Introduction
The purpose of this paper is to provide a critical evaluation of a study by Acharya and Sharma (2021) titled Lived Experiences of Mothers Raising Children with Autism in Chitwan District, Nepal. First, this paper provides a brief overview of the article’s introduction, methodology, and results. Following this, the paper offers a critique of the article’s introduction, methodology, results, and discussion. Finally, the paper concludes with a summary of the study’s strengths and limitations as revealed during the analysis.
Article Summary
Summary of Introduction
The introduction to the paper by Acharya and Sharma (2021) provides a summary of the background and the purpose under analysis. First, the authors focus on the prevalence statistics of autism worldwide. The authors demonstrate that while there are reliable estimations of the condition’s prevalence in some countries, no studies have reported the prevalence of ASD in Pakistan, Bhutan, the Maldives, Nepal, and Afghanistan (Hossain et al., 2017). Thus, autism is a significant problem around the globe.
Acharya and Sharma (2021) state that raising children with autism is associated with significant difficulties for parents. Parents may experience increased amounts of stress, sadness, and depression (Desai et al., 2012). Mothers were found to feel guilt, sadness, and confusion, and were unable to indulge in enjoyable activities, which causes stress and depression. Mothers of autistic children can also experience a sense of loss due to abandoned dreams associated with pursuing their dreams and the future of their children (Altiere & von Kluge, 2009). Even though mothers may develop coping strategies, such as acceptance, a proactive mindset, character growth, spirituality, and parent support networks, the effects of having an autistic child in the family were associated with adverse outcomes for the mothers.
The experiences of parents, and mothers, in particular, vary among countries, which implies that every country should be studied separately, as research results from one country cannot be generalized to other countries. Moreover, limited research is available concerning the experiences of mothers of autistic children in low-income countries in comparison with high-income countries. In Nepal, autism among children is prevalent, while research on it is relatively scarce. Therefore, additional research is required to explore the lived experiences of mothers of autistic children in Nepal.
Summary of Methods
The methodology section provides a detailed description of the approach used to achieve the study’s purpose. The study employs a qualitative phenomenological research design to achieve its purpose. Since qualitative research design assumes that there may be numerous realities depending on the perspective, adopting the research design was appropriate for exploring the personal experiences of mothers raising autistic children in Nepal.
The population under analysis was mothers of autistic children aged below 14 living in Chitwan district, Nepal, who attended autism care centers, such as Asha Bal Bikash Kendra or Autism Care Chitwan Society. The final sample consisted of nine participants, which the authors considered sufficient to achieve the study’s purpose. The researchers utilized purposive sampling techniques to select the information-rich cases.
The data was collected using in-depth interviews with the participants. The researchers developed interview guidelines that consisted of two parts: socio-demographic questions and open-ended questions regarding the experience of raising autistic children. The interviews were recorded using digital technology and notebooks to ensure the data was stored for further analysis. The trustworthiness of the data collection was ensured by conducting interviews in simple Nepali, transcribing the recordings, and conducting multiple interviews with each participant to verify the reliability of the obtained information.
The researchers received approval and permission from all the relevant bodies to conduct the study. Informed consents for participation and recording were obtained from participants before data collection. The interviews were conducted in the participants’ homes to ensure a quiet and peaceful atmosphere. They took between 40 and 60 minutes each, which allowed the participants to express their feelings fully. Both verbal and nonverbal expressions were observed during the interviews. The obtained data were analyzed using a standard thematic analysis procedure, which consisted of seven steps.
Summary of Results
The results section presented the analysis results using tables and narratives. The results section focused on the description of the sample and themes discovered during the analysis. The final sample consisted of nine women, aged between 23 and 36 years old.
All of the participants lived in Urban areas and were educated. The education levels differed between being generally literate and having a Bachelor’s degree. Two participants were employed, while seven were homemakers. Six out of nine children were capable of some daily living activity, while others were incapable of self-care.
The thematic analysis revealed five major themes, including perception of autism, recognition of the problem, modification in the parenting style, impact on day-to-day life, and coping measures. The theme of perception about autism was associated with four sub-themes in which participants described how they viewed autism. The analysis revealed that mothers saw autism as mental retardation, behavioral problems, a lifelong disorder, and a neurodevelopmental problem. The theme of recognition of the problem included five sub-themes, in which the participants discussed the central difficulties they ran into after their children were diagnosed with autism.
The participants stated that autism was associated with communication and socialization problems, restricted or repetitive behavior, and poor developmental tasks. The theme also described the sources the participants used to acquire information about the condition. The parenting modification theme described how the parents had to change their lifestyles.
The subthemes included changing daily activities, the capability of doing everyday tasks, positive reinforcement, using different sources, safety precautions, and perceiving the child’s compatibility. The theme of impact on day-to-day life included 12 minor themes, which described economic, physical, emotional, and social aspects. The final theme of coping measures included sub-themes of respite care, problem-focused strategies, spiritual coping, and positive coping.
