Abstract
The proposed study will investigate the prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion. The study will use systematic literature review to answer the research question. The researcher will examine the potential heterogeneity sources through subgrouping and meta-regression analyses using the baseline features and methodological covariates. Meta-analysis will be used in the proposed study to determine the prevalence of autism spectrum disorders among individuals in the United States and multiple regression analysis to determine the relationship between the prevalence of autism spectrum disorders and age, gender, and religion. The knowledge obtained from this study will be vital for various health policies planning and implementation and for healthcare institutions, researchers, healthcare providers, politician and other decision-makers, scientists, families that are affected by the ASD, and ASD caregivers.
Introduction
Depino and Robinson-Agramonte (2015) defined Autism Spectrum Disorder as a neurodevelopmental disorder, which include Rett Syndrome, childhood disintegrative disorder, and Asperger’s Syndrome. According to Depino and Robinson-Agramonte (2015), approximately one out of 70 8-year old children in the United States are suffering from Autism Spectrum Disorder. Children diagnosed with Autism Spectrum Disorders show various signs such as communication and social interaction difficulties, stereotyped movements, inflexible to adhere to daily routines, food selectivity, insistence to carry out similar activities, hypo or hyper-reaction to various sensory stimuli (Magaña & Bishop, 2020). Even though various studies have been conducted on Autism Spectrum Disorders, Magaña and Bishop (2020) proposes in his study that further research on the topic should use systematic literature review provide reliable analysis and recommendations. This paper proposes to study the prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion.
Literature Review
Richards et al. (2015) defined Autism Spectrum Disorder (ASD) as a complex developmental disorder, which contributes to early social communication and interaction deficits and restricted stereotyped behaviors. According to Richards et al. (2015), ASD is characterized by various behavioral problems, which could lead to functional impairments, especially when one undertakes the daily chores in school, social setting, and workplaces. Baio et al. (2018) state that even though there are different causes that could make children to have ASD, most of the current researchers have not succeeded to completely understand the ASD pathogenesis. The components of ASD pathogenesis, which have not been completely understood by the current researchers on the topic include; environmental and psychosocial factors and the genetic predisposition characterizing ASD (Baio et al., 2018). The study conducted by Baio et al. (2018) estimated the prevalence of ASD in the United States to be about 3% while Agrawal et al. (2018) estimated such prevalence to be 5% in the country. Agrawal et al., (2018) also found out that the prevalence of ASD in the United States is more among the males than the females. In addition, Agrawal et al., (2018) found that the comorbidity of ASD (approximately 50%) are due to physical and mental conditions. On the other hand, the study conducted by Baio et al. (2018) estimated that about 64 million people have been diagnosed with ASD across the globe. It would be significant to conduct a systematic literature review to determine the prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion. Conducting a systematic literature review on the two areas would be necessary to determine the frequency of the disease in the country and to monitor the current trend of the disease as suggested by Baio et al. (2018). The proposed systematic literature review will also suggest the knowledge gap for further studies on the topic.
Important Journal Publishing Papers
The most important journal publishing papers on the chosen topic include:
- American Journal of Psychiatry
- Journal of the American Medical Association
- British Journal of Psychiatry
- The Journal of the American Academy of Child & Adolescent Psychiatry
Justification:
The following important journal publishing papers have been selected for the chosen topic because of their good reputation. The good reputation of these important journal publishing papers is an indication that their journals/articles have good quality for research (Fox & Rawson, 2019). These journal publishing papers also focus and scope of the articles, which will suit the objectives of the chosen research topic. Moreover, these journal publishing papers have good turnaround time, which includes the review process, the average time length from submission of the articles to the time of acceptance or rejection, the frequency of publication, and the time between acceptance and publication (Fox & Rawson, 2019).
International Professional Association
The international professional associations, which bring together researchers doing research on the chosen topic that will be chosen for the proposed study is the International Society for Autism Research.
Justification: International Society for Autism Research will be relevant for the proposed study since the association highlights the specific policies for autism research, which will be essential for the proposed study (Fox & Rawson, 2019). The researcher would also consult the leaders of the association on matters related to research on autism spectrum disorders and to seek for permission to conduct the study.
Most Important Conferences Covering Autism Spectrum Disorder
Some of the outstanding autism conferences in 2019-2020 that cover autism spectrum disorder are National Autism Conference, National Autism Society Annual Conference, POAC, Converge Summit, and Profectum. These conferences attempted to find the implications of the current researches on autism spectrum disorder (Fox & Rawson, 2019). These conferences have also attempted to discuss the current global trends and prevalence of Autism Spectrum Disorders.
