Knowledge levels and awareness of autism spectrum disorder among the parents with 18-to-36-month-old children registered in a primary care clinic

Introduction and Aim: Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder characterized by restricted, repetitive patterns of behavior, interest, or activity, as well as deficits in social communication and interaction. Accurate reporting of data is essential to identify the prevalence of ASD in the population. Therefore, the American Academy of Pediatrics recommends that pediatric healthcare providers perform screening for autism at 18 and 24 months by using a valid and reliable tool. In this study, we sought to explore the level of knowledge and awareness about ASD in parents with 18-to-36-month-old children and their relationship with individual factors. Materials and Methods: This survey-based study was performed in 354 parents with 18-to-36-month-old children between 08.01. 2022 – 01.31.2023 in a primary care clinic in Northern Türkiye. The survey was constitutive of items adapted from the M-CHAT scale, which questions the informants' socio-demographic characteristics, level of awareness about ASD, suspicion as to presence of autism in children, and thoughts about the causes, diagnosis and treatment of autism. All the statistical analyses were carried out using Statistical Package for Social Sciences (SPSS) version 22.0. In order to detect whether the findings were normally distributed, statistical analysis methods such as Kolmogorov-Smirnov / Shapiro-Wilk tests were applied. Finally, to compare the percentages of different groups, Chi-square test (Fisher, Contunity and Pearson) was used when applicable. While the proportion of the high school and university graduate parents who gave the correct answer to the two-word stage question by stating that a child can utter two-word sentences at the age of 2 was high, it was observed that the proportion of the primary school or secondary school graduate parents who gave incorrect answers to the same question was significantly high (p=0,002). When the numbers of the correct answers to the M-CHAT questions were analysed, it was seen that there was a significant difference between the primary school graduate parents and the parents who garduated from other levels of education (p=0,010). There was also a signifant difference between the parents from the working class and the ones from other occupational groups (p= 0,006). Results: 65.3% (n=231) of the study population was female, while 34.7% (n=123) were male. Almost all of the parents (99.2%) reported to have heard of a disease called autism, and 20.9% turned out to have an autistic individual in their surroundings. 68.9% stated that the diagnosis should be performed by an experienced physician through clinical examination and observation, whereas 81.6% reported to consult a clinician immediately if their child's speech was delayed. Another striking result emerging from our analyses was that, although the informants had heard of ASD before, the most authoritative source of information was social media (28.5%), while the proportion of those regarding physicians as the most reliable channel of information were only 19.2%. Conclusion: Children with early diagnosis in primary care are quickly referred to an experienced clinician, thus having the opportunity for early intervention. The prospect of success rests primarily on how well both primary care providers and parents have mastered knowledge, attitudes and behaviors about ASD. Keywords: Autism Spectrum Disorder, autism, awareness, primary care clinic, family Physician