Parental Perception of the Causes of Autism Spectrum Disorders with An Emphasis on Genetic Factors

Background: More than 90% of cases of autism spectrum disorders (ASDs) are idiopathic and are multi-factorial in etiology. To provide better genetic counseling, a clear understanding of parental perspectives on genetics and multi-factorial as an etiologic factor of ASDs is necessary.

Objectives: The aims of this study were: 1. to examine parental perception of the causes of ASDs with an emphasis on genetic factors 2. to identify factors associated with parental perception of the contribution of genetics as a cause of ASDs, and factors associated with the appropriate perception of multi-factorial inheritance of ASDs.

Methods: The study population consists of parents with at least one child diagnosed with ASD recruited from the Child Development Clinic and the Child and Adolescent Psychiatric Clinic at Ramathibodi Hospital. Participants who visited the clinic during January 2006 to December 2007 were contacted either by mail or directly at the time of visit to obtain informed consent. Parents of children with non-idiopathic ASDs including known genetic disorders (e.g. Rett syndrome, fragile X syndrome, tuberous sclerosis) were excluded from the study. From each participating family, only one parent was asked to complete the questionnaire. The questionnaire was divided into 5 parts including participants’ demographic data, general knowledge of ASDs, parental perception regarding causes of ASDs, ASDs recurrence risk, and general knowledge of common pediatric diseases with multi-factorial pattern of inheritance.

Results: Participants included 252 parents of children with ASDs. When questioned regarding the cause with more than one response possible, 44.0% (111/252) of respondents cited genetics as a cause, 62.7% (158/252) reported other factors such as maternal stress and toxic substance exposure during pregnancy, child rearing, etc. Of those who cited genetics as a cause, 78.4% (87/111) had the perception of a multi-factorial concept defined as persons who have genes associated with autism but whether or not ASDs is apparent also depends on environmental factors. According to multivariate analysis, positive family history of ASDs and of speech delay, recurrence risk perception, and knowledge of allergic rhinitis (AR) and attention-deficit hyperactivity disorder (ADHD) as genetic diseases were associated with parental perception of genetics as underlying causes of ASDs. Multivariate analysis also revealed that associated factors with appropriate parental perception of multi-factorial inheritance concept of ASDs were positive family history of ASDs, describing correct definition of ASDs, recurrence risk perception, and having knowledge of AR and ADHD as genetic diseases.

Conclusions: Most of parents cited one or more causes to explain ASDs in their child. Less than half of Thai parents cited genetics as a cause of ASDs. For parents who cited genetics, there is tendency for them to have appropriate perception of multi-factorial concept of ASDs.