Commentary on: Parental care seeking pathway and challenges for autistic spectrum disorder.

Sir,

We read the article – “Parental care-seeking pathway and challenges for autistic spectrum disorders (ASDs) children: A mixed-method study from Bhubaneswar, Odisha[1] and found it quite interesting. There is little emphasis on qualitative research in psychiatry. The authors need to be complimented for taking this initiative. The parallel mixed-method approach by experienced and trained researchers, coordination among researchers, supervision, and the use of qualitative analysis software are definite strengths of this study and ensure scientific rigor. Normal distribution pattern has also been taken care of where ever quantitative analyses were required. However, we would like to emphasize on few of the things that should be taken care of in subsequent studies.

First, in the overall diagnostic process after an initial diagnosis of ASD, it is stated that the ASD was suspected or confirmed after the use of screening or standard diagnostic approaches. However, that results would have better generalizability, had the authors taken only confirmed cases of ASD. Further, treating suspected cases for ASD is not having sufficient scientific merit.

In addition, the authors also state that – some interviews were conducted at home, besides planned facility-based assessments. The proportion of such assessments is not mentioned in the article, further limiting the scope for generalization.

The mismatch between the figures in the table and text should be avoided. The description related to Table 1 states the proportion of first-order children as 58% contrary to figures in table, i.e., 58 (76.7%).

Table 1

Characteristics of parents and children with autism spectrum disorder n%

Sex of the children
Male	67 (88.2)
Female	9 (11.8)
Family setting
Nuclear	55 (72.4)
Joint	4 (5.3)
Extended	17 (22.4)
Order of child
First child	58 (76.7)
Second or latter child	18 (23.7)
Religion background
Hindu	71 (93.4)
Muslim	5 (6.6)
Education of parents of ASD
Father
Graduate	36 (47.4)
Post graduate	40 (52.6)
Mother
Undergraduate	10 (13.2)
Graduate	43 (56.6)
Post graduate	23 (30.3)
Occupation of parents of ASD
Father
Service	27 (35.5)
Government service	19 (25)
Business	30 (39.5)
Mother
Service	10 (10.6)
Homemaker	58 (76.3)
Government service	8 (13.1)

ASD - Autism spectrum disorder

The most surprising about the study is that it was planned as qualitative, and the authors intended to identify themes related to parents' perception about ASD. However, such a thematic analysis[2] is conspicuously missing from the description which is elemental in qualitative research.

Sufficient care should be taken to overcome these discrepancies in subsequent research.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.