Active Duty Military Families with Children with Autism and Their Expriences Recieving Support: A Qualitative Case Study
Abstract: The purpose of this qualitative multiple case study was to examine the experiences of mobile Active Duty Military Spouses (ADMS) of students with Autism Spectrum Disorder (ASD) to document the types of school support they are getting and what further school services the children may need to succeed socially and academically. Using a multiple case study with triangulation, data were collected from a pre-interview survey that listed the exclusion criteria, a questionnaire, semi-structured interviews, and reflective timeline/essay. Data were analyzed using NVivo® 12. Cases were created in NVivo® 12 to develop units of observation, grouping, and comparison. The exploration led to discovering the three dominate themes including (a) academic success, (b) social success and (c) EFMP success. Through the nature of the in-depth case study investigation, various alleged and expected themes were revealed by the participants. The results of this study implied that ASD military dependents are one of the most underserved population and do not receive the appropriate services for their academic and social needs from schools or military programs. In the cases where the services and support are available, there are usually delays waiting for approval and accessing needed care or the quality of the intervention may be questionable. This study further showed there are not enough providers to meet the needs of military dependents diagnosed with ASD or provide continuity of care. Therefore, there is a growing need for the policymakers and the military services to give special consideration to this underserved military population. Recommendations for future research include enlarging the sample size, using civilian families who are highly mobile and following ADMFs for longer periods of time. With this information researchers could possibly create a blueprint of successful strategies for ASD families.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.