Socio-Demographic Variation in Parent Belief about the Causes of Learning and Developmental Problems Among Children with Autism Spectrum Disorder

Thursday, May 15, 2014
Atrium Ballroom (Marriott Marquis Atlanta)
K. Zuckerman1, O. J. Lindly1, B. K. Sinche1, P. D. Sidor1 and C. Nicolaidis2, (1)Pediatrics, Oregon Health & Science University, Portland, OR, (2)Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, OR
Background:  Causes of learning and developmental problems in autism spectrum disorder (ASD) are unclear; however, families’ causal beliefs may be important in understanding health-seeking behaviors and health services utilization for ASD.

Objectives:  The objective of this study was to assess socio-demographic differences in parent beliefs about the causes of learning and developmental problems in a nationally-representative survey of U.S. families of children with ASD.   

Methods:  Using data from the 2011 Survey of Pathways to Diagnosis and Services, we analyzed beliefs of 1420 parents of children with ASD.   Survey items assessed whether parents felt the cause of child’s learning and developmental condition was genetic or hereditary, was caused by an in-utero or post-natal exposure, or was affected by an accident, illness, or injury.  We used bivariate and multivariate logistic regression to assess the associations of socio-demographic characteristics (age, gender, race/ethnicity, household income, health insurance status, U.S. region, functional limitations status, parent educational attainment, and family structure) with each parent belief.

Results:  Beliefs about a genetic/hereditary cause of the child’s condition were less likely among parents of boys (29.1% vs. 44.1% in girls; adjusted odds ratio [AOR]: 0.50 [0.30-0.82]) and parents of Latino children (17.2% vs. 34.6% in White non-Latino children; AOR: 0.21 [0.10 - 0.41]), and more likely among step-families compared to  two-parent biological or adopted families (40.1% vs. 28.3%; AOR: 1.88 [1.06 - 3.32]).  Beliefs about child’s condition being caused by a post-natal exposure were more common in parents of Latino children (25.5% vs. 15.1% in White non-Latino children, AOR: 3.21 [1.33 - 7.75]) and parents of African-American children (35.5% vs. 15.1% in White non-Latino children; AOR: 2.40 [1.07 - 5.39]). Beliefs that an accident, illness, or injury had an effect on development were more likely in families living at <100% of U.S. Federal Poverty Level (64.4% vs. 49.5% in families living at >400% Federal Poverty Level; AOR: 3.48 [1.39-8.71]), and parents of children with functional limitations (61.1% vs. 50.6% of children without functional limitations; AOR: 1.78 [1.06-2.99]).  There was no significant variation in parent beliefs according to child age, U.S. region, or child health insurance status.

Conclusions:  In this nationally-representative sample of families affected by ASD, analyses suggested significant socio-demographic variation in parent beliefs.  Parent beliefs about genetic/hereditary and exposure causes of children’s conditions differed by gender race/ethnicity, and family structure.  In addition, poverty and child functional limits were associated with differences in parent beliefs about accident or illness affecting the child’s condition. Taking these beliefs into account may help providers in their conversations with diverse families. Further research is needed to assess how these beliefs modify health care quality or health services utilization.

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