Date of Award

5-2023

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Clinical Psychology

First Advisor

Abbey Eisenhower

Second Advisor

Lizabeth Roemer

Third Advisor

Christine Mulé

Abstract

Resolution of diagnosis has been associated with a number of positive outcomes, including parental wellbeing and secure child attachment. However, previous studies lacked racially, ethnically, and socioeconomically diverse samples, raising concerns regarding generalizability. Therefore, the aims of this study were a) to examine resolution of diagnosis among a racially and socioeconomically diverse sample of parents of autistic children, b) to determine whether families’ experiences within the healthcare system (i.e., past experience of misdiagnosis, age of autism diagnosis, time elapsed between parents’ initial concern and final receipt of an autism diagnosis, and quality of alliance between parents and providers) were associated with parents’ resolution of diagnosis, c) to determine whether there was an indirect effect of race or socioeconomic status (SES) on resolution of diagnosis through families’ experiences within the healthcare system, and d) to determine whether resolution of diagnosis was associated with family wellbeing (i.e., family empowerment, family support, lower parenting stress). Data was collected electronically in 2021. Parents of 113 autistic children (79% male, 23% female, 1% other gender; mean age=10.63, SD=6.51, ages 2-31 years; 52% White, 48% POC) in the United States completed the survey. Linear regression showed that race was significantly associated with resolution of diagnosis; parents of White children reported higher levels of resolution than parents of children of color. SES was not associated with resolution of diagnosis in this model. Quality of alliance between parents and providers was also significantly associated with resolution of diagnosis, while misdiagnosis, age of autism diagnosis, and time between parents’ initial concerns and receipt of an autism diagnosis were not. Finally, Pearson correlations showed that parents with lower levels of resolution reported more negative feelings about parenting and lower feelings of empowerment. Resolution of diagnosis was not significantly associated with family support. These findings demonstrate the importance of assessing parental resolution of an autism diagnosis, especially for parents of color. Additionally, this study highlights the positive impact of a strong parent-provider alliance on parents’ resolution of diagnosis. Finally, the results of this study provide additional evidence that resolution of diagnosis is associated with positive outcomes for both parents and children.

Comments

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