Current Pediatric Research

Abstract

The study's goal is to discover how parents in the Nifas silk Lafto sub-city perceive and implement socialization problems for children with autism spectrum disorders. 113 parents with autistic children make up the samples. According to the study's findings, just 44.45% of parents had an average understanding of autism spectrum disorder.

The result of perceiving and implementation challenge of average was 94% parents respond agree or strongly agree implies that there is a challenge but most of parents were not perceived the challenges and did not act with in the environment to socialize the child with autism. The number of autistic children and their parents' marital status influence how difficult it is for children to form social bonds. Education level and marital status are the important factors in influencing autism spectrum disorders knowledge. The chi square test of knowledge revealed that the observed and predicted results varied statistically significantly at the 5% level of significance. The study suggests that parents must communicate regularly with school assistances and parent’s committee groups to share experiences, difficulties and challenges of socializing children with autism.

Keywords

Implementation, Perceiving, Autism spectrum, Parents, Stigma, Etiology.

Introduction

Autism Spectrum Disorder (ASD) is characterized as a collection of neurodevelopmental conditions in the course of persistent lifelong deficits in social interaction, communication, and sensory impairments. Parents face many challenges to socialize a child as the disorder is associated with disruptive antisocial behavior. Most parents may perceive challenges but often fail to act on them [1]. Perceived challenge means the ability to assume various perspectives of problem and being willing to take a risk. According to Agyekum [2] perception not only creates our experience of the world around us; it allows us to act within our environment.

The identification of barriers may be an important first step in understanding various factors that may hinder to the successful implementation of social engagement [3]. Implementation is a self-regulatory strategy in the form of an “if-then plan” that can lead to better goal attainment, as well as help in habit and behavior modification. In the parent-implemented intervention, parents directly use individualized intervention practices with a child to increase positive relationships opportunities and gaining of important skills [4]. As Hosseinpour, et al. stated when a child is diagnosed with autism; parents are often at higher risk for several negative psychological problems [5].

Particularly in less developed countries mostly in Africa. The higher level of challenges among parents of children with autism to socialize a child has been associated with the feelings of social isolation, cultural interpretation, public knowledge of autism and the destructive behavior of a child. The inabilities to assume various perspectives of challenges to socialize a child with autism, being parents less taking of risks and do not face the challenges. The aim of this paper is to explore the implementations and perceiving challenges of parents in socializing children with autism spectrum disorders.

Research objective

General objective: The general objective of the study is to investigate the implementations and perceiving challenges of parents in socializing their autistic children.

Specific objectives: The specific objectives of the study include:

• To assess the insight level of parents about implementation challenges to socializing children with autism spectrum disorder.

• To investigate parents understanding about social challenges in the process of socializing a child with autism spectrum disorder.

• To explore the knowledge parents hold about social challenges in the process of socializing.

• To identify the significant demographic characteristics that determines the knowledge of parents with Autism.

• To identify whether there is a statistical significance difference between the observed and expected response of parents about knowledge of autism.

• To identify the significant demographic characteristics that determines the implementation and perceiving challenges.

Methodology

Research design

The research approach applied in this research incorporates both the quantitative and qualitative type it helps insights for triangulation and to gain more in-depth understanding. And descriptive survey design used the rational for choosing this study design is that to accurately and systematically describe a population through frequencies and categories. The researcher utilizes a cross sectional study methods in collecting the primary data from participants of the study.

Instrument and tools for data collection

Questionnaire and interview used as a tool. The questionnaires have three parts. The first part of the questionnaire contain 5 questions deals with personal information, the second part of the questionnaire about parents knowledge of autism and part three have 10 questions of implementation and perceived challenges to socialize a child with autism. Six structured interview will administer to collection data to provide a detail picture of participants’ experiences.

Sampling and participants

The sampling frame of the study is the list of parents of children with autism in champion’s academy, school of redemption and Gudina Tumsa special need education center in Addis Ababa, Ethiopia. The sample size (fn) of the study will be 113 parents. To allocate the sample size among the three schools the researcher used Probability Proportional to Size (PPS) sampling.

