Date Presented 4/21/2018
Income disparities in diagnosis and intervention services have been documented for children with autism spectrum disorder (ASD). This study explored relationships between family socioeconomic status variables and functional independence outcomes for children with ASD.
Primary Author and Speaker: Brittany St. John
Additional Authors and Speakers: Karla Ausderau
BACKGROUND AND PURPOSE: Children in low socioeconomic status (SES) households are less likely to be diagnosed with autism spectrum disorder (ASD) and experience delayed diagnosis, minimizing their ability to receive effective early intervention services supportive of functional independence and skill development. Families with low SES are at increased risk of high levels of household chaos and decreased cognitive capacities such as emotion regulation and executive function. Increased levels of unpredictability in the home along with the cognitive impacts of poverty may impede development of functional independence in children with ASD. Few research studies have explored functional independence outcomes across SES levels for children with ASD. The purpose of this study was to explore the relationship between family SES variables and functional independence outcomes for children with ASD.
METHOD: In a national survey of 404 caregivers of children with ASD aged 2–12, caregivers completed a 90-min survey exploring family demographics, parent stress, intervention services, ASD symptom severity, and children’s functional behavioral outcomes. Functional independence was measured using the Scales of Independent Behavior–Revised support score (SIB–R Support) and standard score (SIB–R SS). One-way analysis of variance was used to identify differences in functional independence (SIB–R Support and SIB–R SS) across categories of maternal education and household income. One-way analysis of covariance was used to explore the impact of potential covariates (ASD severity, parent stress) on any significant findings.
RESULTS: Significant differences in functional independence scores were identified between children from the highest and lowest income categories. A significant difference (p < .05) was found for SIB–R SS, F(5, 319) = 4.860, p = .000, with a small effect size (partial eta squared = .07), and for SIB–R Support, F(5, 313) = 3.494, p = .004, also with a small effect size (partial eta squared = .05). These results remained significant after controlling for ASD symptom severity and parent stress. These differences support that children from the highest income category have increased functional independence compared with children from the lowest income category. No significant differences in functional independence scores were identified across categories of maternal education.
CONCLUSION: This study provides preliminary evidence to support a connection between income and independent behavior for children with ASD and supports the possibility that variables associated with families living in poverty could be impeding the ability of children with ASD to develop functional independence skills. The development of functional independence in childhood is a vital developmental milestone in progress toward adulthood independence and reduces caregiver burden for children with special health care needs. Identifying small influences on functional independence outcomes can contribute to the creation of a larger multifactor model of influences that promote or inhibit the development of independent behavior.
IMPACT STATEMENT: Occupational therapy practitioners working with children with ASD in low-income families can apply knowledge of potential impacts of poverty on children’s functional skills development when planning and implementing intervention. Future research will build on this study to further explore the impacts of poverty on functional skills for children with disability.
References
Daniels, A. M., & Mandell, D. S. (2014). Explaining differences in age at autism spectrum disorder diagnosis: A critical review. Autism, 18, 583–597. https://doi.org/10.1177/1362361313480277
Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., . . . Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: Evidence from a U.S. cross-sectional study. PloS One, 5(7), e11551. https://doi.org/10.1371/journal.pone.0011551
Evans, G. (2004). The environment of childhood poverty. American Psychologist, 59, 77–92. https://doi.org/10.1037/0003-066X.59.2.77
Hart, S. A., Petrill, S. A., Deater Deckard, K., & Thompson, L. A. (2007). SES and chaos as environmental mediators of cognitive ability: A longitudinal genetic analysis. Intelligence, 35, 233–242. https://doi.org/10.1016/j.intell.2006.08.004
