Objective: Autism Spectrum Disorders (ASDs) are relatively common neuro-developmental disorders characterized by deficits in reciprocal social interaction and communication, along with the presence of restricted, repetitive and stereotyped interests and behaviors. ASD affect all areas of life by making serious impairment, and care giving for the affected children is an exhausting, overwhelming and enduring process. In developed countries, families have the tendency to halt reproduction after the diagnosis of a child with ADS and usually do not have another child. Although studies have not been presented on this subject, our clinical observations suggest that in our country families look more positively towards having another child compared to developed countries. In this study, we aimed to investigate reasons and attitudes of parents who already have a child with ASD to having another child.
Methods: The sample included 77 patients (18 females, 59 males) with an age range of 5 to 20 years old who were diagnosed ASD and had a later-born sibling. A questionnaire designed by the authors was administered to the parents. We asked whether their previous child was diagnosed ASD or they had an awareness of their children’s a problem when they planned or gave birth to the later child. We asked them to mark any of a number of given reason(s) that was/were closer to the way they thought.
Results: In 36% of the subjects (n=28), the child with ASD had not yet received a diagnosis or the parents had not suspected or known about ASD in the previous child when they had the later pregnancy or birth. In the remaining 64% of the subjects (n=49), the child with ASD had been diagnosed with ASD and the parents knew that they had a child with ASD when they had the pregnancy or gave birth to the later child. 10 of those 49 parents stated that the later pregnancy was unexpected or unplanned. 39 parents stated that they decided to have another child after a child with ASD for the following reasons: ‘To make friendship with his/her affected older sibling’ (n=13; 33%), ‘To have a healthy child’ (n=8; 20%), ‘To help nursing his/her sibling with ASD’ (n=7; 17%), ‘To have a child of a different sex’ (n=2; 5%), ‘Health professional‘s recommendation’ (n=3; 7%), ‘Grandparents/relatives’ wishes and insistence’ (n=1; 2%), and ‘Other reasons’ (n=3; 7%)
Conclusion: We found that the most important motivation for parents to have another child after a child has been diagnosed with ASD is to make friendship with his/her elder sibling. Other frequent reasons include the expectation that the younger sibling would take care of their older sibling with ASD after the parents die or get old and the desire to have a healthy child. Having another child after one with ASD could be a hard decision for the families, when the responsibility of taking care to a child with ASD, emotional and economic burden and the significant increase of the recurrence risk of having another child with ASD compared to the normal population are taken into consideration. There is limited data on this subject in the literature and further investigations with larger samples may be required.