The disparity of maternal childcare pressure and quality of life between children diagnosed with autism spectrum disorder and developmental delay in the Chinese culture context: Taiwan Birth Cohort pilot Study

Background: Many studies have shown that parents express higher stress when taking care of children with autism spectrum disorder (ASD). However, cultural context should be taken into consideration when investigating children's diagnosis and parental quality of life (QOL). Therefore, this study aimed to investigate the pathway relationship among parental QOL, child development, ASD and developmental delay (DD) risk at 3 years of age, and ASD or DD diagnosis 2.5 years later.Methods: A birth cohort study database collected at age 3 and 5.5 years was used (N=1618). The Modified Checklist of Autism in Toddlers, Taiwan Birth Cohort Study Developmental Instrument, and the Short Form-36 was used to assess ASD risk, developmental condition (DD risk), and parental QOL, respectively.Results: By structural equation modeling, an indirect influence was found between children's diagnosis and maternal health QOL. Mothers of children diagnosed with ASD perceived more family support, and those who perceived more family support had better health QOL. Conversely, mothers of children diagnosed with DD perceived higher childcare pressure, and mothers who perceived higher childcare pressure had worse health QOL.Conclusions: The differences in mother's experience when their children are diagnosed with DD and ASD can only be found in pathway analysis, showing the importance of structural equation models. Healthcare personnel should take into consideration the cultural context of the families we encounter, and the vital role family support plays should be taken into consideration when interacting with families from collectivism cultures.