health related quality of life with children of autism spectrum disorder in bangladesh
TRANSCRIPT
![Page 1: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/1.jpg)
Health Related Quality Of Life in Children with Autism Spectrum Disorder (ASD) in
Bangladesh
Presented byDr. Farhana Safa
ID:14-98079-3Department of Public Health
American International University, Bangladesh (AIUB)January 8, 2016
![Page 2: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/2.jpg)
Introduction
• Autism Spectrum Disorder (ASD) sometimes referred to as “autism”.
• It is “a chronic disorder whose symptoms include failure to develop normal social relations with other people, impaired development of communicative ability, lack of imaginative ability, and repetitive, stereotyped movements”
![Page 3: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/3.jpg)
• Quality Of Life is a broad concept incorporating the person's physical health, psychological state, level of independence, social relationships, personal beliefs and their relationship to salient features of the environment.
• The importance of quality of life (QoL) is widely recognized in many fields, including economics, social sciences, and medicine.
![Page 4: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/4.jpg)
• Measurement of QOL is important indicator.
• It is necessary for treatment purpose.
• Usually autistic children have lower quality of life in comparison to normally developing peers.
• In Bangladesh, measurement have not done yet.
![Page 5: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/5.jpg)
Background information
• Autistic Disorder, Asperger’s Disorder and PDD- NOS are collectively known as Autism Spectrum Disorder. (DSM-5)
• Autism spectrum disorders (ASD) are complex neurodevelopment disorders characterized by qualitative impairments in three domains-
-Social interaction -Communication and -Repetitive, stereotyped behavior.
![Page 6: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/6.jpg)
• About 1 in 68 children has been identified with autism spectrum disorder (ASD) according to estimates from CDC's (ADDM) Network.
• ASD is almost 5 times more common among boys (1 in 42) than among girls.
• ASD has great impact on the affected child and his/her family's quality of life.
• Lifetime cost for an individual with ASD at $3.2 million.
![Page 7: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/7.jpg)
Justification of the study
• 1 child in 500 in Bangladesh has autism.• Approximate number of children with ASDs in
Bangladesh is no less than 280,000.• General attitude towards autism is mostly
negative. • It is considered as a social barrier.• Treatment facility is not properly available.• Measurement of QOL have not done yet.
![Page 8: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/8.jpg)
Research hypothesis:• Health related quality of life in children with
Autism Spectrum Disorder (ASD) is poor in comparison to normally developing peers in Bangladesh.
General objective:• To assess the HRQL in children with ASD (8-12
years) by using the Modified Pediatric Quality Of Life inventory 4.0 Generic Core Scale.
![Page 9: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/9.jpg)
Specific objectives
• To estimate the socio-demographic characteristics of children with ASD.
• To assess the HRQL in children with ASD (8-12 years) by using the Modified Pediatric Quality Of Life inventory 4.0 Generic Core Scale from parent’s perspective.
• To assess the HRQL in normally developing peers by using the same scale and compare it with ASD children.
![Page 10: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/10.jpg)
List of variables Independent variable:1) Variables related to socio-demographic status:• Age• Gender• Occupation of parents • Monthly family income of parents• Educational status of parents• Religion2) Autism Spectrum Disorder (ASD) Dependent variable:• Health related quality of life (HRQL)
![Page 11: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/11.jpg)
Conceptual framework
![Page 12: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/12.jpg)
Operational definitions
• Health: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. (WHO)
• Quality of life: Individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.(WHO)
![Page 13: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/13.jpg)
• Children: The United Nations Convention On the Rights of the Child defines child as "a human being below the age of 18 years unless under the law applicable to the child, majority is attained earlier.
• Autism spectrum Disorder or autistic spectrum describes a range of conditions classified as neurodevelopmental disorder. (DSM-5)
![Page 14: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/14.jpg)
Literature review
• Literature review was done appropriately by using
- Books - Journals - Magazines - Internet - Library documents etc.
