Objectives: The purpose of this study was to obtain information on early signs that caused parental concern, age of diagnosis and provision of intervention, available intervention services, and parental satisfaction with services. This investigation was an online survey of Chinese parents (n = 146) residing in mainland China who have a child with ASD.
Methods: Participants and sampling procedure. A convenience sample of 146 Chinese parents of children with ASD who reside in mainland China responded to this survey which was administered via a website created for the survey. A pre-survey notice was sent to parents to inform them of the upcoming survey and a second email containing the link of survey was sent a week after the pre-survey notice. An overall return rate of 28% resulted for the survey.
The survey contained questions addressing the age at which parents were concerned about their children’s development, the signs that caused their concern, the age when the initial diagnosis was obtained, availability of services provided by public schools or private sectors, intensity of services, and overall satisfaction with the diagnostic and intervention process.
Results: Parents reported that they first had concerns about development at a mean 3.1 years old (sd = 0.9), diagnoses were provided, on average, at 3.8 years (sd = 1.3), and interventions began at a mean of 4.3 years of age (sd = 1.4). Children whose parents reported the presence of greater numbers of autism-related symptoms tended to have concerns about the child’s development at lower age (χ2 (6, n=146) =24.07, p=.001), though the presence of more symptoms was not associated with earlier diagnosis or intervention, possibly suggesting the need for greater concentration on early identification of ASD in the professional community in China. Data also suggested that some ASD symptoms, (e.g. not responding to his/her name when called, lack of sharing interest in activities or objects, and less showing of objects) may be particularly salient as early signs of ASD for Chinese parents. Over 70% of parents reported that they were either dissatisfied or strongly dissatisfied with the diagnostic process and the intervention services accessed by their child.
Conclusions: These results suggested the need for increased early intervention awareness in the Chinese professional community, perhaps building on the U.S. Know the Signs, Act Early model. Data also indicated that the presentation of ASD-related symptoms may be distinct in Chinese families, indicating need for culturally relevant assessment and intervention strategies, some of which will be addressed.