Parental perspectives on the maltreatment of children with autism spectrum disorder and associated factors: A cross-sectional study in Indonesia

Background: Parental maltreatment of children with autism spectrum disorder (ASD) remains a serious global issue and continues to be reported in developing countries. Parental perspectives on maltreatment can directly influence how parents take care of their children with ASD. Research specifically examining this issue in developing countries is limited. This study aimed to explore parental perspectives on maltreatment of children with ASD and their associated factors in Indonesia. Methods: A cross-sectional study was conducted among 345 parents who were caring for children with ASD. Participants were selected by consecutive sampling in schools and facilities for children with special needs in two major cities in West Kalimantan Province, Indonesia, from January to March 2023. A self-administered questionnaire was developed for the Indonesian context. Data analysis involved descriptive, comparative, and multivariate regression analyses. Results: This study included 251 participants, with a response rate of 72.8%. The majority were mothers (84.9%), with a mean age of 38.1 ± 7.1. The majority were aged >35 years (60.6%). Only 32.7% of the participants had the appropriate perspective that children with ASD should not be maltreated. Factors associated with appropriate perspectives were being a parent whose first child did not have ASD (OR=2.240, CI=1.227–4.090, p=0.009), having knowledge of typical development (OR=1.254, CI=1.048–1.499, p=0.013) and of ASD (OR=1.743, CI=1.316–2.309, p=<0.001), and a high need for pre-diagnosis support (OR=1.225, CI=1.042–1.439, p=0.014). Conversely, participants aged >35 years were more likely to have inappropriate perspectives (OR=0.532, CI=0.290–0.976, p=0.042). Conclusion: Parental perspectives on maltreatment and their associated factors may contribute to the increased risk of maltreatment in children with ASD. Pre-diagnosis support, opportunities for socialization, and training aimed at increasing knowledge of non-violent parenting are needed to address inappropriate parental perspectives that tolerate the maltreatment of children with ASD in developing countries, especially Indonesia.