Breaking the Myths: Understanding the Challenges of Caregivers of Autism in Pakistan – A Systematic Review
DOI:
https://doi.org/10.52053/jpap.v5i4.328Keywords:
Autism Spectrum Disorder, Awareness, Parents of Children with ASD, Knowledge, Practice, Pakistan, Social Stigma, Systematic ReviewAbstract
The aim of this systematic review is to critically evaluate selected research articles, examining the nature of the problem, study focus, theoretical and conceptual frameworks, sample size, sampling methods, instruments used, key findings, and limitations. It also explores implications for future research. As part of a PhD project, the researcher reviewed local studies from 2011 to 2024 to identify the main challenges and influencing factors faced by parents of children with autism. This review employed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) model. Google Scholar, Research Gate, and PubMed were used to find relevant articles. Of 46 articles, 20 met the inclusion criteria. These studies were conducted in major cities of Pakistan, including Karachi, Islamabad, Rawalpindi, Lahore, Peshawar, and Multan. The findings revealed a significant lack of awareness and prevalent cultural myths about autism among stakeholders (e.g., healthcare professionals, general practitioners, psychologists, teachers) in Pakistan, contributing to delays in diagnosis, misdiagnosis, and multiple diagnoses. The study highlighted the need to dispel these myths, as they magnified the challenges faced by parents. It also emphasized the necessity of culturally sensitive interventions and awareness programs. This review primarily focuses on urban populations, with little information on rural populations. Furthermore, most studies collected data from mothers, with few addressing the challenges faced by fathers. Future research should include rural populations, address fathers' concerns, and collect larger sample data.
References
Aftab, R., Pirani, S., Mansoor, M., & Nadeem, T. (2023). Caregiver strain and its associated factors in autism spectrum disorder in Karachi, Pakistan. Journal of the College of Physicians and Surgeons Pakistan, 33(7), 784-788. https://doi.org/10.29271/jcpsp.2023.07.784
Ahmed, M., Sikandar, E., & Javid, A. (2024). Autism spectrum disorder – The fight of the public against a disease it fails to understand. Journal of the Pakistan Medical Association, 74(2), 427. https://doi.org/10.47391/JPMA.10250
Akhai, N. A., Aziz, M., & Anjum, G. (2022). Walking with the spectrum: A phenomenological study on the experiences of mothers raising an Autistic child. JISR management and Social Sciences & Economics, 20(1), 43-63. https://doi.org/10.31384/jisrmsse/2022.20.1.3
Akhter, N., Mumtaz, N., & Saqulain, G. (2020). Autism Cognizance: A dilemma among medical and Allied Medical practitioners. Pakistan Journal of Medical Sciences, 36(4), 678. 10.12669/pjms.36.4.1703
Almansour, M. A., Alateeq, M. A., Alzahrani, M. K., Algeffari, M. A., & Alhomaidan, H. T. (2013). Depression and anxiety among parents and caregivers of autistic spectrum disorder children. Neurosciences Journal, 18(1), 58-63. https://doi.org/10.17712/nsj.2013.1.234067777
Anwar, M. S., Tahir, M., Nusrat, K., & Khan, M. R. (2018). Knowledge, awareness, and perceptions regarding autism among parents in Karachi, Pakistan. Cureus, 10(9), e3299. https://doi.org/10.7759/cureus.3299
Arif, A. (2019). Effects of parents’ beliefs on their choices for early intervention to children with autism (Doctoral dissertation, University of Management and Technology). https://prr.hec.gov.pk/jspui/handle/123456789/14804
Arif, M. M., Niazy, A., Hassan, B., & Ahmed, F. (2013). Awareness of autism in primary school teachers. Autism Research and Treatment, 2013(1), 961595. https://doi.org/10.1155/2013/961595
Asghar, B., Fatima, S. M., & Riaz, E. (2023). The rise in autism spectrum disease: Is the Pakistani population aware of the symptoms? International Journal of Surgery: Global Health, 6(2), e0247. 10.1097/GH9.0000000000000247
Ashraf, M., Saeed, B., Mansoor, A. F., Ijaz, M., Mushtaq, F., Khan, M. A., & Faridi, T. A. (2022). Autism spectrum disorder in Pakistan: A review. Pakistan Journal of Health Sciences, 3(7), 1-13. https://doi.org/10.54393/pjhs.v3i07.384
Ayub, A., Naeem, B., Ahmed, W. N., Srichand, S., Aziz, K., Abro, B., Najam, S., Murtaza, D., Janjua, A. A., Ali, S., & Jehan, I. (2017). Knowledge and perception regarding autism among primary school teachers: A cross-sectional survey from Pakistan, South Asia. Indian Journal of Community Medicine, 42(3), 177-179. 10.4103/ijcm.IJCM_121_16
Aziz, A., & Khan, N. (2021). The Exploration of Stigma and Discrimination Among Patients Suffering from Depression: A Phenomenological Study. NUST Journal of Social Sciences and Humanities, 7(2), 206-230. https://doi.org/10.51732/njssh.v7i2.90
Bashir, N., Khanum, H., & Mobeen-Ul-Islam, D. (2024). Autism in Pakistan: Understanding the challenges and seeking solutions. Journal of Autism Research, 12(3), 45-62.
