 0.05) as well as the group that had rotation in developmental and behavioral pediatrics department only (p < 0.05). Our multivariate linear regression model demonstrated significant statistical differences (p < 0.05), and showed that gender and systematic exposure to ASD knowledge had significant effects on cognitive scores (p < 0.05).

CONCLUSION

Most participants had relatively low levels of awareness and knowledge about ASD, especially on ASD comorbidities and age of onset. Women, systematic learning of ASD knowledge in medical school, successful passing of the physician examination, and rotation in the developmental and behavioral pediatrics (DBP) department significantly influence the levels of ASD awareness and knowledge. It is, therefore, important to strengthen ASD education in medical students at the university level and make rotation in the DBP department a requisite for pediatric trainees.

Parents' knowledge and attitude and behavior toward autism: a survey of Chinese families having children with autism spectrum disorder

BACKGROUND

In recent years, parent-mediated intervention for children with autism spectrum disorder (ASD) has increased. Therefore, implementing effective parent training programs for parents of children with autism is of paramount importance, particularly in low- and middle-income countries. However, little is known about the status of and gaps in parents' knowledge on ASD, which may hinder the development of valid parental training programs. Herein, we aimed at exploring the status of Chinese parents' knowledge, attitude and behavior toward ASD, and potential factors affecting the acquisition of correct knowledge.

METHODS

This study used a self-designed parental knowledge questionnaire of autism (PKQA) comprising 20 questions alongside another questionnaire comprising additional 17 questions covering the aspects of family demographics, attitudes, and behaviors of parents. In total, we included 394 parents who visited the outpatient department of the Child's Development and Behavior Center of the Third Affiliated Hospital of Sun Yat-Sen University between December 2018 and May 2019, with their children meeting the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for ASD.

RESULTS

The median knowledge score in the PKQA was 15 [interquartile range (IQR), 13-17]. Advanced paternal age and longer time interval from diagnosis to enrolling into the parent training program were associated with a lower total knowledge score (all P<0.001). Higher maternal education attainment, higher family income, child being currently under intervention, and family members sharing a common perception of the diagnosis were associated with a higher total knowledge score (all P<0.01). Reading autism-related books (P<0.001) or attending professional lectures (P=0.019) were also associated with a higher total knowledge score.

CONCLUSIONS

Taken together, this study revealed that family demographics and parents' attitudes and behaviors toward ASD may significantly influence their knowledge about autism, suggesting the need for promoting more targeted parental skills training programs.

Awareness of Autism Spectrum Disorder Among Pre-School Teachers in Qassim Region, Saudi Arabia

Background

Autism Spectrum Disorder (ASD) is a lifelong condition that affects children and early intervention to provide an appropriate education for ASD children is necessary.

Objective

This study aimed to assess the awareness of ASD among preschool teachers in Qassim region, Saudi Arabia.

Methods

A cross-sectional study was carried out from December 2021 to February 2022 among preschool teachers in the Qassim region of Saudi Arabia. A random sampling technique was applied to select teachers through the Ministry of Education website.

Results

A total of 164 preschool teachers took part in the questionnaire. The most common age group was 30 – 40 years (58.5%). The total mean score of AKQ was 15.0 (SD 4.97). Nearly three-quarters (74.4%) of the teachers were classified as having a poor level of awareness while 25.6% had a good awareness level. Factors associated with a good awareness level include being a teacher (p=0.034) and having direct contact with autistic children (p=0.016). It is important to note that having more years of experience was significantly associated with knowledge regarding the correct pattern to diagnose children with autism (p=0.049).

Conclusion

The awareness of preschool teachers regarding ASD was deficient. Teachers who are in contact with autistic students demonstrated better knowledge than the rest of the preschool teachers. Preschool teachers are expected to maintain high standards in their work to meet the children’s abnormal development and to identify them from an early stage, then refer them to diagnosis services.