Data analysis

After the data gathered analyze through Inferential of chisquare and regression, descriptive of mean and standard deviation used for analysis. Inferential analysis will be made to analyze the analysis of variance considering all the demographic characteristics as a factor. Descriptive analysis also made to present the data in a more meaningful way, which allows simpler interpretation of the data.

Results

Demographic characteristic of the respondents

As can be seen in the result, 78 (68.4%) of the respondents were female while 35 (31%) were male. Regarding marital status of respondents (108,94.7%) and 5 (4.4%) of the respondents were married and divorce respectively. With regard to the educational status of respondents, the study revealed that most of the participants (39, 34.2%) were degree holders and 30 (26.3%) completed diploma in both sexes, 30 (26.3%) were master holders and 14 (12.3%) respondents were unable to read and write. Result of relationship with a child is 78 (68.4%) of the respondents were mother to the child while 35 (30.7%) of them were fathers. Moreover 104 (91.2%) of the respondents had 1 child with autism while 8 (7%) had 2 children with autism and 1 (0.9%) parent had 3 children (Table 1).

Table 1. Demographic characteristic of the respondents.

Parent knowledge of Autism Spectrum Disorder (ASD)

The average result of parents knowledge indicate 40.2%, 44.6%, 46.2%, 40.2% and 50% on the assessment and diagnosis, cause and prevalence, treatment, outcomes and prognosis, symptoms respectively.

Predictors of autism spectrum disorder knowledge

Results show that sex of the respondents (t calc=-1.109, p=0.27), Children with autism (t calc=-1.516, p=0.132) and relationship with child (t calc=-1.039, p=0.301) are statistically insignificant at 5% level of significant while education level of the respondent (t calc=-2.005, p=0.048) is significant at 5% level of significance and marital status (t calc=3.38, p=0.001) is statistically significant at 10% level. A chi square test was also conducted for all the individual questions identified to check whether there is a statistically significance difference between the observed and the expected results. Accordingly the test revealed that there is a statistically significance difference between the observed and expected result at 5% level of significance (Table 2).

Table 2. Summary of multiple regression analysis for predicting ASD knowledge perceived challenge to socialize children with autism.

Implementation and perceived challenge to socialize children with autism

The perceived challenge result show the average 94% agrees and strongly agrees and the rest 6% disagree and strongly disagree. Result from the descriptive statistics indicates that an average value of 4.2 was obtained indicating that the majority of the respondents agree or strongly agree for the implementation challenges. An average standard deviation value of 0.85 asserted that the majority of the respondent replied in similar way (agree or strongly agree).

Implementation challenges perceived by parents

The result in general shows that there is a significant implementation challenge to socialize children with autism among the general parent population. When looking at the implementation challenges measure, on the average 84% agrees or strongly agrees for the question “lack of implementation plan due to lack of support “and “Due to high cost of regular follow-up lack of implementation for plan at home” because of the reasons of lack of support and high coast of regular follow up parent didn’t used implementation plan to socialize a child.

Predictors of perceiving and implementation challenges to socialize a child related with demographic characters

Multiple linear regressions was performed by considering the demographic characteristics of the respondents as independent (explanatory) variables and perceived and implementation challenge as dependent variables. Results show that sex of the respondents((t calc=1.035, p=0.303), education level of the respondent(t calc=-0.189, p=0.850), and relationship with child (t calc=1.067, p=0.288) are statistically insignificant at 5% level of significant while marital status(t calc=2.561, p=0.012) is significant at 5% level of significance and children with autism(t calc=1.675, p=0.097) is statistically significant at 10% level of significant (Table 3).

Table 3. Summary of multiple regression analysis for predicting perceived challenge.

Discussion

Parent knowledge of Autism Spectrum Disorder (ASD)

Parent knowledge of ASD may play an important role in the well-being of children with ASD. Being aware of the etiology, symptoms, and other ASD related concepts may help parents to feel more empowered and comfortable with knowing when to seek an evaluation and feel empowered when communicating with the society. In the processes, those parents tend to socialize and teach their children they must have to know basics about autism to specifically understand the challenges. For example, if a child behaves is shouting, throwing, biting, screaming and aggressiveness.