Justification: These conferences have been chosen to provide vital knowledge, discussions, debates, and information about the chosen topic of study. The information and discussions documented by these conferences would also provide guidance and the principles of conducting research (Fox & Rawson, 2019). Therefore, such information would be necessary to guide the researcher throughout the proposed study.
Most Influential Authors Working on Autism Spectrum Disorder
Many of the authors and groups of authors have been researching autism spectrum disorder. In this regard, one of the influential groups of authors who is chosen for this study is Baio, who attempted to research the prevalence of autism spectrum disorder among children aged 8 years. Baio et al. (2018) found out that the prevalence of the disorder has been increasing over the years. However, such prevalence in ASD varies among the different racial and ethnic groups as well as communities. The other influential author chosen for this study is Pinto-Martin who also attempted to research the prevalence of autism spectrum disorder among adolescents who were born weighing less than 2 kilograms. Pinto-Martin et al. (2011) specifically revealed that “the diagnostic prevalence of ASD in this LBW preterm cohort was higher than that reported by the Centers for Disease Control and Prevention for 8-year-olds in the general US population in 2006”. The other influential authors, who will be necessary for this study are Richards, Jones, Groves, Moss, and Oliver (2015). These authors further conducted a systematic review and meta-analysis on the prevalence of autism spectrum disorder phenomenology among individuals with genetic disorders. Richards et al. (2015) specifically stated, “ASD phenomenology varied between syndromes, but was consistently more likely than in the general population. Richards et al. (2015) also suggested that further research is needed in these populations, including how ASD in genetic and metabolic syndromes differs from idiopathic autism and what that can tell us about the mechanism underlying ASD”. The next influential authors whose works will be relevant for this study are: Agrawal, Rao, Bulsara, and Patole. These four authors conducted a meta-analysis on the prevalence of autism spectrum disorder in preterm infants in 2018 and found out that autism spectrum disorder is significantly more prevalent among the preterm individuals compared to that of others. (Agrawal et al., 2018) also recommended that adequate resources are required to improve the health outcome of children diagnosed with ASD
Justification
The above mentioned authors have been chosen due to the expertise expressed in their studies on the selected topic. The researcher has also chosen these authors to compare their arguments on the chosen topic and develop the literature review part of the proposed study. Knowledge and additional requirements suggested by these authors would also be instrumental for developing the new research direction (questions).
Article Selection
| Article | Alallawi, B., Hastings, R. P., & Gray, G. (2020). A Systematic Scoping Review of Social, Educational, and Psychological Research on Individuals with Autism Spectrum Disorder and their Family Members in Arab Countries and Cultures. Review Journal of Autism and Developmental Disorders, 1-19. AUTISM SPECTRUM DISORDER: A SYSTEMATIC REVIEW ABOUT NUTRITIONAL INTERVENTIONS
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| Title | A Systematic Scoping Review of Social, Educational, and Psychological Research on Individuals with Autism Spectrum Disorder and their Family Members in Arab Countries and Cultures |
| Purpose of the Research | To describe the social, educational, and psychological research focusing on people diagnosed with Autism Spectrum Disorder and their family members in Arab countries and cultures through the use of a systematic scoping review approach. |
| Research paradigm | No significant systematic review on social, educational, and psychological research focusing on people diagnosed with Autism Spectrum Disorders and their members of family in Arab countries and cultures has been carried out by the previous researchers. |
| Conceptual framework | Previous researchers and the already existing literature reviews have mainly provided general knowledge about the Autism Spectrum Disorders. moreover, the previous studies on Autism Spectrum Disorders are also characterized by several weaknesses. For example, Alallawi et al. (2020) state that the previous studies on the topic did not include the application of comprehensive data-based searching and quality assessment of the used literatures. Alallawi et al. (2020) also state that the previous studies on the topic only reviewed the English language articles. Based on these weaknesses of the previous studies, Alallawi et al. (2020) decided to conduct a systematic scoping review, which includes the application of comprehensive data-based searching and quality assessment of the previous studies to describe the social, educational, and psychological research focusing on people diagnosed with Autism Spectrum Disorder and their family members in Arab countries and cultures. |
| Hypotheses/ Research Question | · What social, educational, and psychological research has been conducted on individuals with ASD in Arab countries and Cultures?