Critique
Critique of Introduction
An introduction is a crucial part of a research paper, as it introduces the topic of the analysis, provides a background of the study, and describes the research problem (Saunders, Lewis, and Thornhill, 2019). Additionally, an introduction of a qualitative article usually includes clearly stated research questions, aims, objectives, and the study’s significance (Creswell, 2007). The article’s introduction by Acharya and Sharma (2021) includes some of the parts described above, while other crucial consistencies of a good introduction are missing.
The topic of the paper is clearly introduced, starting from the broad topic of autism and gradually narrowing it down to the lived experiences of mothers of autistic children in Nepal. According to Bailey, Hennink, and Hutter (2020), it is the most appropriate method of introducing a research topic. Additionally, the background of research is provided in full by discussing both the prevalence of autism and the overview of the literature concerning the lived experiences of parents of autistic children around the world.
The problem is also clearly stated as “there is a great need to explore the lived experiences of mothers raising children with autism” (Acharya & Sharma, 2021, p. 2). Defining the problem is crucial for a research article, as it demonstrates that further research is needed to solve a particular issue (Merriam, 2009). In summary, the strengths of the article’s introduction are a clearly stated topic, a formalized research problem, an in-depth description of the background, and an overall logical flow of the text.
The introduction section also has weaknesses that should be mentioned. First, it lacks a list of aims and objectives. According to Saunders, Lewis, and Thornhill (2019), stating the research aims and objectives is crucial for defining a study’s scope, making conclusions easy to evaluate.
Moreover, research aims and objectives establish the depth of a project, which is crucial for avoiding unnecessary research (Saunders, Lewis, and Thornhill, 2019). Even though the research aim can be deduced from the problem statement, the objectives are unclear. Therefore, the article would have benefited from clearly stating the research aims and objectives.
Second, the introduction lacks research questions crucial to a research project. Similar to research aims and objectives, research questions help to guide the research process and help to avoid focusing on unneeded knowledge (Bailey, Hennink, and Hutter, 2020). While skipping either research questions or research aims and objectives may be appropriate, lacking both aspects of a good introduction is challenging to justify. Thus, the primary weakness of the article’s introduction is the absence of research aims, objectives, and questions.
Critique of Methods
The methods section is well-structured and addresses almost all the parts of the ‘research onion’ (Saunders, Lewis, and Thornhill, 2019). In particular, the description of the methodology includes a discussion of the research approach, population, sampling methodology, data collection instrument, trustworthiness, and data collection and analysis procedure. However, one essential part of the research onion is missing: research philosophy.
There are three possible research philosophies: positivism, interpretivism, and pragmatism. When utilizing positivism as the primary paradigm for a study, researchers are expected to act unbiasedly and deduce the cause-and-effect relationships using context-free methods (Babbie, 1998). Interpretivism is the opposite worldview compared to positivism (Kuhn, 1970).
Interpretivism, in particular, assumes that multiple realities coexist and require interpretation. Pragmatists believe that both qualitative and quantitative methods can be used if they solve the problem (Frey, 2018). Even though Acharya and Sharma (2021) did not state the research philosophy specifically, it can be deduced that the researchers used interpretivism as the primary research philosophy.
The use of the qualitative approach to the study was appropriate, as the purpose was to learn about the experiences of mothers of autistic children. Basias and Pollalis (2018) state that qualitative research seeks to understand phenomena by analyzing behaviors, experiences, and observations made locally. Quantitative approach requires a clearly formulated research and rigorous methodology to test the identified hypotheses (Creswell, 1994).
The quantitative approach aims to derive information from numerical data by applying mathematical and statistical tools (Saunders, Lewis, and Thornhill, 2019). The quantitative approach may have been considered for the present paper to increase the reliability of findings. However, the lived experiences of participants are challenging to quantify. Therefore, the qualitative approach is the most appropriate for the study.
The sampling technique may be a source of bias in the research. Acharya and Sharma (2021) used non-probability sampling to recruit the participants. While non-probability sampling methods may have their advantages, they are associated with significant sampling bias, as it is highly dependent on the judgment and skill of the researcher (Elliott & Valliant, 2017). Non-probability methods are used for quantitative research, as such research requires large samples, which means increased risk of sampling bias.
Probability sampling methods are preferred when there is a high chance of sampling bias. Probability sampling methods allow every member of the target population to have an equal chance of being involved in the research (Acharya et al., 2013; Etikan & Bala, 2017). Since there is a low chance of selection bias, using non-probability sampling is appropriate for the research conducted by Acharya and Sharma (2021).
The researchers used purposive sampling to select information-rich cases (Acharya & Sharma, 2021). Purposive sampling refers to the researcher choosing “the participants as per his/her own judgment, keeping in mind the purpose of the study” (Showkat & Parveen, 2017, p.8). In this case, purposive sampling is appropriate to avoid conducting unnecessary or non-representative data. Therefore, no problem was found with the selection of the sampling technique.
