Quality versus quantity: The role of socioeconomic status on parent-reported service knowledge, service use, unmet service needs, and barriers to service use.
Parent income changes what keeps them from services—poor families need facts and transport, rich families want proof of quality.
01Research in Context
What this study did
Libero et al. (2016) asked 244 parents of children with autism to complete a survey.
The survey looked at how family income and education shaped service use, service knowledge, unmet needs, and barriers.
What they found
Low-income parents knew fewer service options and needed home-based help.
High-income parents knew more but still wanted higher-quality services.
Both groups left gaps: poor families lacked access, rich families lacked satisfaction.
How this fits with other research
Colombet et al. (2023) later asked over 1,000 French caregivers and found the same unmet needs, showing the pattern crosses countries.
Chiviacowsky et al. (2013) showed parents rate doctors lower than doctors rate themselves; E et al. add that parent knowledge, not just doctor skill, drives use.
Davy et al. (2022) reviewed leisure and job loss in caregivers; E et al. explain part of why—low-SES parents can’t find services that let them work.
Why it matters
You can close the equity gap in two ways.
Give low-SES families a short, visual list of local services and offer evening or in-home visits.
For high-SES families, add quality markers—credentials, data, parent reviews—to your flyers.
One page, two messages, better access for all.
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02At a glance
03Original abstract
Research within the autism spectrum disorder field has emphasized the role of socioeconomic status in shaping parents' ability to access services for their child with autism spectrum disorder. However, research has yet to explore the possible mechanisms underlying this relationship. This study sought to address this research gap by examining the following questions: (1) Does parents' service knowledge mediate the relationship between parent socioeconomic status and parents' autism spectrum disorder service use? (2) What are parents' reported service needs and service barriers, and do these needs vary across higher and lower socioeconomic status groups? Quantitative results from 244 parents of a child with autism spectrum disorder indicate that parents' autism spectrum disorder service knowledge partially mediates the relationship between parent socioeconomic status and parents' autism spectrum disorder service use. Qualitative findings helped to clarify this relationship by suggesting that both high and low socioeconomic status parents are aware of their child's basic autism spectrum disorder needs. However, low socioeconomic status parents more often report needing more information about services and more in-home services and emphasize that a number of structural barriers impede their ability to meet their child's autism spectrum disorder needs. On the other hand, high socioeconomic status parents more often report a need for "higher quality services," possibly reflecting their better recognition of best practice guidelines. These results highlight the need for a multi-pronged approach to tackling unmet service needs within the autism spectrum disorder field.
Autism : the international journal of research and practice, 2016 · doi:10.1177/1362361315569745