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Measuring Sociodemographic Risk in Families of Very Young Children Receiving Early Autism Intervention

Friday, 3 May 2013: 14:00-18:00
Banquet Hall (Kursaal Centre)
J. Winter1, A. Estes2, Z. Zargar1,3, J. G. Greenson1, M. L. Rocha4, L. A. Vismara5, A. L. Fitzpatrick1 and S. J. Rogers6, (1)University of Washington, Seattle, WA, (2)Speech and Hearing Sciences, University of Washington, Seattle, WA, (3)University of Washington, Bothell, WA, (4)UC Davis MIND Institute, Sacramento, CA, (5)University of California at Davis MIND Institute, Sacramento, CA, (6)M.I.N.D. Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, Sacramento, CA
Background:   Research has demonstrated that early intervention for young children with autism has a significant positive impact on child progress (Dawson et al., 2010).  However, little is known about the effectiveness of early autism intervention for children with different levels of sociodemographic risk. The developmental systems model describes a process by which risk factors, including family sociodemographic factors, act to disrupt central family functions, and can negatively or positively influence the effectiveness of early intervention (Guralnick, 2001).  We will examine the effect of these family risk factors on the efficacy of the Early Start Denver Model (ESDM) intervention.   

Objectives:   We aim to develop a scale of family sociodemographic risk (SDR) factors.  We will examine the relationship of this new scale to child and family factors in order to investigate the validity of this new measure. We hypothesize that families with a greater number of risk factors will have children with significantly lower communication abilities and higher levels of problem behaviors.

Methods:   We created the SDR scale from existing variables in a multisite, randomized, controlled trial of early intervention using the ESDM.   These data are from a subset of 74 families, when the child with autism was 12-24 months old.  Items were from the Life Experiences Survey (Sarason et al., 1978), the CHARGE family characteristics questionnaire (Hertz-Picciotto et al., 2006), and enrollment interviews.  The scale consisted of 16 risk factors.  For each factor endorsed by the parent, a point was given, for a possible score of 16 points.

Results:   Item-level analysis of SDR revealed the following:  child not living with both parents, 10.8%, mother with high school degree or less, 16.2%, father with high school degree or less, 10.8%, unemployed father 6.8%, family income below $50,000, 23%, one/both parents born outside the US, 21.6% resided in US for < 10 years, 17.6%, one/both parents with a primary language other than English, 25.7%, sibling with a disability, 29.7%, mother/ father with a disability, 13.5%, parent with a recent major illness, 13.5%, parent in jail, 2.7%, recent foreclosure, 5.4%, recently moved, 24.3%, recent pregnancy,  12.2%, recent death in family, 13.5%. The responses ranged from 0-9 points (mean = 2.47, SD = 1.753, median = 2, mode = 2).  Of the respondents, 10.8% had a score of 0, 18.9% had a score of 1, 25.7% had a score of 2, 23% had a score of 3, 10.8% had a score of 4, 6.8% had a score of 5, and scores of 7, 8, and 9 were found in 1.4% of children each.  Additional analyses addressing validity will be presented, including the relationship of the SDR score to child communication, problem behaviors and other family characteristics.

Conclusions:   The results suggest that the SDR scale may be a useful tool to investigate variability in response to intervention and parent learning.   These family risk factors may have implications for individualization of intervention and ultimately increase the effectiveness of support for parents in the context of early autism intervention.

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