Analysis of the Autism Spectrum Disorder (ASD) Knowledge of Cuban Teachers in Primary Schools and Preschools

Teachers’ knowledge of autism spectrum disorder (ASD) plays a key role in the successful inclusion of children with ASD in regular schools. The objective of this study was to analyze Cuban teachers’ knowledge of ASD of at inclusive primary schools and preschools and to compare it with the results obtained in previous studies carried out at an international level. To do this, a cross-sectional study was conducted with Cuban teachers from urban and rural areas throughout the country. The sample was selected using a non-probabilistic technique. In total, 131 primary school and preschool teachers participated. Data were collected by applying the Autism Knowledge Questionnaire (AKQ) that measures ASD knowledge. The results indicated that Cuban teachers had an acceptable knowledge regarding ASD (0.57). Primary education teachers (17.58 ± 4.06) showed a higher level of knowledge than preschool teachers (15.35 ± 2.74). Regarding previous training, teachers who claimed to have received some type of specific ASD training (10.88 ± 3.29) made a greater number of errors than teachers who had not received specific training on ASD (8.91 ± 3.06). At the international level, Cuban teachers were observed to have similar knowledge about ASD when compared to active teachers or pre-service teachers from other countries where similar studies have been carried out. The results suggest that the training of Cuban teachers is not yet optimal to educate students with ASD in primary schools and preschools which are open to diversity.

Knowledge and Attitudes toward Autism Spectrum Disorder in Saudi Arabia

Aims: The diagnosis of autism spectrum disorder (ASD) is not easy as there is no direct test that exists to establish such a diagnosis. Increasing community and healthcare professional knowledge of the ASD spectrum is crucial because it will encourage parents of ASD children to seek screening and diagnosis from a specialist, allowing for better early detection and treatment. This study explored the knowledge of the general population in Saudi Arabia regarding ASD and assessed variables associated with an accurate understanding of ASD. Methods: A total of 769 participants were involved in this cross-sectional study, which was conducted in Saudi Arabia between November 2021 and February 2022 using an online survey tool to explore the knowledge of the general population in Saudi Arabia regarding typical child development and ASD. A binary logistic regression analysis was used to determine factors affecting participants’ knowledge of autism. Results: Overall, the study participants showed a weak level of knowledge about autism with a mean score of 5.9 (SD: 3.1), comprising 34.7% of the total maximum obtainable score. Participants with a middle income category of 5000–7500 SR are less likely to be knowledgeable about autism compared to others (OR: 0.60 (95% CI: 0.39–0.92)) (p-value = 0.020). Conclusion: The participants in our study showed limited knowledge about autism. Government funds should be made available to facilitate educational services for ASD children. More funding and resources should be allocated by the government to provide assistance for children with special needs, and changes in public facilities are required to meet the demands of ASD patients. Through an informed educational effort, various media platforms should assist in improving the community’s understanding of ASD and their attitude toward ASD patients. Educational campaigns should focus on enhancing the public’s knowledge about ASD treatment and etiology.

Teachers’ Attitudes toward Autism Spectrum Disorder: A Systematic Review

(1) Teachers’ attitudes toward the inclusion of students with autism spectrum disorder (ASD) in mainstream schools influence daily educational practices. Depending on whether these attitudes are favorable or not, inclusive education could be fully or partially reached. This systematic review aims to analyze teachers’ attitudes toward ASD and to determine the variables that moderate them. (2) We conducted a systematic review in WoS, Scopus, and PsycINFO databases, obtaining an amount of 16 studies included in this review. (3) The results revealed inconclusive levels in teachers’ attitudes: Some of the teachers reported positive attitudes, some neutral, and some negative. (4) Among the variables that probably moderate attitudes, we found knowledge, experience, training, and gender. Future research and implications for pre-service and in-service teachers, school administrators, and policy makers are suggested.

Awareness and knowledge of autism spectrum disorder in Western China: Promoting early identification and intervention

PURPOSE

Given the increasing prevalence of autism spectrum disorder (ASD) and the public health problems it creates; early identification and interventions are needed to improve the prognosis of ASD. Hence, this study surveyed different groups of people who are likely to have early contact with autistic children to provide an informed basis for early detection and effective diagnosis and interventions.

METHODS

Three groups of people were recruited for the study from Changshou District and Wushan County of Chongqing, in Western China: 269 medical workers, 181 educators, and 188 community residents. Their understanding and knowledge of autism was measured using a self-made questionnaire.

RESULTS

The positive finding was that the three groups had a certain level of understanding of autism, but they had some misunderstandings of the core problems, and there were significant differences in the understanding of autism among the three groups. Younger medical workers knew more about autism than older ones did. The ability of educators and community residents to identify autistic symptoms was positively related to their level of education and their experience with autistic children. Television and the internet were the main sources of information about autism for participants.

