Year : 2019  |  Volume : 61  |  Issue : 6  |  Page : 662--663

Authors' response to commentary on: Parental care seeking pathway and challenges for autistic spectrum disorder

Pranab Mahapatra1, Abhimanyu Singh Chauhan2, Sanghamitra Pati3,  
1 Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
2 Qualitative Health Research, Public Health Foundation of India, Gurgaon, Haryana, India
3 Department of Health Research, Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India

Correspondence Address:
Sanghamitra Pati
Department of Health Research, Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha

How to cite this article:
Mahapatra P, Chauhan AS, Pati S. Authors' response to commentary on: Parental care seeking pathway and challenges for autistic spectrum disorder.Indian J Psychiatry 2019;61:662-663

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Mahapatra P, Chauhan AS, Pati S. Authors' response to commentary on: Parental care seeking pathway and challenges for autistic spectrum disorder. Indian J Psychiatry [serial online] 2019 [cited 2020 Jul 6 ];61:662-663
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This is in response to the critical review of our published article. First, the author mentioned that, in the overall diagnostic process after the initial diagnosis of autism spectrum disorder (ASD), it is stated that the ASD was suspected or confirmed after the use of screening or standard diagnostic approaches. However, that results would have better generalizability and had the authors taken only confirmed cases of ASD. Further, treating suspected cases of ASD is not having sufficient scientific merit, we reiterate that we have included diagnosed ASD Cases. Charting the pathway to care for an illness involves tracing the process from the earliest symptom appearance/suspicion of any abnormality till the patient reaches the point of care. Kindly note the following errors in the original article, a typing error.[1] Page 4; column-2. Para-2-typo error, replace “diagnosis” with “symptoms.” Read as: “The overall diagnostic process after the initial symptoms of ASD is shown in [Figure 2]b.”{Figure 2}

The author highlighted that some interviews were conducted at home, besides planned facility-based assessments. The proportion of such assessments is not mentioned in the paper, further limiting the scope for generalization, we would like to share that all the assessments were undertaken by trained physicians with decades of experience in the diagnosis of ASD using a standard assessment tool. We strongly believe that the “settings” in this case would not introduce bias in diagnostic outcome, therefore not included in the manuscript.

The author highlighted that there is a mismatch between the figures in the table and text. The description related to the [Table 1] in the original article states the proportion of first-order children as 58% contrary to the figures in the table, i.e., 58 (76.7%). We would like to thank the author for the observation. This is just a typo mistake. Please read it as a number not as a percentage when reading in the text. Because we reported enrollment of 76 parents in the study and 58 were 1st order, this is definitely 58 as number and 76.7 as proportion (58 out of 76). I am not sure if the typological errors should actually be considered for a letter to editor in response to a published paper. We strongly believe that the authors should proof read the document meticulously, but minor errors are sometimes inevitable.{Table 1}

Finally, the author mentioned that the most surprising about the study is that it was planned as qualitative, and the authors intended to identify themes related to parents' perception about ASD. However, such a thematic analysis is conspicuously missing from the description, which is elemental in qualitative research. We would like to share that the qualitative and mixed methods always played an important role in gathering evidence in the field of public health, more specifically in mental health research including community research and health systems. Qualitative methods are used to provide a thick description eliciting the viewpoint of those being studied, these explore issues with limited evidences and develop conceptual theories, which potentially leads to hypothesis formulation for quantitative approaches. Thematic analysis is a traditional method and widely used in qualitative research in the Global South and more specifically in Indian subcontinent unlike factor analysis using Q methods or serious game approach.[2] Thematic analyses involved step-by-step approach to analyze the data, which involve free listing, axial coding, selective coding, agreements and disagreements, etc.[3] Considering we reported both qualitative and quantitative data, to allocate more word count to results and discussion, we intentionally avoided a detailed description of the thematic analysis operational process. We strongly believe that journal is targeted to a specialized audience who are well versed with the basic and tradition methodologies in their day-to-day practice. However, we would like to thank the author to raise this issue. We realized that the section is missing good referencing. We would consider the point in our forthcoming publications and ensure that the section with a mention of thematic analysis methods would be appropriately referenced.

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Conflicts of interest

There are no conflicts of interest.


1Mahapatra P, Pati S, Sinha R, Chauhan AS, Nanda RR, Nallala S. Parental care-seeking pathway and challenges for autistic spectrum disorders children: A mixed method study from Bhubaneswar, Odisha. Indian J Psychiatry 2019;61:37-44. doi:10.4103/psychiatry.
2Churruca K, Perz J, Ussher JM. Uncontrollable behavior or mental illness? Exploring constructions of bulimia using Q methodology. J Eat Disord 2014;2:22.
3Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77-101.