Batool, S. S., & Khurshid, S. (2015). Factors associated with stress among parents of children with autism. Journal of the College of Physicians and Surgeons Pakistan, 25(10), 752-756.
Faiz, Z., Azeem, A., Bashir, R., & Younas, W. (2021). Teachers and Parents Perspectives about Educational Problems faced by Students with Autism Spectrum Disorder. Psychology and Education, 58(5), 7219-7236.
Farooq, A., & Ahmed, S. (2020). Sociocultural barriers to early diagnosis of autism spectrum disorder. Life & Science, 1(4), 139-144. https://doi.org/10.37185/LnS.1.1.106
Furrukh, J., & Anjum, G. (2020). Coping with autism spectrum disorder (ASD) in Pakistan: A phenomenology of mothers who have children with ASD. Cogent Psychology, 7(1), 1728108. https://doi.org/10.1080/23311908.2020.1728108
Georganda, E. T. (1990). The impact of thalassemia on body image, self-image, and self-esteem. Annals of the New York Academy of Sciences. https://doi.org/10.1111/j.1749-6632.1990.tb24334.x
Haider, A., & Shehzad, S. (2015). Survey regarding the need of intensive training workshops for autism community. Pakistan Journal of Medical Health Sciences, 9(4), 1325-1328.
Hayat, K., & Yousaf, T. (2023). Caregiver burden and psychological distress among mothers of children with physical illness versus psychological illness. International Journal of Psychological and Behavioural Research, 3(1), 93-117. https://doi.org/10.37605/ijpbr.v3i1.34
Huggett, C., Birtel, M. D., Awenat, Y. F., Fleming, P., Wilkes, S., Williams, S., & Haddock, G. (2018). A qualitative study: Experiences of stigma by people with mental health problems. Psychology and Psychotherapy: Theory, Research and Practice, 91(3), 380-397. https://doi.org/10.1111/papt.12167
Imran, N., Chaudry, M. R., Azeem, M. W., Bhatti, M. R., Choudhary, Z. I., & Cheema, M. A. (2011). A survey of autism knowledge and attitudes among healthcare professionals in Lahore, Pakistan. BMC Pediatrics, 11(107), 1-6. https://doi.org/10.1186/1471-2431-11-107
Iqbal, F., Majeed, Z., Parveen, Z., Aftab, M. J., Nazir, M., & Khurshid, M. M. (2023). Survey of myths and misconceptions about children having autism spectrum disorder among people in South Punjab. Qualitative Research, 23(2). https://doi.org/10.XXXX/QR.2023.XXXX
Kausar, N., Akram, B., Dawood, S., & Ahmad, F. (2019). Development of an indigenous parental perceived stress scale for children with autism spectrum disorder. Pakistan Journal of Psychological Research, 34(2), 433-456. https://doi.org/10.33824/PJPR.2019.34.2.24
Khalid, M., Raza, H., Driessen, T. M., Lee, P. J., Tejwani, L., Sami, A., Nawaz, M., Baig, S. M., Lim, J., & Raja, G. K. (2020). Genetic risk of autism spectrum disorder in a Pakistani population. Genes, 11(10), 1206. https://doi.org/10.3390/genes11101206
Khalil, I., Gul, S., & Aftab, M. J. (2024). Understanding the experiences of fathers raising children with autism spectrum disorder: A qualitative study in Pakistan. Al-Mahdi Research Journal, 5(4), 316-328. https://doi.org/10.53350/mrj.v5i4.237
Khan, S., Qayyum, R., & Iqbal, J. (2019). Prevalence of Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorders (ADHD) among Adult Psych. Pakistan Armed Forces Medical Journal, 69(2), 419-23.