In this study assessment was made on the identified parents in relation to the knowledge of ASD by categorizing the knowledge areas in to five parts which includes: assessment and diagnosis cause and prevalence, treatment, outcomes and prognosis, symptoms and associated behaviors. From the result part one can easily observe that the average of the parent’s knowledge on the ASD was 44.45% indicating that the majority parents do know little about ASD. The same output indicated that 40.2%, 40.2%, 44.6%, 46.2% and 50% of the parents have knowledge on the assessment and diagnosis cause and prevalence, treatment, outcomes and prognosis, symptoms and associated behaviors respectively.

This result shows that there is a significant lack of ASD knowledge among the general parent population. When looking at the individual questions on the knowledge measure there was seen a wide range of accuracy (11.4%-81.4%). This range shows that there is a wide range of knowledge within the ASD knowledge base of parents. All but one of the items on the knowledge measure was answered with an accuracy of less than 80% correct. In general, parents in this sample had relatively more knowledge in areas that concern overt behavior (e.g., social communication) and less knowledge in areas concerning how to and who can assess for ASD.

The result also revealed that the parent sample is most knowledgeable in the realms of symptoms and associated behaviors (e.g., intelligence, social communication deficits, play behaviors), and outcomes and prognosis (e.g., speech difficulties, symptom perseverance throughout life). In contrast, the sample was least knowledgeable regarding treatment (e.g., effectiveness of food restrictions, what effects treatment success), etiology and prevalence (e.g., racial disparities, risk factors), and assessment and diagnosis (e.g., professionals who can diagnose, age of diagnosis and development.

Implementation and perceived challenges to socialize children with autism

The study tried to see what the perceived challenges to socialize children with autism faced by the parents of ASD. In relation to the issue under the subject seven questions were identified to deal with it. Individual question includes whether there were lack of social visits to relatives and friends due to social judgment, lack of social and recreational activities due to the destructive behavior, refusal of family members to deal with the child, siblings sadness because of lack of visits and social relations, respond negatively for negative feedback from others, feeling the day is heavy and long and staying at home with a child is the matter of shame. The result in general shows that there is a significant challenge to socialize children with autism among the general parent population.

On the average 94% agrees or strongly agree implies that most of parents were not perceived the challenges and did not act with in the environment to socialize the child with autism. According to Jill, et al. [6] perception not only creates our experience of the world around us; it allows us to act within our environment. And the rest 6% disagree or strongly disagree. Result from the descriptive statistics indicates that an average value of 4.3 was obtained indicating that the majority of the respondents agree or strongly agree for the perceived challenges. An average standard deviation value of 0.7 asserted that the majority of the respondent replied in similar way (agree or strongly agree). Similarly implementation challenges to socialize children with autism were evaluated by the respondents.

In relation to the issue under the subject three questions were identified to deal with it. Individual question includes whether there were high cost of regular follow-up for implement intervention at home, need of basic knowledge to socialize implementation plan and not to apply intervene due to lack of social support. The result in general shows that there is a significant implementation challenge to socialize children with autism among the general parent population. When looking at the implementation challenges measure, on the average 84% agrees or strongly agrees for the question “lack of implementation plan due to lack of support “and “Due to high cost of regular follow-up lack of implementation for plan at home” because of the reasons of lack of support and high coast of regular follow up parent didn’t used implementation plan to socialize a child.

This imply parents were not perceived those challenges because implementation is a self-regulatory strategy in the form of an “if-then plan” that can lead to better goal attainment, as well as help in habit and behavior modification. This generally indicated that there is a strong implementation challenges to socialize children but parents were not perceived and tried to implement any intervention plan for the better social skill of a children. Result from the descriptive statistics indicates that an average value of 4.2 was obtained indicating that the majority of the respondents agree or strongly agree for the implementation challenges. An average standard deviation value of 0.85 asserted that the majority of the respondent replied in similar way (agree or strongly agree). The result from chi-square test indicated that most of respondents replied either yes or no as the result the observed and expected result is quite different.