· What social, educational, and psychological research has been conducted on family members of individuals with ASD in Arab countries and cultures? |
| Research Design and Methods | Alallawi et al. (2020) used systematic literature review to conduct the study. The researcher conducted electronic literature searches using eight databases such as PsyclNFO, MEDILINE, ERIC, EBESCO, Web of Science, Google Scholar, EMBASE, and Social Science Citation Index. The researcher also assessed the quality of the previous studies through the use of Critical Appraisal Skill Program (CASP) tool, and Public Health Practice Project (EPHPP) tool. |
| Types of data | Secondary data |
| Statistical Methods | Alallawi et al. (2020) used statistical meta-analysis of the study results based on their quality |
| Ethical issues | Alallawi et al. (2020) considered the following ethical issues while conducting the study; availability of bias in the previous studies, language bias, country bias, and familiarity bias. The researcher also considered the potential impacts of publication bias and search bias. |
| Selection of literature | Alallawi et al. (2020) selected literature reviews that satisfied the following components of inclusion criteria: studies that adopted any research design or methodology, including cases studies, reported data, and case series, studies that focus on studying the social, educational, and psychological issues, which affect individuals diagnosed with Autism Spectrum Disorders within Arab countries and cultures, studies published in English and other languages, and participants from Arab countries and Arab cultures. Articles that did not satisfy these inclusion criteria were being excluded |
| Conclusion | Alallawi et al. (2020) concluded that significant gaps in research evidence base and research on interventions on ASD services. Alallawi et al. (2020) also concluded by recommending additional and high-quality study on the individual diagnosed with ASD in Arab countries and cultures. Alallawi et al. (2020) also recommended that further studies on the topic should be culturally-sensitive. |
Comments/ Critique on the Article
The article is significant for the study of chosen topic because of how it has addressed various components of a quality and comprehensive systematic literature review study. The components include; article title, objectives/purpose, research question, research paradigm, research design and methods, type of data, statistical methods, ethical issues, literature search, and conclusion. The title of the article is effectively expressed since from the title, any reader can identify that the research is a systematic literature review. The research paradigm and conceptual framework are also effectively outlined such that the reader can read and understand the ground on which the research was conducted. Alallawi et al. (2020) also outlined the research questions and purpose based on the research paradigm and conceptual framework, making it an interesting study. The conclusion of the study is also effectively with recommendation of the additional components that should be included in further studies on the topic.
However, there are various weaknesses and gaps that characterized the study. For example, even though Alallawi et al. (2020) have indicated the inclusion criteria that must be met by the searched article, one critical area is still missing. Alallawi et al. (2020) did not mention the publication years of the searched articles that had to be met while selecting the best articles. For instance, Alallawi et al. (2020) were to indicate that the articles that will be included in the study must have been published in the last five years. This is because the articles that are published above five years ago could be outdated and contain biased data (Fox & Rawson, 2019). In addition, it was important to use the secondary data since collection of secondary data is cost-effective and time-saving and the researcher can carry out further research to compare the results (Smile & Anagnostou, 2015). On the other hand, even though Alallawi et al. (2020) have explained ethical considerations that were undertaken during the study, certain issues were not mentioned, which should be considered during the further study on the chosen topic. One of the issues is that future researcher should scrutinize the applicability of the systematic review to prevent the possible unintended extrapolation of review findings (Smile & Anagnostou, 2015). The future systematic reviewers should effectively represent the perspectives of previous researchers and locate the missing perspectives.
Proposed Research Question
- What is the prevalence of autism spectrum disorders among individuals in the United States?
- What is the relationship between the prevalence of autism spectrum disorders and age, gender, and religion?
Aim/ Objectives
- To investigate prevalence of autism spectrum disorders among individuals in the United States
- To determine the relationship between the prevalence of autism spectrum disorders and age, gender, and religion
Research paradigm and Conceptual Framework
Most of the previous studies on prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion have mainly been primary research studies. However, no current study has focused on systematic literature review of prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion (Magaña & Bishop, 2020). Therefore, this study would bridge the gap by conducting a systematic literature review to answer the two research questions.
METHODOLOGY
Proposed Research Design and Method
The researcher proposes to use systematic literature review to conduct the study. The researcher has chosen systematic literature review because the method provides clear and comprehensive overview of the available evidence and data on the chosen topic of study (Walton & Coury, 2015). Through the application of systematic literature review, the researcher will manage to identify the research gaps and understanding of the topic. The use of scientific literature review would also help the researcher to avoid duplication of the studies that had been previously conducted and to identify the need for further studies on the topic (Walton & Coury, 2015).