Masulani-Mwale, C., Mathanga, D., Kauye, F., & Gladstone, M. (2018). Psychosocial interventions for parents of children with intellectual disabilities–A narrative review and implications for low income settings. Mental Health & Prevention, 11, 24-32. https://doi.org/10.1016/j.mhp.2018.05.003
Minhas, A., Vajaratkar, V., Divan, G., Hamdani, S. U., Leadbitter, K., Taylor, C., Aldred, C., Tariq, A., Tariq, M., Cardoza, P., Green, J., Patel, V., & Rahman, A. (2015). Parents' perspectives on care of children with autistic spectrum disorder in South Asia - Views from Pakistan and India. International Review of Psychiatry (Abingdon, England), 27(3), 247–256. https://doi.org/10.3109/09540261.2015.1049128
Mushtaq, S., Arif, S., Anjum, F., Mir, R., Shahzad, K., & Siddiqui, M. (2024). Raising an autistic child: A phenomenological study of Pakistani mothers. Journal of Population Therapeutics & Clinical Pharmacology, 31(3), 798-810. https://doi.org/10.53555/jptcp.v31i3.5029
Nadeem, N. J., Afzal, S., Dogar, I. A., Smith, J. G., Shah, T., Noreen, M., & Ali, A. (2024). The impact of having an autisTic child on parental mental health and wellbeing in pakistan. Research in Autism Spectrum Disorders, 115, 102423. https://doi.org/10.1016/j.rasd.2024.102423
Noor, N., Talha, M., Ahmad, S. A., Mohydin, M., Shah, S. S. A., Mohydin, S., & Faheem, F. (2021). Evaluation of the prevalence of childhood autism awareness amongst medical professionals in Pakistan. Pakistan Journal of Medical & Health Sciences, 15(6), 1356-1361. https://doi.org/10.53350/pjmhs211561356
Okoye, C., Obialo-Ibeawuchi, C. M., Obajeun, O. A., Sarwar, S., & Tawfik, C. (2023). Early diagnosis of autism spectrum disorder: A review and analysis of the risks and benefits. Cureus, 15(8), e43226. https://doi.org/10.7759/cureus.43226
Parlak, M. E., Küçükkelepçe, O., Öz, E., Özbey, M. Y., & Kap?c?, Y. (2023). Knowledge levels of mothers with children aged 0-6 about autism spectrum disorder. The European Research Journal, 2023, 1-6. https://doi.org/10.18621/eurj.1223874
Qadir, N. A., Burki, S.-u.-R., Abbasi, A., & Ahmad, U. (2023). Knowledge of childhood autism among health workers of Peshawar: A cross-sectional study. Journal of Health Research & Review, 3(2), 848-854. https://doi.org/10.61919/jhrr.v3i2.221
Qureshi, M. S., Shoukat, A., & Kirby, A. (2022). Receiving a diagnosis of autism spectrum disorder (ASD) in Pakistan. Journal of Special Education Research, 5(1), 52-59.
Rahbar, M., Ibrahim, K., & Assassi, P. (2011). Knowledge and attitude of general practitioners regarding autism in Karachi, Pakistan. Journal of Autism and Developmental Disorders, 41(4), 556-564. https://doi.org/10.1007/s10803-010-1068-x
Rauf, N. K. (2016). Child characteristics, coping, and stress in parents of children with autism (Doctoral dissertation, National Institute of Psychology, Quaid-i-Azam University). https://www.library.nip.edu.pk/index.php?p=show_detail&id=10750
Rizvi, A. Z., & Batool, S. S. (2024). A qualitative study on the perspective of parental stress and lower marital quality among parents of children with autism spectrum disorder. International Journal of Developmental Disabilities.1-20. https://doi.org/10.1080/20473869.2024.2341196
Thakur, I., Azeem, A., & Faiz, Z. (2020). Access to quality education of children with autism in Lahore: A perspective of teachers and parents. Orient Research Journal of Social Sciences, 5(2), 101-109. https://doi.org/10.12345/orjss.v5i2.221
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