![Page 15: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/15.jpg)
Methods and materials
![Page 16: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/16.jpg)
Study design: Cross sectional comparative study.Study population: Children age group 8-12 years, both ASD and
normally functioning peers.Study period: July 2015- December 2015. The total study
period was six months. A prior work schedule was prepared on the basis of different tasks.
![Page 17: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/17.jpg)
Study locale
• 3 centers of Dhaka city which are dealing with autistic children.
1) Bangladesh Protibondhi Foundation (BPF), Kalyani.
2) SWID Bangladesh and its sister wing Ramna Protibondhi Shongstha.
3) Institute of Neuro-develpment and Research Centre.
![Page 18: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/18.jpg)
For normally developed children the chosenstudy locales are: 1) Willes Little Flower School and College 2) Sky View Garden Apartment, and 3) Cordova International School and College
![Page 19: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/19.jpg)
Sample size calculationSample size was calculated from study population by using the formula: n= z2pq / d2
Where, n= desired sample size. p= 0.5 (as there is no reasonable estimate of any prevalence rate, we use 50%). q = 1-p = 1-0.5 = 50% d = degree of error (absolute precision of the study assumed 0.05) z = the reliability co efficient at the 95% Confidence Interval = 1.96. Thus required sample size is 385.
![Page 20: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/20.jpg)
Study sample
• Considering the complexity of the study and my definitive age group (8-12 years), my feasible study sample was 115.
• 57 ASD children and 58 normally developing peers were chosen as my study sample.
![Page 21: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/21.jpg)
Eligibility criteria
Inclusion criteria:• Have one of the three ASD diagnoses (e.g.
autism disorder; pervasive developmental disorders, not otherwise specified; or Asperger disorder).
• Are not suffering from other complicated diseases.
• Parents of autistic child who are willing to provide data.
![Page 22: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/22.jpg)
Exclusion criteria:• Are not diagnosed as ASD.• Suffering from other diseases• Parents of autistic child who are not willing to
provide data.
![Page 23: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/23.jpg)
Development of Research Instrument• A semi structured interview questionnaire was
prepared.• Developed on the basis of relevant literature.• The questionnaire was pre-tested and evaluated
thoroughly.• Necessary revision and adjustment was done
accordingly.• It was prepared in both Bangla and English.• 80% were close ended & 20% were open ended
questions.
![Page 24: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/24.jpg)
Data collection procedure• Data was collected from the parents in the
institution premises by face to face interview.• Two or three visits within a 4-week period at the
location of six study places were done.• During the first visit, eligibility criteria was
confirmed.• During the second visit, the PedsQL was
administered.• Interviewing the parents (either father or mother)
according to scale was required 20 min each.• In a day I collected data from 15 participants.
![Page 25: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/25.jpg)
Data analysis• Data analysis was done according to the specific
objectives of the study.• Data was entered into computer using SPSS 20 version.• Then relationship between the variables was established
by mean, median, mode, standard deviation and t- test.• After that MLR (Multiple Logistic Regression) was done
to assess the strength of association between the variables.
• For inferential statistics, mainly one way ANOVA, and Pearson’s correlation was used.
• In all the tests p˂0.05 was considered to be statistically significant.
![Page 26: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/26.jpg)
Data presentation & interpretation• Data was presented by: -Tables -Graphs -Chart -Statistical interference.• Easy demonstration was done for general understanding.
![Page 27: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/27.jpg)
Results and Findings
• A cross sectional comparative study was carried out among 115 children, 57 of them were diagnosed as Autistic children.
• Data was collected from the parents of autistic and normal children.
• My respondents were very much cooperative and responded well.
• There was no missing data.• Data are presented through tables and figures.