CONCLUSIONS

The medical workers, educators, and community residents in the investigated areas in western China may be able to identify early signs of autism but have an inadequate understanding of autism. In areas far from cities, it is necessary to strengthen the training of medical workers in primary health care to promote autism screening and referral in educational institutions and communities. Using internet technology to provide public education and professional training about autism in remote areas could be a very promising method in Western China.

Auditory-Motor Mapping Training Facilitates Speech and Word Learning in Tone Language-Speaking Children With Autism: An Early Efficacy Study

PURPOSE

It has been reported that tone language-speaking children with autism demonstrate speech-specific lexical tone processing difficulty, although they have intact or even better-than-normal processing of nonspeech/melodic pitch analogues. In this early efficacy study, we evaluated the therapeutic potential of Auditory-Motor Mapping Training (AMMT) in facilitating speech and word output for Mandarin-speaking nonverbal and low-verbal children with autism, in comparison with a matched non-AMMT-based control treatment.

METHOD

Fifteen Mandarin-speaking nonverbal and low-verbal children with autism spectrum disorder participated and completed all the AMMT-based treatment sessions by intoning (singing) and tapping the target words delivered via an app, whereas another 15 participants received control treatment. Generalized linear mixed-effects models were created to evaluate speech production accuracy and word production intelligibility across different groups and conditions.

RESULTS

Results showed that the AMMT-based treatment provided a more effective training approach in accelerating the rate of speech (especially lexical tone) and word learning in the trained items. More importantly, the enhanced training efficacy on lexical tone acquisition remained at 2 weeks after therapy and generalized to untrained tones that were not practiced. Furthermore, the low-verbal participants showed higher improvement compared to the nonverbal participants.

CONCLUSIONS

These data provide the first empirical evidence for adopting the AMMT-based training to facilitate speech and word learning in Mandarin-speaking nonverbal and low-verbal children with autism. This early efficacy study holds promise for improving lexical tone production in Mandarin-speaking children with autism but should be further replicated in larger scale randomized studies. Supplemental Material https://doi.org/10.23641/asha.16834627.

Knowledge mediates attitude in autism spectrum disorders? Data from Malaysia

Limited efforts have been made in middle- and low-income countries to raise public awareness of autism spectrum disorders (ASD) over the past ten years. We report data from a general population survey exploring the relationship between awareness, knowledge, and attitudes regarding autism in Malaysia. A questionnaire consisting of items related to awareness, knowledge, and attitudes regarding ASD was distributed. The scores of knowledge of ASD and attitude towards ASD were 6.87 (SD = 4.17; with a total possible score of 12) and 6.39 (SD = 2.77; with a total possible score of 9), respectively, indicating that, on average, the participants had moderate levels of knowledge and attitude. Structural equation modeling showed that improving awareness and knowledge about ASD will enhance more positive attitudes towards ASD. Efforts should be geared towards disseminating information about ASD, in order to increase acceptance of the disorder.

Teachers’ Knowledge Regarding Autism Spectrum Disorder (ASD): A Systematic Review

The increasing number of students with autism spectrum disorder (ASD) in mainstream education environments require teachers to know how to identify their needs, being capable to adapt their education processes and make their inclusion easier. The purpose of this study is to conduct a systematic review about teachers’ knowledge of ASD, including teachers from any stage and specialization. The research has been conducted from four databases (Web of Science, Scopus, PsycInfo and Google Scholar) during the period of 2015–2020. In total, 25 articles were analyzed. The results show that, in general, teachers’ knowledge of ASD is poor. It depends on the education stage (being higher in early childhood teachers and in university professors), prior training and possible prior contact with students with ASD.

While quarantined: An online parent education and training model for families of children with autism in China

PURPOSE

In the wake of the COVID-19 outbreak, already limited services and resources for families of children with autism spectrum disorder (ASD) in China became even more scarce. This qualitative case study highlights one online parent education and training (PET) program developed during the pandemic to offer home-intervention strategies to parents of children with ASD in mainland China. This exploratory study sought to examine the emic perspectives of the trainers and parents who participated in the 12-week intensive training program while considering the cultural context in China and the transnational, remote nature of the program.

