Reproductive decisions of parents of children with autism spectrum disorders

Reproductive decision making can be a complex process, particularly for families with a history of a multifactorial condition, such as autism spectrum disorder. This study examines whether having a child with an autism spectrum disorder affects the decision to have more children. Parents of children diagnosed with an autism spectrum disorder under the age of eight years old were surveyed regarding their reproductive decisions and personal perceptions of autism spectrum disorders. The findings suggest that having a child with an autism spectrum disorder does affect parents' future reproductive decisions. Among the ninety-nine participants, 60.8% reported that their decision to have more children was affected by having a child with an autism spectrum disorder. An important factor found to have a significant correlation with the decision to have more children was parental concerns of having another child with an autism spectrum disorder (Chi-square= 66.70, df=16, p<0.001). Another factor found to significantly influence the decision to have more children was parental perception of recurrence risk (Chi-square= 59.33, df=16, p<0.001) The majority of our respondents (70.59%) with one child with an autism spectrum disorder overestimated their recurrence risk, as did the vast majority (92.86%) of parents with two or more affected children overestimated their recurrence risk. Additional reported factors influencing reproductive decisions included the cost of providing for the child with an autism spectrum disorder, the severity of the child's condition, and the treatability of the condition. Results offer insight into the reproductive decisions of parents of children with autism spectrum disorders, and indicate a need for better education of families with children diagnosed with autism spectrum disorders. Genetic counseling for autism spectrum disorders can clarify misunderstandings and provide education so that parents can make informed reproductive decisions. It also suggests the importance of a multi-disciplinary assessment for individuals with autism spectrum disorders, to include medical genetics.