![Page 28: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/28.jpg)
Socio-demographic characteristics of respondents
77.2
22.8
MaleFemale
Figure : Sex distribution of autistic children
![Page 29: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/29.jpg)
74.1
24.9
MaleFemale
Figure: Sex distribution of normal children
![Page 30: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/30.jpg)
Table 1: Distribution of Age of the children
![Page 31: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/31.jpg)
96.5
3.5
IslamHindu
Figure: Distribution of religion of autistic children
82.8
17.2
IslamHindu
Figure: Distribution of religion of normal children
Figures represent that majority of the respondents (96.5%) of autistic children’s parents were Muslims and so as normal children’s parents (82.8%) and rest were Hindus
![Page 32: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/32.jpg)
0
5
10
15
20
25
30
5.3
1.8
28.1
14
24.626.3
Figure: Distribution of educational status of respondents in autistic children group
![Page 33: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/33.jpg)
secondary higher secondary
graduate post graduate0
5
10
15
20
25
30
35
40
45
50
5.2
19
29.3
46.6
Figure: Distribution of educational status of respondents in normal children group
![Page 34: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/34.jpg)
Previous 2 figures show that major proportion of respondents (50.9%) was in the educational level of Graduate & Post graduate in autistic group and 75.9% in normal group. Educational status among the respondents of normal child is higher than the respondents of autistic child.
![Page 35: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/35.jpg)
1.8
61.4
1.8
14
14 5.3 1.8
unemployedHousewifeAgricultural workerGovt. servicePrivate serviceBusinessmanretired
Figure: Distribution of occupational status of respondents in autistic children group
![Page 36: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/36.jpg)
20.7
12.1
39.7
27.6
HousewifeGovt. servicePrivate serviceBusinessman
Figure : Distribution of occupational status of respondents in normal children group
![Page 37: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/37.jpg)
Previous 2 figures state that among 57 respondents of Autistic child group 61.4% were housewives, service holder 28% (both govt. and private) and rests were businessman (5.3%),unemployed, retired and agricultural worker (1.8% of each) whereas majority under normal child group (51.8%) were service holder.
![Page 38: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/38.jpg)
10000-25000 25001-50000 50001-75000 75001-100000
100000+0
10
20
30
40
50
60
15.8
54.4
17.5
8.83.5
0
48.3
39.7
12.1
0
autistic normal
Figure: Distribution of monthly family income of respondents of both groups
![Page 39: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/39.jpg)
This bar chart shows that monthly family income of the respondents was ranging from 10000 to 100000+ taka. Higher proportion of the respondents 54.4% and 48.3% had family income 25001-50000 taka of Autistic and normal child group respectively.
![Page 40: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/40.jpg)
Quality of life related variable
0-4 5-9 10-14 15-19 20-24
45.6
36.8
8.8 71.8
Figure: Total physial function of autistic children
0
10
20
30
40
50
60
70
80
90
100
100 0-4
Figure : Total physical function of normal child
![Page 41: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/41.jpg)
5.3
43.942.1
8.80-45-910-1415-19
96.6
3.4
0-45-9
Figure: Total emotional function of autistic child
Figure: Total emotional function of normal child
![Page 42: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/42.jpg)
0-45-9
10-1415-20
0
10
20
30
40
50
60
70
80
90
100
autistic
normal0 3.5
45.6 50.9
100
00
0
autisticnormal
Figure: Total social function of both autistic and normal child
![Page 43: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/43.jpg)
0-4 5-9 10-14 15-200
10
20
30
40
50
60
70
80
90
100
17.5
43.938.6
0
100
0 0 0
autisticnormal
Figure: Total school function of both autistic and normal child
![Page 44: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/44.jpg)
Comparing Means of Autistic Children & Normal Children
Characteristics Group Mean SD P-Value
Physical Health Summery
AutisticNormal
6.040.10
5.2810.10 0.000
Emotional Health Summery
AutisticNormal
9.771.79
3.1281.373 0.000
Social Health Summery
AutisticNormal
14.5100
2.86100 0.000
School Health Summery
AutisticNormal
8.120.45
3.6010.626 0.000
![Page 45: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/45.jpg)
Higher mean value for variables ‘Physical Function’ , ‘Emotional Function’ , ’ Social Function’ , ‘School Function’ indicates a lower quality of life . Here , Mean of ‘Physical Function’(Autistic Child)=6.04 >Mean of ‘Physical Function’(Normal Child) =0.10 ; Mean of ‘Emotional Function’(Autistic Child) =9.77 > Mean of ‘Emotional Function’ (Normal Child ) = 1.79 ; Mean of Social Function (Autistic Child ) =14.51 >Mean of Social Function(Normal Child ) =0;Mean of School Function(Autistic Child ) =8.12> Mean of School Function(Normal Child ) = 0.45 . Since the mean value for all these variables is higher for autistic children than for normal children, we can conclude that autistic children enjoy a lower quality of life.