METHODS

The primary data focused on the experiences of the trainers and parents within PET program's structure and strategies, which were adapted from the Training of Trainers model, and were collected from semi-structured, in-depth individual and focus group interviews conducted virtually with trainers (n = 4). Supplemental data sources included training session materials and feedback forms collected from parents (n = 294) at the midpoint and end of the program. After the collected data were sorted and condensed, a thematic analysis was performed using the data analysis spiral to further organize and code the data, and the codes were finally collapsed into themes.

FINDINGS

Three overarching themes were identified: (1) training as modeling with resources, (2) dilemmas in cultural contexts and expectations, and (3) cultivating parent support networks.

CONCLUSION

The online PET program became a hub of support networks and learning spaces for parents of children with ASD in different regions in China during the pandemic. Through the interactive virtual training sessions, parents were supported by continuous feedback on their home intervention and coached to cultivate support networks among themselves despite tensions arising from cultural differences and to implement effective intervention strategies that were individualized and authenticated to their specific familial needs.

Urgency in Improving Child Health Care Workers' Awareness and Knowledge of ASD: Findings From a Cross-Sectional Study in Southwest China

Objective: To evaluate the levels of awareness and knowledge of ASD among child health care workers in China, we conducted a cross-sectional, questionnaire-based study to assess the participants' awareness and knowledge of ASD. Methods: A total of 159 child health care workers from Southwest China participated in the survey and filled out the questionnaire.Descriptive analysis was conducted on the five parts of the questionnaire, including general knowledge, symptomology, screening and diagnosis, and intervention and treatment. Univariate analysis was used to assess impacts of the participants' basic demographic characteristics on the questionnaire scores. Multivariate analysis was used to analyze association of the participants' basic demographic characteristics and the questionnaire scores. Results: Less than 15% of the participants knew that ASD is a developmental, congenital and genetic disorder. Few participants knew that the symptoms include language disorder (38.4%) and social dysfunction (29.6%). A minority of the participants knew the diagnostic criteria (22.6%) and the age for early screening (14.5%). A total of 23.9% of the participants agreed that there are no effective drugs to treat ASD, and 6.3% agreed that ASD is incurable. A number of years in practice of ≥10 (OR = 0.3249, 95% CI: 0.1080-0.9189) was the main factor related to a high questionnaire score. Conclusions: Most participants had relatively low levels of awareness and knowledge of ASD, especially in terms of general knowledge as well as knowledge of intervention and treatment. Working for more than 10 years was a significant predictor of higher levels of awareness and knowledge of ASD. ASD-related training and knowledge dissemination are crucial for the early diagnosis and intervention of ASD. Child health care workers' awareness and knowledge of ASD needs to be improved to help build public awareness about ASD.

Chinese Validation of the Multidimensional Attitude Scale toward Persons with Disabilities (MAS): Attitudes toward Autism Spectrum Disorders

The literature on tools of attitudes towards ASD was limited. This study is the first to examine the factor structure and psychometric properties of the multidimensional attitudes scale toward persons with disabilities (MAS) in a sample of Chinese college students (N = 1002, 32.10% males). Confirmatory factor analysis supported the G-MAS-R model's 4-factor structure: calm, negative affect, positive cognitions and behavioral avoidance. The results suggest that the Chinese version of the MAS has satisfactory internal consistency. Pearson correlation analysis showed that the MAS scores were significantly correlated with the Social Distance Scale and Autism Stigma and Knowledge Questionnaire scores. Overall, the findings indicate that the MAS is appropriate for assessing attitudes toward people with ASD in a Chinese context.

Preschool Teachers' Beliefs towards Children with Autism Spectrum Disorder (ASD) in Yemen

It is perplexing that some preschool teachers not only advise parents who have children with autism spectrum disorder (ASD) to go to religious healers, but also attribute such neurological disorders to the curse of the “evil eye” or vaccines. Although it is now the twentieth century, this behavior simply reflects the concerns of over-protective teachers and the cultural misperceptions about the actual definition of ASD. In Yemen, the term “ASD”, with its wide range of symptoms, is still ambiguous among preschool teachers. Thus, in a rather insightful piece for the education community, this study has attempted to look beneath the surface of the beliefs (religious belief–social belief–personal belief) of Yemeni preschool teachers regarding ASD. Based on the data collected from 213 teachers (20–30\31–40-~≥40 age) in the Taiz district, this study found that misconceptions specific to autism spectrum disorder were strongly evidenced among teachers who taught preschoolers. Due to personal ignorance and growing superstitions, these teachers tend to believe the society’s perceptions of ASD, thus resulting in the ignorance of scientific views. However, the mass media can increase this group’s awareness of ASD by continually assessing the inaccurate views on ASD, and correcting them. And by influencing the teachers to take a more conceptual scientific approach in serving their special needs students, furthermore, by informing preschool teachers of children’s rights in normal life in the future through providing children with an optimal chance of development by early intervention.

