Urban and rural differences in needs, service use and satisfaction among caregivers of autistic children in Morocco.
Maretha de Jonge, Mohamed Boutjdir, Tahar El-Korchi and 4 others
PMID 36800902WHAT IT FOUND
Rural caregivers reported far less non-medication intervention and school enrolment for their children than urban caregivers, despite similar verbal ability and satisfaction.
Priorities were similar, but challenges differed.
Key findings
01Rural caregivers reported no non-pharmacological intervention for their child much more often than urban caregivers (40% rural vs 9% urban).
02Rural children were significantly more likely to be not enrolled in school than urban children (30% rural vs 10% urban).
03Urban and rural caregivers did not differ significantly in satisfaction with services or in top priorities and training needs.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
Convenience sampling through parent associations, NGOs and special schools may miss families not connected to these services. The analysed sample was 131 caregivers, and it was not a random population sample. Children were not formally assessed for autism, development, adaptive behaviour or language in this study; parents reported diagnosis and verbal level. Reported unmet needs may underestimate rural needs because caregivers without access to schools or associations were not reached. Most participants were interviewed in person, which may create social desirability bias. Urban and rural groups differed in who responded, with more fathers in rural communities and more mothers in urban communities, and maternal education was lower in rural communities. The sample included a broad age range, so age-specific needs were not examined in detail.
Declared interests
The work was supported by Autism Speaks Inc., which also developed the Caregiver Needs Survey used in the study. The authors declared no potential conflicts of interest.
The easy way to misread this
Do not conclude that rural caregivers are less satisfied or that rural children need less support. Satisfaction and verbal ability did not differ significantly, and rural service gaps reflect access barriers.