The result from the regression model in general indicated that marital status is among the significant variable in determining the level of the challenge to socialize children. In literature it was identified that married parents have perceived and implementation challenges as compared to the single or widowed challenge to socialize their children as there are opportunities between the married couples to help one another for perceiving and implementation challenges in socializing their children. Apart from marital status, parents who have children with autism is a statistically affects the socializing process of children with autism. As we all know parents who have more than one child with autism got additional problem from the community as they associate the problem from the curse. As a result from the chi-square this indicated that most of respondent either agree/strongly agree or disagree/strongly disagree. That is why the observed and the expected result are quite disagreeing.

Parent interview

Parents of autistic children faces so many challenges starting from the time they realized that there are developmental abnormalities in their children. Parents in the study Koegel, et al. [7] report the stigma surrounding autism particularly challenging. As some researcher describe negative reactions and attitudes from others also lead families to feel socially isolated and socially excluded [8]. The present study found that parents having autistic child explained they received different bad comments and negative powerful words. Others replied those words came from families and relatives, neighborhoods, shopping areas, health centers, religious places, transport stations and where ever they took their children. The research conducted by Orbell, et al. [9] explained parents feeling blamed for their child’s atypical behavior.

The present study revealed that more of parents respond for the comments aggressively they scold, fight, angry some of participants ignored the comments and cried alone, feeling sad but one parent explained to commenter her child is autistic. Most participants in current study explained they feel misunderstood by the society, family, neighborhoods and spouse. Parents reported the community and even relatives didn’t understand the responsibility and burden. Except the one respond he got positive feedback and encouraged by his wife and he feel recognized by his spouse and neighborhood. So from the response of participants it can be concluded that parents were not perceived there may be a challenge of misunderstanding with in the society. Most of parents replied that they departed from social events such as taking their child to recreational places and parties.

Parents mentioned the destructive behavior of a child, fear of discrimination; the stigmas surrounding autism, and having shortage of time are some reasons lead most families to refuse to join with society. According to the study of Tekola, et al. [10] parents were reported that their child's autistic behaviors, combined with social stigma and isolation, make their lives more challenging. This indicated that parents were not perceived the above mentioned challenges occur from the community to sociaslize autistic child. Children with Autism tend to do best when they have a highly-structured schedule or routine. According to parent’s home involvement in their children’s therapy and education is considered a best practice. Regarding the respond of participants of the interview, even if most parents didn’t have a formal plan to teach a child with autism how to socialize in the community, they tried to communicate with a school special need assistance for what to do at home to help a child and one parent replied that the family had a plan to improve a child communication skill and socializing ability. Participants explained even if they had a plan there are lots of barriers to apply. About the barriers of implementation most parents explained they had a barriers of implementation got from they were assisted from the school, like improper environment, the difficulty of handling the destructive behavior of a child, shortage of resources and shortage of time to spend with a child. Because of the above barriers parents were not well intervene to socialize their child so this express that parents didn’t perceived there may be implementation barriers.

Conclusion

To socialize the children there are lots of challenges parents faced thus it’s important to perceive the challenges in socializing. Perception involves both recognizing environmental stimuli and actions in response to these stimuli. The finding of the study showed that there is a lack of knowledge by the parents of the ASD. Parents are not perceived the challenges they faced to socialize the child as the result parents isolate themselves and the child with autism. The study revealed that support from spouses and immediate family members remain fundamental to how parents overcome the challenges of having an autistic child. Regarding about support for parents with autism child to implementation, participants replied they got a support from school, child assistances, spouse and home servant but most parents didn’t get help from family and relatives for the application of socializing a child. Because of this parents explained thy felt loneliness and helplessness. This implies that, parents were not perceived facing challenges of not to be helped from relatives and nearby.

Recommendation

Parents’ knowledge and understanding about the disorder is crucial for the development and improvement of autistic children social life. So it is recommended that parents need to read, educate and participate awareness rising trainings about autism. Parents’ with autism children faced lots of challenges so it’s recommended to parents communicate regularly with school assistances and parents committee groups to share challenges, experiences and leanings in the difficult task of raising children with autism. Implementation plan is very important to the progress of children appropriate social skill. It recommended that parents need to empower themselves by taking trainings how they plan proper implementation and empowered themselves by professional support. Other researchers should focus on implementations and perceiving challenges of parents in socializing children with autism spectrum disorders by using this study as a base.