Pre-School Teachers' Knowledge, Belief, Identification Skills, and Self-Efficacy in Identifying Autism Spectrum Disorder (ASD): A Conceptual Framework to Identify Children with ASD

Recently, the identification and detection of children with autism spectrum disorder (ASD) has become an essential issue under ASD intervention services. The high percentage of ASD among children requires preschool teachers to recognizse children's abnormal development and identify them at an early stage, followed by referral to specialists. Therefore, this identification calls for a specific ability among preschool teachers, identified as knowledge, belief, identification skills, and self-efficacy (KBISSE). This conceptual framework aims to utilize the current literature to present a discussion on preschool teachers' KBISSE in identifying children with ASD and making decisions to refer children suspected with ASD to specialists. The conceptual framework is discussed based on social cognitive theory (SCT) and the health belief model (HBM). The conceptual framework emphasizes the need for preschool teachers to be educated in ASD via an educational module that could increase teachers' self-efficacy in identifying children with ASD. Besides, knowledge in ASD, belief in ASD, and identification skills are also necessary variables for building the educational module. The educational module is useful for guiding future research on preschool teachers' identification of children with any disability, one of which is ASD, and subsequent specialist referral at an early stage.

Burden of major depressive disorder and quality of life among mothers of children with autism spectrum disorder in urban bangladesh

This cross-sectional study examined the burden of depression and quality of life (QoL) among mothers of children with autism spectrum disorder (ASD) attending six schools offering special educational services for children with ASD in urban Dhaka, Bangladesh. All consenting mothers were 18 years of age and older and met criteria for major depressive disorder (MDD) on the Structured Interview for DSM-V-TR Research Version-non patient edition administered by trained raters. QoL was assessed by the EuroQol five-dimensional standardized questionnaire. MDD was diagnosed in 45% of mothers and was proportionally higher among those who did not work outside the home, had no childcare support at home, expressed low level of satisfaction with the quality of providers when they had sought care for their children with ASD, and reported being recipient of negative attitudes from neighbors toward their children with ASD. QoL was negatively associated with MDD, mothers' illness, and low satisfaction with the health care providers for children with ASD, as well as experiencing a negative attitude by neighbors toward their children. QoL was positively associated with the reported family monthly income and improvement of the children with ASD on school attendance. The prevalence of MDD among mothers of children with ASD was high and associated with poor QoL. Integrating mental health services and supports for mothers in the ASD care of children is likely to address the high burden of depression they face, and improve their overall quality of life. Autism Res 2020, 13: 284-297. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The levels of depression were assessed among mothers of children with autism spectrum disorder (ASD) attending six schools offering special educational services for children with ASD in urban Dhaka, Bangladesh. Almost one in two mothers was found to have major depression. The quality of life of these mothers was generally poor. Integrating mental health services for mothers with ASD care in children is likely to address the burden of depression among the mothers of children with ASD and improve overall quality of life.

Effectiveness of video assisted teaching on knowledge, attitude and practice among primary caregivers of children with Autism Spectrum Disorder

Purpose

Parents or primary caregivers of children with Autism Spectrum Disorder (ASD) have important role in early recognition of the disorder as well as in the management of the disorder. Knowledge, attitude and practice of primary caregivers towards children with ASD are important factors in promoting health and wellness of such children. The purpose of this paper is to evaluate the effectiveness of video-assisted teaching regarding care of children with ASD on knowledge, attitude and practice among primary caregivers.

Design/methodology/approach

Quasi-experimental research design with one group pre-test post-test was adopted. A total of 60 primary caregivers were selected through stratified random sampling technique. Video-assisted teaching was given to 60 primary caregivers. Data collection was done before and after the video-assisted teaching programme using structured questionnaire which consists of 57 questions.

