Viewpoint - the relationship between neighbourhood socioeconomic status and health of children with ASD

Autism Care

Research
Education
Community
Policy

Research

“Future research needs to focus not only on the biological markers of ASD but also include data about functioning, participation, and environmental barriers and facilitators.”

Dr. Olaf Kraus de Camargo  //  Developmental Pediatrician

 

MacART is laying the foundation for creating a systematic way of linking scientific research on Autism Spectrum Disorder (ASD) at McMaster University to clinical practice at McMaster Children’s Hospital.

The physical proximity of McMaster Children’s Hospital, Hamilton Health Sciences, and McMaster University has a number of characteristics that provides the rare opportunity for collaborative research. Taking advantage of existing university and clinical infrastructure and cross-appointments for clinicians at the university, ASD experts from these organizations are coming together to integrate ASD research into clinical practice.

The focus of MacART members’ research is in the areas of basic science, clinical practice, clinical research, epidemiology and statistical modelling, knowledge translation and exchange, and social science research. By promoting the collaboration of stakeholders across disciplines, MacART is reducing barriers to implementing research in clinical practice, with the goal of advancing autism care through meaningful research.

Learn more about our research HERE.

Education

MacART members are now supervising more than 50 research trainees at the undergraduate, graduate, and postgraduate levels, and are engaged in the mentoring of junior and intermediate faculty members.

In the future, we intend to establish research and clinical training programs for students in McMaster’s undergraduate medical, health sciences, and psychology programs, and for residents and fellows in Pediatrics and Psychiatry.

By training and mentoring emerging researchers and practitioners, we will help to solidify their understanding of and commitment to using basic science to inform their clinical practice, and to use their clinical experience to help formulate research questions. It is our belief that involving these learners in MacART educational activities will promote their use of practices that advance autism care through meaningful research.

Community

“Our scientists are working collaboratively with local clinicians to generate the evidence needed to improve autism services. This symposium is a great example of McMaster’s community engagement efforts.”

Dr. Patrick Deane // President & Vice-Chancellor // McMaster University

 

The community engagement component of MacART strives to work with stakeholders and involve them as partners in every step of the research process.  By doing so, the questions that drive research begin to change. They become more meaningful because they address the real day-to-day challenges faced by children and their families, and the clinicians supporting them.

MacART aims to increase participation and involvement of members of the McMaster and Hamilton communities in the research process. With community members driving the research, new and relevant knowledge can be produced to bridge the research-to-practice gap in ASD and advance autism care through meaningful research.

Policy

“People whose lives are connected to the challenge of autism can share knowledge – from clinicians to educators to parents – and what an amazing opportunity that is. We have a real opportunity to translate challenges into research, and research into practice that will help families living with autism.”

Rob MacIsaac  //  President & CEO // Hamilton Health Sciences

 

Policies should be created using the best available evidence that make positive impacts on the lives of individuals with ASD, along with their families.

MacART’s founder, Stelios Georgiades, serves on both federal and provincial advisory committees about ASD treatment funding.  Along with the wide-ranging expertise of its many ASD experts, MacART is set to act as a highly credible source of evidence-based information to influence and inform public policy about the provision and funding of ASD diagnosis, treatment, and family supports.

MacART will continue to find ways to collaborate with policymakers to both learn more about the policymaking process, and to contribute our expertise and knowledge to inform policymaking, in order to advance autism care through meaningful research.

The relationship between neighbourhood socioeconomic status and health of children with Autism Spectrum Disorder: A population-level perspective

 

My name is Ayesha Siddiqua, and I am a second year PhD student in the Health Research Methodology program at McMaster University. For my doctoral research I am working under the supervision of Dr. Magdalena Janus and examining the relationship between neighbourhood socioeconomic disadvantage and the developmental health of children with Autism Spectrum Disorder (ASD). Research shows that health is unevenly distributed across socioeconomic status (SES) – those living in poverty tend to have poorer health. It has been suggested that characteristics of individuals (e.g. individual SES) do not explain inequalities in health outcomes in a population. There is growing recognition that characteristics of groups, such as characteristics of neighbourhoods, may be the most important determinants of health of a population – which speaks to the importance of examining the impact of neighbourhood SES on the health of children with ASD.

 

The relationship between a neighbourhood’s SES and how common ASD is remains largely unexplored. It is possible that children who are otherwise similar but live in different neighbourhoods receive an ASD diagnosis at different ages, not due to their individual characteristics, but characteristics of the neighbourhoods they live in – leading to neighbourhood differences in ASD prevalence. Although characteristics of neighbourhoods can impact access to services as well as care-seeking behaviours, there is a lack of evidence on the relationship between neighbourhood SES and health service use among children with ASD. Low SES affects the speed of brain development, indicating that socioeconomic disadvantage is likely to have a stronger impact on children with ASD than on typically-developing children. However, there is little evidence on the relationship between neighbourhood SES and the development of children with ASD. Understanding the relationship between neighbourhood SES with prevalence, health service use, and development of children with ASD is crucial for identifying areas of need. This can help inform policy-level decision-making – for example, about the type and location of early identification and intervention services. From a public health planning perspective, this is a key first step for reducing socioeconomic inequalities in the health of children with ASD in different areas.

 

The objectives of my project are:

  1. to examine the relationship between neighbourhood SES and prevalence of children with ASD across jurisdictions;
  2. to examine the relationship between neighbourhood SES and health service use among children with ASD across jurisdictions;
  3. to examine the relationship between neighbourhood SES and developmental outcomes of children with ASD across jurisdictions. Jurisdictions refer to provinces, health regions, and public health units in the context of my project.

 

My project will use data from a large population-wide database of child development gathered in kindergarten by the Early Development Instrument (EDI). The EDI is a teacher-completed questionnaire that provides information on children’s developmental status in 5 areas: physical, social, emotional, language/cognitive, and communication/general knowledge. EDI data have been matched at the neighbourhood level with SES information from the Canadian Census and Taxfiler data. This EDI-SES database will be also linked with health service utilization databases from British Columbia, Manitoba, and Ontario. Statistical methods will be used to examine the relationships between neighbourhood SES with ASD prevalence, developmental outcomes, and health service use.

 

I hope that the findings from my project will provide information on how neighbourhood socioeconomic disadvantage affects the health of children with ASD, which is currently not available. More practically, this information can help to customize service planning based on the different needs that different areas have. For example, if developmental outcomes of children with ASD living in neighbourhoods with higher SES are found to be better than those living in neighbourhoods with lower SES, policy makers can focus on establishing more early intervention services in neighbourhoods with lower SES to support the development of children with ASD living in those areas.  Integrating the findings of my project in a variety of policies and programs in areas of health, education, and economic/social development can generate significant return on investment not only for society, but also families of children with ASD.