Parental Choices Regarding Treatment Interventions: A Comparison between Parents of Children with Recognized versus Unrecognized Neurodevelopmental Disabilities

Extensive evidence highlights the importance of early therapeutic interventions in promoting the functioning of infants and children with neurodevelopmental disabilities. Among these disabilities are conditions that receive substantial scientific attention, such as autism, alongside syndromes described in the literature as “undiagnosed,” for which empirical knowledge remains limited, such as fetal alcohol spectrum disorder (FASD). 
The aim of the present study was to examine, through Andersen’s Behavioral Model of Health Services Use (Andersen, 1995), the contribution of personal resources (locus of control, shame and guilt, parental adaptation to diagnosis) and family resources (parenting stress) to parental choices regarding therapeutic interventions among parents of children with recognized disabilities compared to parents of children with undiagnosed disabilities.

A cross-sectional case-control study was conducted using a purposive convenience sample of 73 parents of children aged 3–12 with neurodevelopmental disabilities. Participants were divided into two groups: 43 parents of children diagnosed with autism and 30 parents of children diagnosed with an undiagnosed disability. Data were collected through self-report online questionnaires, including measures of locus of control, parenting stress, shame and guilt, parental adaptation to diagnosis, and demographic information. Recruitment was carried out via a snowball sampling method through social networks and through distribution in centers providing support and services to families of children with disabilities.

Findings indicated significant differences between the groups in locus of control, shame and guilt, parenting stress, and adaptation to diagnosis; however, no differences were found in the use of evidence-based interventions. Hierarchical regression analysis showed that parenting stress positively predicted the use of evidence-based interventions, whereas a diagnosis of fetal alcohol spectrum disorder predicted decreased use of such interventions. Other variables, including locus of control, shame, guilt, and adaptation to diagnosis, did not emerge as direct predictors. These findings suggest that parental intervention choices reflect a combination of emotional and familial resources.

To the best of our knowledge, this study is the first to examine a multivariable model incorporating factors not previously explored as predictors of therapeutic decision-making among parents of children with developmental disabilities. Practically, the findings underscore the importance of accessible professional information, emotional support, and parental guidance particularly for parents of children with undiagnosed conditions to enable informed decision-making and to encourage engagement in evidence-based interventions. In addition, the study suggests that parenting stress may function as a motivational mechanism for therapeutic action. Periods of moderate emotional strain may create a “window of opportunity” in which parents exhibit increased motivation to seek assistance and make treatment-related decisions. Accordingly, a practical recommendation emerging from the findings is the importance of professionals recognizing these points in time and guiding parents toward evidence-based interventions during these windows of opportunity.