The sample size, however, may be a matter of concern. Acharya and Sharma (2021) selected nine participants from the Chitwan district, Nepal. Numerous approaches to selecting a sample size include a rule of thumb, statistical formulae, and numerical guidelines (Sim et al., 2018). According to Boddy (2016), any sample size is appropriate as long as it is justified. Hence, even though the sample of nine participants may be appropriate, it has not been justified by Acharya and Sharma (2021). Therefore, the sample size may be a matter of concern.
The data collection methods are appropriate, as they serve the purpose of the study, support trustworthiness, and do not contradict research ethics. The data analysis technique aligns with the standard approach introduced by Virginia Braun and Victoria Clarke (Braun, Clarke, and Weate, 2016; Sang & Sitko, 2015). Thus, the only concern with the research methods is the absence of justification for the sample size.
Critique of Results
The results section aims to describe the analysis outcomes in the most unbiased way (Saunders, Lewis, and Thornhill, 2019). When writing a results section, researchers must avoid presenting interpretations or opinions concerning the analysis results (Saunders, Lewis, and Thornhill, 2019). In other words, the article’s authors must let the reader draw conclusions based on the results before stating their own interpretation (Saunders, Lewis, and Thornhill, 2019).
The results section provided by Acharya and Sharma (2021) is well-structured, allowing the reader to get a clear idea about the central themes revealed during data analysis. Acharya and Sharma (2021) presented the results using three tables and a narrative description. The tables included the socio-demographic description of the sample and the list of major and minor themes.
The narrative description of the results was divided into sections with sub-headings, which helps the reader understand the study results. The authors included direct quotes of the participants that justified the themes. No interpretations or opinions were included in the section.
While no significant weaknesses of the results section were identified, there are two improvement points. First, some of the demographic data may have been presented as figures, which can help visualize the frequencies (Anderson et al., 2001). Second, the frequencies of the themes and sub-themes may have been presented to demonstrate which themes were more critical than others (Creswell, 1994). The results section was written almost flawlessly, and only minor improvements could be considered.
Critique of the Discussion
The purpose of the discussion section is to draw all the previous sections together to put the study’s findings in the research context. A good discussion section starts with a restatement of the purpose of the study and is preceded by demonstrating how the results helped to achieve the aim of the research or answered the research questions (Saunders, Lewis, and Thornhill, 2019). Additionally, the research section discusses the findings against the previous body of knowledge, which connects the results with the literature review (Saunders, Lewis, and Thornhill, 2019).
Acharya and Sharma (2021) started the discussion section by stating the study’s objective, which was not present in the introduction section. After that, the section was structured based on the themes discovered during the analysis. In other words, instead of organizing the discussion section by a previously created design, Acharya and Sharma (2021) let the design of the results of the research guide the discussion section, which may be appropriate for phenomenological explorative studies (Saunders, Lewis, and Thornhill, 2019).
Acharya and Sharma (2021) also included the results of previous studies in the discussion, which allowed the reader to understand the context of the results. However, the researchers failed to clearly mark any abnormal findings, making it unclear whether any expected results were achieved. In summary, the discussion section was written comprehensively, promoting an understanding of the study’s results in the context. No significant drawbacks were discovered.
Conclusion
The article by Acharya and Sharma (2021) is well-written scientific literature. The article includes all the crucial elements of a research article, including the introduction, methodology, results, and discussion. All the parts of the article are clearly structured using headings and subheadings, which makes it convenient to read and analyze.
The numerous strengths of the research article should be acknowledged. First, the introduction section provides an in-depth analysis of the background of the study by providing the results of previous research and the prevalence of autism in different countries. The introduction also clearly states and justifies the problem, allowing the reader to evaluate the study’s findings.
Second, the methods section clearly describes the methods utilized to solve the problem. The researchers used the qualitative approach by conducting nine in-depth interviews with mothers of autistic children in Nepal. The selected research approach was appropriate, as the purpose of the study was to learn about the lived experiences of mothers of autistic children, which would be difficult to achieve using quantitative research methods. The sampling technique used also facilitated the study process.
Third, the results of the analysis were presented in a comprehensive and unbiased manner. Finally, the discussion section provided in the article unites all the sections by putting the results in the context of the literature review and the study’s objectives.
There are also some drawbacks to the article that should be mentioned. First, the introduction does not clearly explain the research aims, objectives, and questions. As a result, it isn’t easy to understand if the purpose of the study was achieved. However, since the problem is stated clearly, the results can be discussed in the light of the problem being solved.
Second, the authors of the article failed to justify the sample size. While the sample of nine was appropriate for achieving the purpose of the study, no explanation of why such a sample size was selected was provided. Third, the results section may have included a table with frequencies of all themes, and some of the descriptive statistics may have been presented in figures rather than tables. Finally, the discussion section could have outlined any abnormal findings that made the research stand out. However, all the drawbacks discussed in this paper are minor and do not affect the reliability and validity of findings.
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