Findings

The result of the study showed that the post-test level of knowledge attitude and practice among primary caregivers of children with ASD was significantly high (p<0.0001) when compared to pre-test level by using Wilcoxon Signed Rank Test. The study finding revealed that video-assisted teaching was effective in enhancing the knowledge, developing a positive attitude and good practice among primary caregivers regarding care of children with ASD.

Social implications

Findings of this study will help mental health nurses, psychologists, intellectual disability nurses, teachers, public health, social workers, etc. to know the importance of video-assisted teaching programme regarding care of children with ASD and to motivate the primary caregivers to participate in such teaching programme. The community mental health nurse can plan video-assisted teaching programme in a community regarding care of children with ASD.

Originality/value

Results of this study indicate that the video-assisted teaching is effective and helps the primary caregivers to enhance the knowledge, attitude and practice regarding care of children with ASD. So continuous awareness in primary health centre and community area is necessary to improve the knowledge, attitude and practice of primary caregivers.

Neuropsychiatric Symptoms, Parenting Stress and Social Support in Chinese Mothers of Children with Autism Spectrum Disorder

Although little is known about the current situation regarding autism spectrum disorder (ASD) in mainland China, psychiatric disorders are common among Chinese mothers of preschool children with ASD. Previous studies showed ASD child's behavioral symptoms, maternal anxiety, and maternal depressive symptoms were associated with overall parenting stress in northern China. In the present study, we retrospectively analyzed medical records at the hospital related to neuropsychiatric symptoms, parenting stress and social support in mothers of children with ASD from southern China. A total of 80 mothers of children with ASD were screened. Among them, 34 mothers were in low-functioning ASD group (L-ASD group) and 46 mothers were in high-functioning ASD group (H-ASD group). Identification of the ASD cases was confirmed with a Revised Autism Diagnostic Inventory. Neuropsychiatric symptoms, parenting stress and social support were measured by neuropsychiatric inventory (NPI), parenting stress index short form (PSI-SF), and multi-dimensional scale of perceived social support (MSPSS). Total mean score of the NPI in the L-ASD group was significantly higher than that in the H-ASD group (P<0.01). The subscale scores of NPI, including depression, anxiety, apathy, irritability, agitation, night time behavior disturbances and change in appetite were significantly higher in the L-ASD group than those in the H-ASD group (P<0.01 or P<0.05). Meanwhile, the total PSI-SF scores and the scores of parental distress (PD), parental-child dysfunctional interaction (PCDI) and difficult child (DC) in the L-ASD group were significantly higher than those in the H-ASD group (P<0.01 or P<0.05). The total score of MSPSS was also higher in the L-ASD group than in the H-ASD group (P<0.01). This study goes further to show the neuropsychiatric symptoms and parenting stress are significantly higher in mothers of children with ASD, and more social supports are needed for mothers of children with ASD from southern China, especially for mothers of children with low-functioning ASD.

Knowledge, Awareness, and Perceptions Regarding Autism Among Parents in Karachi, Pakistan

Background

The prevalence of autism is growing worldwide. Owing to parents being the primary caregivers in most situations, their ability to recognize the signs and symptoms of autism and respond appropriately is of paramount importance in aiming to provide the best healthcare to autistic individuals. This study was conducted with the aim of ascertaining the parent’s knowledge and awareness of autism.

Methods

A cross-sectional survey was conducted among parents residing in Karachi, Pakistan. We excluded any individuals belonging to the medical profession, those who have autistic children, and those who couldn’t completely comprehend English and Urdu. A sample size of 339 parents was selected. A validated and pre-tested questionnaire was administered among the study participants to record demographic information, knowledge, and perceptions regarding autism and its signs and symptoms. Data were analyzed using Statistical Package for Social Sciences (SPSS version 23.0, IBM Corp., Armonk, NY, US). A knowledge score was calculated for opinions about autism and its sign and symptoms individually to reflect a participant’s overall knowledge regarding autism.

Results

From our study population, 75% of our population had heard of autism, with those who knew of someone with the disorder displaying greater awareness. However, our participants displayed poor knowledge scores, with a mean score of 5.59 in the section concerning correct opinions on autism and that of 6.84 in the section testing knowledge of signs and symptoms. Despite this, 95.6% of the participants were willing to get their children treated, in the event of them being diagnosed with autism.

