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文化多元的瑞典 ASD 幼儿家庭:父母的解释模型。

Culturally diverse families of young children with ASD in Sweden: Parental explanatory models.

机构信息

Department of Special Education, Stockholm University, Stockholm, Sweden.

Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden.

出版信息

PLoS One. 2020 Jul 27;15(7):e0236329. doi: 10.1371/journal.pone.0236329. eCollection 2020.

Abstract

BACKGROUND

Research suggests that families' knowledge and cultural perceptions of autism spectrum disorder (ASD), and beliefs about its etiology and prognosis, can affect parents' recognition of the first signs of autism in their children and influence help seeking and treatment decisions.

OBJECTIVE

This study investigated explanatory models of autism among parents of young children with ASD in the multicultural context of Sweden.

METHOD

Seventeen parents from diverse cultural, ethnic and linguistic backgrounds participated in semi-structured interviews. A deductive approach to qualitative content analysis was used to analyze data. Five domains of the Explanatory Model supplementary module of the Cultural Formulation Interview (CFI) were used as coding categories, operationalized as 'Parents' understanding of autism'; 'Autism prototypes'; 'Causal explanations'; 'Course of autism', and 'Help seeking and treatment expectations'.

RESULTS

The results showed that parents' prior knowledge of autism and experience of young children's typical developmental trajectories, as well as the opinions of children's grandparents and preschool teachers, affected symptom recognition and help seeking. There were differences in parents' explanatory models before and after ASD diagnosis. Initial interpretations of the disorder included medical conditions and reaction to environmental influences, while genetic, supernatural/religious factors, and vaccinations were mentioned as definite causes after obtaining a clinical diagnosis. Parents also held multiple explanatory models, influenced by the views of family members and information obtained from media or from health care professionals. Parents' treatment decisions included use of available state-funded support services, and complementary and alternative treatments.

CONCLUSION

The results demonstrate the utility of the CFI's Explanatory Model supplementary module in autism research. Implications for clinical practice are discussed.

摘要

背景

研究表明,家庭对自闭症谱系障碍(ASD)的知识和文化认知,以及对其病因和预后的信念,会影响父母对子女自闭症早期迹象的识别,并影响寻求帮助和治疗的决策。

目的

本研究在瑞典多元文化背景下,调查了 ASD 幼儿父母的自闭症解释模型。

方法

17 名来自不同文化、种族和语言背景的父母参与了半结构化访谈。采用演绎法对定性内容分析进行数据分析。文化构念访谈(CFI)的解释模型补充模块的五个领域被用作编码类别,即“父母对自闭症的理解”;“自闭症原型”;“因果解释”;“自闭症病程”和“寻求帮助和治疗期望”。

结果

结果表明,父母对自闭症的先验知识和对幼儿典型发展轨迹的经验,以及孩子的祖父母和幼儿园老师的意见,会影响症状识别和寻求帮助。在 ASD 诊断前后,父母的解释模型存在差异。最初的解释包括医学条件和对环境影响的反应,而在获得临床诊断后,遗传、超自然/宗教因素和疫苗接种被认为是明确的原因。父母也持有多种解释模型,受到家庭成员的观点以及从媒体或医疗保健专业人员那里获得的信息的影响。父母的治疗决策包括使用现有的国家资助的支持服务,以及补充和替代治疗。

结论

结果表明 CFI 的解释模型补充模块在自闭症研究中的有效性。讨论了对临床实践的影响。

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