![Page 46: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/46.jpg)
Association between groups and socio-demographic status
Educational status Autistic Normal Total X2 P-Value
Frequency per Frequency per Frequency per
16.08 a 0.000Below H.S.C 20 35.1 3 5.2 23 20
H.S.C and above 37 64.9 55 94.8 92 80
**Fisher’s exact test with 2 tailed significance
Table : Association between educational status of the respondents with the group (autistic and normal)
![Page 47: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/47.jpg)
Table reveals that 64.9% percent respondents of autistic children are found whose educational status is H.S.C and above while 94.8% respondents of normal children are found who is in same status. There is significant relationship between the educations of respondents with autism as p<0.001.
![Page 48: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/48.jpg)
Occupationalstatus
Autistic Normal Total X2 P-Value
Frequency per
Frequency per Frequency per
9.46 a 0.002Employed 21 36.8 38 65.5
59 51.3
Unemployed 36 63.2 20 34.5 56 48.7
**Continuity Correction with 2 tailed significant
Table : Association between occupational status of the respondents with the group (autistic and normal)
![Page 49: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/49.jpg)
Table reveals that 63.2% percent respondents of autistic children are found who were unemployed while 34.5% respondents of normal children are found who is in same status. There is significant relationship between the occupation of respondents with autism as p<0.05.
![Page 50: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/50.jpg)
Monthly Family income
Autistic Normal Total X2 P-Value
Frequency per Frequency per Frequency per
5.17 a 0.01710000-50000 40 70.2 28 48.3 68 59.1
> 50000 17 29.8 30 51.7 47 40.9
****Continuity Correction with 2 tailed significant
Table: Association between monthly family income of the respondents with the group (autistic and normal)
![Page 51: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/51.jpg)
Table reveals that 70.2% percent respondents of autistic children are found whose monthly family income Is within 10k-50k taka while 59.1% respondents of normal children are found who is in same status. There is significant relationship between monthly family income of respondents with autism as p<0.05.
![Page 52: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/52.jpg)
Total physical function
Autistic Normal Total X2 P-Value
Frequency per Frequency per Frequency per
43.185 a 0.000Good 26 45.6 58 100 84 73.0
Poor 31 54.4 0 00 31 27.0
** Fisher’s exact test with 2 tailed significance
Table: Association between total physical function of the children with the group (autistic and normal)
![Page 53: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/53.jpg)
Table shows that, only 45.6% autistic children have good physical function where all the normal children have also good physical function. So, there is a significant association between autism and physical function as p<0.001.
![Page 54: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/54.jpg)
Total emotionalfunction
Autistic Normal Total X2 P-Value
Frequency per Frequency per Frequency per
95.894 a 0.000Good 03 5.3 56 96.6 59 51.3
Poor 54 94.7 02 3.4 56 48.7
** Fisher’s exact test with 2 tailed significance
Table: Association between total emotional function of the children with the group (autistic and normal)
![Page 55: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/55.jpg)
Table represents that, 94.7% autistic children have poor emotional function where only 3.4% of the normal children are emotionally disturbed. So, there is a significant association between autism and emotional function as p<0.001.
![Page 56: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/56.jpg)
Total socialfunction
Autistic Normal Total X2 P-Value
Frequency per Frequency per Frequency per
115.000 a 0.000Good 00 00 58 100 58 50.4
Poor 57 100 00 00 57 49.6
** Fisher’s exact test with 2 tailed significance
Table ; Association between total social function of the children with the group (autistic and normal)
![Page 57: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/57.jpg)
Table reveals that, no autistic children have good social function where only all the normal children are emotionally sound. So, there is an obvious significant association between autism and emotional function as p<0.001.