Research Strategies
The researcher would search the electronic databases and bibliographies to identify the relevant previous studies on the topic and evaluate them against the proposed inclusion criteria. The researcher would conduct electronic literature searches using eight databases such as PsyclNFO, MEDILINE, ERIC, EBESCO, Web of Science, Google Scholar, EMBASE, and Social Science Citation Index. The researcher would also use Critical Appraisal Skill Program (CASP) tool, and Public Health Practice Project (EPHPP) tool to assess the quality of the searched articles. The researcher would also use meta-analysis to determine the prevalence of autism spectrum disorders among individuals in the United States and multiple regression analysis to determine the relationship between the prevalence of autism spectrum disorders and age, gender, and religion.
The list of terms that will be used for the literature search include; autism, spectrum, disorders, relationship, United States, America, ASD patients, prevalence, age, and religion. The searched articles will be briefly browsed to examine the relevance of the found articles to the research topic. The researcher will carefully analyze the relevant articles to determine the answers to the research questions. The researcher would use some of the relevant articles for background information on the selected topic of study.
Data Collection and Evaluation
The data collected will be recorded in two systematic frameworks. The first framework will be labelled Appendix A that will provide the synopsis of the collected data indicating the article, author(s), publication year, title of the article, main purpose of the study, research methods/design, summarized synopsis, and database used. Therefore, the first framework will be necessary for tracking and controlling the articles log used in the systematic literature review. The second framework labelled B will be used to record the findings of the obtained articles. Therefore, the second framework will be necessary for determining the common trends and themes concerning the prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion. Compiling the first and second frameworks will provide vital framework for analyzing and understanding prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion.
Inclusion criteria
The articles that will be used for the proposed study on prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion must meet the following inclusion criteria:
- The articles must be related to study on prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion.
- The researcher will include the observational studies, especially health surveys, cohort, and cross-sectional studies. Cross-sectional studies will be the most appropriate to determine the prevalence of ASD in the United States.
- The articles’ publication years must fall within five years range, between 2015-2020
- Articles must be related to studies on autism spectrum disorder in the United States and few studies that were conducted in other countries such as Australia and United Kingdom for comparison and meta-analysis.
Exclusion Criteria
The obtained articles with the following features will be excluded for this proposed systematic literature review study on prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion.
- Articles published from 2014 backwards
- Articles related to study on prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion in other countries other than United States, United Kingdom, and Australia.
Ethical Consideration
The researcher would investigate the availability of bias in the previous studies, language bias, country bias, and familiarity bias. The researcher also considered the potential impacts of publication bias and search bias while conducting the study. The researcher will also scrutinize the applicability of the systematic review to prevent the possible unintended extrapolation of review findings. The researcher will also represent the perspectives of previous researchers and locate the missing perspectives.
RESULTS ANALYSIS
The researcher will investigate further the potential heterogeneity sources through subgrouping and meta-regression analyses using the baseline features and methodological covariates. Investigation of the potential sources of heterogeneity will be conducted if the researcher succeeds to identify sufficient studies and data points. The researcher is also planning to analyze the collected data based on gender, religion, age, and geographical distribution of ASD prevalence. On the other hand, the researcher will use the random effects meta-regression models to explore the prevalence of ASD in the United States. The researcher will also explore and assess the small study effects by using the Egger’s test and Begg’s test to inspect the symmetry of the funnel plots. Finally, the researcher will conclude a potential small study effects if the p value of the analysis in less than 0.10 i.e. p<0.10
DISCUSSION
The use of systematic literature review in this proposed study will help to identify, determine, evaluate, and integrate the epidemiological knowledge about the prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion. Such important epidemiological knowledge will be necessary for healthcare institutions, researchers, healthcare providers, politician and other decision-makers, scientists, families that are affected by the ASD, and ASD caregivers (Baio et al., 2018). Moreover, the knowledge obtained from this study will be relevant for implementation of various health policies.
Study Strengths and Limitations
The researcher is planning to comprehensively evaluate the epidemiological data on the research question, explore the degree of heterogeneity and possible biases on the searched articles in order to address the potential research limitations. The researcher is also planning to identify the knowledge gaps, which could have limited the previous studies and address these gaps using the recommendations provided in these studies. Finally, the researcher will suggest the possible knowledge gaps for further studies.
CONCLUSION
In conclusion, it would be significant for the researcher to conduct the proposed study on the prevalence of autism spectrum disorder in the United States and the relationship between the prevalence of autism spectrum disorders and age, gender, and religion. The knowledge obtained from this study will be vital for various health policies planning and implementation. The knowledge obtained from the study will also be necessary for healthcare institutions, researchers, healthcare providers, politician and other decision-makers, scientists, families that are affected by the ASD, and ASD caregivers (Baio et al., 2018).
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