Exploring Factors Related to Decision-Making and Barriers to Service for Single Parents

Background: Research on children with ASD has shown that appropriate interventions, delivered at appropriate developmental periods, can lead to marked increases in functioning across a range of domains (for review, Warren et al., 2011). Given the importance of treatment choice and timing, families’ decisions about intervention type and subsequent service use, are of great interest to both the research and professional fields. Research shows that socioeconomic status, autism knowledge and education level affect treatment and service use (Pickert & Ingersoll, 2015). Yet most studies examine the experiences of multi-parent households, few have addressed the possible added considerations and barriers experienced by single parents.

A survey of caregivers of individuals with ASD in Ontario found that 33% of respondents identified as single parents, (Ontario average single-parent households, 20%; Statistics Canada, 2016). Given the high number of single-parent households within the ASD community it is important to determine needs and experiences when accessing services.

Objectives: To fill knowledge gaps of different family structures by examining how single-parent households make decisions about treatment and subsequent barriers to service they experience.

Methods: Autism Ontario conducted an online survey for caregivers in April, 2017. It was distributed across our network, via partner organizations and Ontario’s regional autism providers. It was available in English and French, and focused on various aspects of service and support.

Results: There were 3,130 respondents, 1,024 who identified as single parents. The majority of respondents cared for male children (81.2%) and 15.3% indicated that they cared for more than one child with ASD. Children ranged from toddlers to adults.

Respondents rated potential barriers to service on a 5-point likert scale. After controlling for age of the child, child’s gender and region, single-parents rated financial restrictions, travel, services not available at convenient times, previous poor experiences with professionals, lack of response from providers and lack of in-home services as significantly larger barriers to service compared to non-single parents (Fs > 4.14, ps < 0.05). Factors including, child deemed ineligible, long waitlists and services in non-preferred language were not significantly different between single- and non-single parent respondents (Fs < 2.27, ps > 0.05).

Respondents rated amount of influence various sources have during the decision-making process regarding treatment. After controlling for age of the child, child’s gender and region, single-parents rated Ministry of Children, social media and news media as significantly more influential sources than non-single parents (Fs > 7.55, ps < 0.05). Non-single parents rated current research as a significantly more influential source than single-parents (F (1,1996) = 8.08, p < 0.01). Sources including, family and friends, other parents, professionals, school personnel and your own understanding of your child were not significantly different between single- and non-single parents (Fs < 3.7, ps > 0.05).

Conclusions: Single-parent households experience different barriers to service and rely on different sources of information when considering intervention options for their children. We will discuss the implications of these findings in regards to the tailoring of services and supports for children of families that differ from typical multi-parent households.