Parents of Children with Autism: Issues Surrounding Childhood Vaccination
Bibliographic record
Abstract
IntroductionDespite increasing evidence of genetic causes of autism spectrum disorder (ASD) (1-3) and an authoritative review rejecting a causal association between MMR vaccination and ASD (4), fear that childhood vaccines play a key role in the etiology of ASD persists (5). In fact, a review by Brown and colleagues (6) identified a significant association between parents' belief that vaccines cause autism and lower vaccine uptake. The controversy continues to attract media attention and many parents remain skeptical about the safety of childhood vaccines (7,8). The issue is particularly salient for parents of children with autism (PCA) and, with an estimated ASD prevalence of one in 88 (9), vaccine uptake among this group could have a substantive impact on public health.Online surveys of parents involved with autism organizations in the US and Canada revealed that 40% of parents believed that vaccines were among the most significant contributory factors involved in their child's autism (10). Many factors play a role in producing these beliefs, including the temporal proximity of childhood vaccination and the manifestation of autism, distrust of governmental agencies, perceptions of the risks posed by vaccine-preventable diseases (VPDs), and information from popular media sources (11). Several studies have suggested that the latter, especially web-based sources, may fuel distrust in childhood vaccinations (12-15); yet, given limitations in extant research, developing interventions to address these influences would be challenging (16).Healthcare providers are on the frontlines in the debate about vaccines and autism, and can have a substantial influence on decisions about childhood vaccination (17-21). Therefore, it remains critical that healthcare providers offer information to caregivers, and to PCA, as early after diagnosis as possible (17). The purpose of this study was to examine attitudes toward childhood vaccination among PCA. The association between various dimensions of healthcare satisfaction, vaccine attitudes, and child autism severity and cognitive ability was explored, as was exposure to media sources portraying a link between vaccines and autism.Our studyA convenience sample of PCA were recruited through their participation in randomized controlled trials of a parent-teacher consultation intervention in Kentucky and Indiana (22,23). All children met the diagnostic and statistical manual IV-TR definition of autistic disorder (24) as confirmed by professionally-administered Autism Diagnostic Observation Schedule Modules 1 or 2 (25). Parents (n=79) were mailed two self-administered surveys assessing their attitudes toward childhood vaccines and their satisfaction with their child's medical care. Fifty parents completed the Parent Satisfaction with Care Questionnaire and 49 completed the Vaccine Attitude Questionnaire (described below). Respondents were not significantly different than non-respondents in terms of child's age, parental education level, income, or race. All study procedures were approved by the University's Institutional Review Board.Demographic information including child age, gender, race, household income, number of siblings, and parent education level was collected (described in table 1). Measures assessing children's severity of autism (Childhood Autism Rating Scale; CARS) and cognitive ability (Differential Abilities Scale; DAS) were administered by the research team (23). The CARS is a valid and reliable, observational scale comprised of 15 items evaluating behaviors such as social relating, resistance to change, communication, and body use (26). The General Conceptual Ability subscore of the DAS, which has strong internal and test-retest reliability (27), was used to assess children's cognitive ability.Participants also completed questionnaires assessing their satisfaction with their child's primary healthcare provider (PCP); Table 2 provides example items and coefficient alphas for subscales. …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.025 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".