Parental Help-Seeking Behaviors In Children with High Functioning Autism: The Role of Parental Confidence and Children's Symptomatology

Background: Autism Spectrum Disorders (ASD) are characterized by deficits in social interactions, language delays and the presence of stereotypic behaviors (Mastrangelo, 2009). Rogers and Vismara (2008) recommend that children with ASD receive comprehensive and intensive interventions. However, little is known about how, when, or why parents seek services for their children. In parents of children with ASD, research has shown that self-confidence in managing their children’s anger and anxiety episodes increased when parents were involved in the treatment process (Sofronoff, Attwood, Hinton, 2005; Sofronoff, Attwood, Hinton, & Levin, 2007).

Objectives: However, to the authors’ knowledge, no studies have investigated parental confidence and the potential association with help-seeking behaviors in children with ASD. Because of this lack of research, no hypotheses were predicted. This study sought to examine the associations between parental confidence and child symptomatology with (1) school interventions and (2) medical treatment. 

Methods: Participants consisted of 12 children with ASD (83% male) aged 4.5 to 7 years old, recruited to participate in an intervention study for stress and anger management in children with high functioning ASD. Children had to have an ASD diagnosis or meet ASD criteria on the Autism Diagnostic Observation Schedule (ADOS). They were attending kindergarten or first grade, were verbal, and able to understand and follow verbal instructions. Children’s social and communication symptoms were measured using the Communication and Social domain sub-scores of the ADOS (Lord et al., 2000; Lord, et al., 1999). Parental confidence in their own and their child’s ability to deal with anger/anxiety-related emotions and type of intervention (medical treatment, school services) were measured via parent report.

Results: Because our sample was small, it was considered appropriate to conduct a series of non-parametric comparisons (i.e., Mann-Whitney test). Parents reported significantly lower levels of confidence in their child’s ability to deal with anger and anxiety when their child was receiving school services (M=4.63 for anger and M=4.75 for anxiety) than when their child was not receiving such services (M=9.67 for anger and M=9.33 for anxiety, p<0.05). However, children who received or did not receive medical treatment did not significantly differ on parental confidence. Similarly, no differences were found between parental self-confidence and children’s services utilization. Finally, children who received or did not receive school services or medical treatment also did not significantly differ on the ADOS social or communication sub-scores.

Conclusions: Although parental perception of their own abilities did not appear to be related to interventions provided to children, parental confidence in their children’s abilities did appear to influence the decision to seek for services. Children’s ASD symptom severity did not appear to be associated with the services the child was receiving. These findings indicate that in a sample of children with diagnosed ASD, parental help-seeking behaviors seem to be associated with parents’ perception of their children’s abilities to deal with their emotional states, rather than a child’s social or communication deficits. Future research should focus not only on whether children receive interventions, but also what mechanisms are contributing to parental help-seeking behaviors.