Parent perceptions of autism severity: Exploring the social ecological context

doi:10.1016/j.dhjo.2012.06.002

Disability and Health Journal

Volume 5, Issue 4, October 2012, Pages 298-304

https://doi.org/10.1016/j.dhjo.2012.06.002 Get rights and content

Abstract

Background

Health professionals incorporate parent reports into the diagnosis and treatment of children with an autism spectrum disorder (ASD). Yet little is known about the contextual forces that may shape parents' perceptions of their child.

Objectives

The current study seeks to: 1) compare the social ecological contexts of parents of children with ASD and parents of non-autistic children, and 2) explore the social ecological influences on parents' perception of their child's ASD severity.

Methods

This study employed a cross-sectional analysis of data from the 2007–2008 National Survey of Children's Health (NSCH) in the United States. Social ecological factors of interest included variables depicting family physical environment, family social environment, and individual parent characteristics.

Results

Results indicate that parents of children with ASD had increased odds of reporting poor neighborhood social capital, greater aggravation, more difficulty coping, and lower levels of relationship satisfaction and mental health. Parents' perceptions of their child's ASD severity were associated with several factors of their social ecological context. More severe parent-reported ASD was associated with aspects of the physical environment (rundown housing and garbage on the street), the social environment (parent relationship satisfaction) and individual parent characteristics (parent aggravation and mental health).

Conclusions

Results suggest ways that professionals can contextualize parent reports to aid in the diagnosis and treatment of children with ASD. Findings also highlight a need for longitudinal research using well-characterized measures to determine the nature and direction of relationships between contextual factors and parents' perceptions.

Section snippets

Parent perceptions of autism severity: exploring the social ecological context

Autism is a neuro-developmental disorder characterized by impairments in social reciprocity, communication, stereotypic behaviors, and restricted and repetitive interests.¹ Recent population-based studies estimate that about 1 in 110 school age children in the United States are diagnosed with an autism spectrum disorder (ASD).2., 3. As the reported incidence of autism continues to rise, there is a growing need for effective assessment and treatment across the country.4., 5., 6. Families living

Methods

The 2007 National Survey on Children's Health (NSCH), used in the current study, was funded by the Health Resources and Services Administration's Maternal and Child Health Bureau of the Department of Health and Human Services and was administered by the Center for Disease Control's National Center for Health Statistics (NCHS). The NSCH used a random-digit-dialing protocol to identify and query parents and guardians regarding the health and well-being of their child(ren), under age 18, via

Measures

The current study utilized items from several modules within the NSCH including initial demographics (sex, race/ethnicity, age, family poverty level, family employment, and number of children in the household), child health and functional status, family functioning, parental health, and neighborhood and community characteristics. Child race/ethnicity was self-reported by parents regarding their children. Family poverty level was calculated as a percentage of the federal poverty level based on

Analyses

The analyses for the current study were restricted to children, age 2–17, whose parents reported that they did or did not have a lifetime ASD (n = 81,923). The initial step involved basic descriptive analysis on demographic and other characteristics of interest (see Table 1). The main analyses utilized a set of weighted logistic regressions to assess the strength of association between parent-reported child lifetime ASD and individual social ecological factors including individual

Results

Demographic characteristics of the sample are shown in Table 1. In the overall sample, 1.7% of children had a parent-reported lifetime ASD (n = 1427). The majority of children in the total sample were male and white/non-Hispanic. Additionally, they most often had at least one family member who worked full time for at least 50 weeks during the previous year and lived in families whose income was greater than 300% of the national poverty level. Compared to other children, the subsample of those

Discussion

This study's findings shed light on the relationship between the social ecological contexts of parents with children with autism and parents' perceptions of their children. Comparisons between parents of children with ASDs and parents of non-ASD children were consistent with previous reports from the NSCH 2003 survey.²³ Parents of children with ASD reported lower mental health and coping ability, and higher aggravation than other parents. They also reported lower relationship satisfaction and

Acknowledgments

The 2007 National Survey on Children's Health (NSCH) was funded by the Health Resources and Services Administration's Maternal and Child Health Bureau of the Department of Health and Human Services. The authors also wish to thank the field workers who collected the data for this project.

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: Financial disclosure: Neither Dr. Hock nor Dr. Ahmedani have any conflicts of interest, financial or otherwise, with this research.

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Research PaperParent perceptions of autism severity: Exploring the social ecological context

Abstract

Background

Objectives

Methods

Results

Conclusions

Section snippets

Parent perceptions of autism severity: exploring the social ecological context

Methods

Measures

Analyses

Results

Discussion

Acknowledgments

Behav Res Ther

Health and Place

Soc Sci Med

Prev Med

Prevalence of parent-reported diagnosis of autism spectrum disorder among children in the U.S., 2007

Pediatrics

Prevalence of autism spectrum disorders: autism and developmental disabilities monitoring network, United States, 2006

MMWR

The rise in autism and the role of age at diagnosis

Epidemiology

Trends in autism spectrum disorder diagnoses: 1994-2007

J Autism Dev Disord

Incidence of autism spectrum disorders: changes over time and their meaning

Acta Paediatr

Factors associated with age of diagnosis among children with autism spectrum disorders

Pediatrics

Identification and evaluation of children with autism spectrum disorders

Pediatrics

Research Paper
Parent perceptions of autism severity: Exploring the social ecological context