![Page 58: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/58.jpg)
Total schoolfunction
Autistic Normal Total X2 P-Value
Frequency per Frequency per Frequency per
80.880a 0.000Good 10 17.5 58 100 68 59.1
Poor 47 82.5 00 00 47 40.9
** Fisher’s exact test with 2 tailed significance
Table: Association between total school function of the children with the group (autistic and normal)
![Page 59: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/59.jpg)
Table reveals that, 82.5% autistic children have impaired or poor school functions where all the normal children have good school function according to the pedsQL scale. So, there is a significant association between autism and emotional function as p<0.001.
![Page 60: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/60.jpg)
Table: Multiple Logistic Regression of Total Physical Function
![Page 61: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/61.jpg)
![Page 62: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/62.jpg)
Discussion• This study set out to increase our knowledge of
children with ASD’s HRQL compared to typically developing peers.
• Regarding HRQOF, I have found a significant poorer QOL in children with autism in comparison to normally developing peers from parent’s point of view by using Pediatric Quality Of Life inventory 4.0 Generic Core Scale.
• Higher mean value for variables ‘Physical Function’ , ‘Emotional Function’ , “Social Function” , ‘School Function’ indicates a lower quality of life .
![Page 63: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/63.jpg)
• Chi square test was done and each of the 4 domains – total physical, emotional, social and school function shows significant difference as p value is less than 0.001.
• Multiple Logistic Regression was done to strengthen the association and that was also found statistically significant.
![Page 64: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/64.jpg)
Data Quality Management• Data quality management was done in every
stages of research. • During the data collection in the field, data was
checked and re-checked for data consistency. • After the data entry, data was checked again for
ensuring there was no missing information as well as inconsistent by comparing the raw data and the entry data.
• Data filtration was also done again after the statistical test.
![Page 65: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/65.jpg)
Study Limitations
• The study population was a specific group (8-12 years children) of the country, does not include all the age groups of ASD.
• Not merely represent the general population of the country.
• I did not include all the ASD children in our study, so the study did not contain the overall HRQL of ASD children.
![Page 66: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/66.jpg)
Ethical issues
• Ethical clearance was obtained from the university authority.
• Informed written consent (ICF) was taken.• Data secrecy part was assured to every
participant. • No one had been forced to provide data unless
they give it deliberately.• Privacy of the respondents was maintained
during data collection.
![Page 67: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/67.jpg)
Work statement July August September October November December
Topic selection
and proposal
submission
Approval of
proposal
Literature review
Development of
research
instrument &
pretest
Data collection
Data compilation
& analysis
Report writing
and editing
Printing and
submission
July – December, 2015
![Page 68: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/68.jpg)
Conclusion• This study is the first to estimate HRQL in
children with ASD in Bangladesh as compared to normally developed peers, from the parent’s point of view.
• Children with ASD reported having lower HRQL than peers, which was confirmed by parents.
• Autism Spectrum Disorder has been, and continues to be, a major health issue in our current society.
• This study will help the policy makers contribute in implementing different strategies for improving health status of autistic children.
![Page 69: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/69.jpg)
Recommendation
• Improve educational Setting.• Improve functional Skills.• Individualized Educational Plan (IEP) should be
incorporated.• Training should be provided to teachers, aides,
and therapists.• Providing education to family members.• Siblings should also be monitored.
![Page 70: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/70.jpg)
Acknowledgement
• My academic supervisor Prof. Dr. Md. Nazrul Islam ph.D sir
• Dr. Ahmed Neaz, Advisor, Department of Public Health of AIUB.
• All the faculty members of AIUB.• My family members.• My classmates.• Respondents.
![Page 71: Health Related Quality of Life with Children of Autism Spectrum Disorder in Bangladesh](https://reader035.vdocuments.us/reader035/viewer/2022070519/58f2affa1a28ab7c308b4581/html5/thumbnails/71.jpg)
Thank you all