Conclusion

Unfortunately, our population displayed a lack of awareness and knowledge regarding autism. To fill this gap, awareness programs should be conducted to promote parent’s knowledge regarding autism, so as to allow for early diagnoses and an appropriate treatment plan/therapy. On a positive note, most were willing to get their children tested and treated in case of a diagnosis. However, only a small number of participants knew of autism centers in Karachi. General practitioners are needed to play a key role in counseling parents about autism.

Biases in Understanding Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder in Japan

Recent research has shown high rates of comorbidity between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) and difficulties regarding differential diagnosis. Unlike those in Western countries, the Japanese ADHD prevalence rate is lower relative to that of ASD. This inconsistency could have occurred because of cultural diversities among professionals such as physicians. However, little is known about attitudes toward ADHD and ASD in non-Western cultural contexts. We conducted two experiments to identify biases in ASD and ADHD assessment. In Study 1, we examined attitudes toward these disorders in medical doctors and mental health professionals, using a web-based questionnaire. In Study 2, medical doctors and clinical psychologists assessed four fictional cases based on criteria for ADHD, ASD, oppositional defiant disorder, and disinhibited social engagement disorder (DSED). Diagnosis of ASD was considered more difficult relative to that of ADHD. Most participants assessed the fictional DSED case as ASD, rather than DSED or ADHD. The results provide evidence that Japanese professionals are more likely to attribute children’s behavioral problems to ASD, relative to other disorders. Therefore, Japanese therapists could be more sensitive to and likely to diagnose ASD, relative to therapists in other countries. These findings suggest that cultural biases could influence clinicians’ diagnosis of ADHD and ASD.

Public awareness of autism spectrum disorder

Objective:

Examine the awareness of autism spectrum disorders (ASD) in our community which would help in early recognition and improved support of affected families.

Methods:

A focused 20-item questionnaire was designed to survey the public awareness and knowledge of ASD. Personal interviews were conducted during an ASD awareness day, which was organized in a major shopping mall on February 20, 2015 in Jeddah, Kingdom of Saudi Arabia.

Results:

A total of 259 individuals participated in the study with 47% being <30 years of age and 57% being females. Most participants (60%) were married, educated (68% university level), and employed (54%). When asked if they knew what autism is, 88% responded positively. However, when asked to rate their degree of knowledge, 41% felt that it is weak. Females and those older than 30 years of age were more likely to feel knowledgeable (p=0.04 for females and p=0.013 for those >30 years of age). Females were more likely to think that autistic children can be employed in the future (p=0.008), whereas males were more likely to think that autism is similar to mental retardation (p=0.005).

Conclusions:

The public awareness of ASD needs improvement. Areas for targeted education were identified to help improve the quality of life of autistic children and their families.

CARACTERÍSTICAS PERINATAIS DE CRIANÇAS COM TRANSTORNO DO ESPECTRO AUTISTA

Objective:

To analyze perinatal features of children with autism spectrum disorder (ASD).

Methods:

Retrospective review of the medical records of 75 children with ASD, between January 2008 and January 2015. Inclusion criteria were diagnosis of ASD based on DSM-5 criteria, and the informed consent form signed by the person who is legally responsible. The exclusion criterion was missing on the medical record. The variables analyzed were maternal age, prematurity (gestational age under 37 weeks), low birth weight (<2,500 g), and perinatal asphyxia (5^th minute Apgar score <7). Data were analyzed using the difference between proportions test, being significant p<0.05.

Results:

Seventy-five patients were included. Maternal age ranged from 21.4 to 38.6 years (29.8±4.1 years). Premature birth occurred in 14 (18.7%) patients, perinatal asphyxia in 6 (8.0%), and low birth weight in 32 (42.6%) patients. The prevalence of prematurity, low birth weight, and perinatal asphyxia among the children in our study was higher than the general prevalence of these conditions among all live births in our country, region, and state, which are, respectively, 11.5, 2.3, and 8.5% in Brazil; 11.0, 2.2, and 8.5% in Southern Brazil; and 10.5, 2.0, and 8.4% in the state of Paraná.

Conclusions:

Our findings show a higher prevalence of prematurity, low birth weight, and perinatal asphyxia among children with ASD. Some limitations are the retrospective study design, and the small sample size. Large prospective studies are needed to clarify the possible association between perinatal complications and ASD.