PARENTS PLAY A SIGNIFICANT ROLE IN THE DETECTION OF CHILDREN WITH AUTISM SPECTRUM DISORDER IN LOW RESOURCE SETTINGS Iranthika W.K.H, Sumanasena S.P, Ediriweera D Faculty of Medicine, University of Introduction Results Total population = 150 The Center for Disease Control and Prevention (2014) estimated 1 in 68 children to Participants: Mothers 133(88.7%) Fathers 17(11.3%) Male children: 120(80%) have Autism Spectrum Disorder (ASD) in the USA in 2010. Small community studies Female children: 30(20%) in estimated ASD prevalence to be 1 per 93 children, aged 18–24-months. The mean age of parental concern: 27.49 (SD 9.566) months Speech delay was the main reason for presentation in a similar local study. There is a The mean age of diagnosis: 33.19 (SD 10.499) months worldwide increase in the prevalence of children with ASD. The mean duration taken to seek services after identifying the problem: 21.83 (SD The age and the reason for parental concern is an important indicator of early 29.535) weeks. identification. Early identification leads to early intervention and therefore better Mothers identified the child to have a problem in 80% of children. outcomes. Therefore identifying the factors leading to concerns regarding their children Families with a higher educational level in the father sought intervention earlier than For speech and language therapy interventions it is important to identify the the others (p = 0.003). presentations of these children in the local settings. Conclusion Objectives Figure 1: Median comparison of main concerns of the parents 100 The proportions of males: females in this study matched the global patterns. Mothers 90 General objective 90 80 being the principal caregivers identified the condition first. Unlike in previous findings To describe the parental concerns leading to seek intervention for their children with 70 60 from Sri Lanka this study shows communication and specifically poor eye contact as an ASD aged less than 5 years attending selected special clinics in the Western Province 50 40 Frequency early feature for parental concern. The cultural factors significantly contributed to the 30 21 15 20 12 12 10 delay in seeking services. Specific objectives 0 Family Doctor Public health midwife Paediatrician Speech and Language Psychiatrist Discussion To describe main presenting features of children with ASD Category Therapist Eye contact and neologisms were the most frequently observed features. Majority of To define pathways taken by parents when seeking interventions Figure 2: The first contact service provider children were referred for services at the first contact but 10.70% were reassured. To describe the factors in the family that initiated them to seek intervention. 60.00% 54.70% Cultural factors contributed to the delay in presentation for services. 50.00%

Method 40.00% 32.70% Recommendations 30.00% Increasing awareness amongst mothers about early communication is important for

Design: A descriptive cross sectional study. Frequency 20.00% 10.70% Study period: March to December 2015 10.00% early detection. More epidemiological studies should be undertaken on ASD to identify 2.00% Study setting: Government: Clinics at the Department of Disability Studies Faculty 0.00% culturally specific reasons for presentations Reassure Commenced an Referred for another Commenced an intervention program services intervention program of Medicine , Child Mental Health Clinic at Lady Ridgeway Hospital for and Referred for another References services Children Private: 2 speech therapy clinics in the Western province. Category Camarata, S. (2014). Early identification and early intervention in autism spectrum Figure 3: The outcome of the first consultation disorders: accurate and effective? International Journal of Speech-Language Pathology, 16(1), 1– Study population: The parents of children with ASD aged 1- 5 years with a confirmed 10. http://doi.org/10.3109/17549507.2013.858773 90 diagnosis according to the DSM - 5 criteria and no other co-morbidities. Chakrabarti, S. (2009). Early identification of autism. Indian Pediatrics, 46(5), 412–414. 80 http://doi.org/10.1097/IYC.0b013e3181a02f7f 70 Sampling procedure : Convenience-sampling- All eligible children with ASD we 1 Perera, H., Jeewandara, K. C., Guruge, C., & Seneviratne, S. (2013). Presenting symptoms 60 14 of autism in Sri Lanka: Analysis of a clinical cohort. Sri Lanka Journalof Child Health, 42(3), selected from three clinics to represent the public and the private sector 50 Economical factors 139–143 40 84 Personal Factors Patten, E., Baranek, G. T., Watson, L. R., & Schultz, B. (2014). Child and family and Sample size :150 mothers or fathers representing parents of 150 children with ASD Frequency Coultural Factors 30 characteristics influencing intervention choices in autism spectrum disorders, 1–15. 51 Did not wait were selected according to the inclusion criteria. 20 http://doi.org/10.1177/1088357612468028.Child Saint-georges, C., Mahdhaoui, A., Chetouani, M., Cassel, R. S., Laznik, C., Apicella, F., … 10 Data collection method : a pre tested interviewer-administered questionnaire. Cohen, D. (2011). Do Parents Recognize Autistic Deviant Behavior Long before Diagnosis ? 0 Did not wait Category wait Taking into Account Interaction Using Computational Methods, 6(7). Data analysis: SPSS software http://doi.org/10.1371/journal.pone.0022393 Figure 4: Reasons for the delay in seeking services