Parent perspectives on services available to autistic children in Canada: A mixed methods survey study

OBJECTIVES: Given the differing opinions among interest holders on services that are commonly accessed by autistic children, exploration of parent perspectives is needed to contribute to this knowledge base. Our objective was to explore perspectives of parents of autistic children on select services accessed by autistic children in Canada. METHODS: Using a mixed methods survey, the perspectives of parents of autistic children living in Canada on occupational therapy (OT), speech-language pathology (SLP) services, and applied behaviour analysis (ABA) based therapies were sought. The Theoretical Framework of Acceptability (TFA) and its constructs were used to develop the survey and served as a framework for qualitative content analysis. RESULTS: Eighty-seven parents completed the survey. Acceptability scores were higher for OT and SLP compared to ABA (F (2, 239) = 43.42, p < 0.01). Related to the TFA construct of Ethicality, parent respondents shared concerns about potential harms of negative therapy experiences, emphasized the value of neurodiversity-affirming services and held mixed views on behavioural approaches. Under the construct of Perceived Effectiveness, acceptability was contingent on parents attributing improvements to the therapy and therapist fit. For the construct of Self-Efficacy, respondents reported the importance of therapist engagement with parents. CONCLUSIONS: Across OT, SLP, and ABA, Ethicality, Perceived Effectiveness, and Self-Efficacy informed the perceived acceptability of autism services. This work highlights that many parents are concerned with promoting a positive autistic identity for their children, including through therapies. Future work should seek to develop shared definitions and goals for therapy between clinicians, parents/care partners, and autistic people.