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  <front>
    <article-meta>
      <title-group>
        <article-title />
      </title-group>
      <contrib-group content-type="author">
        <contrib id="person-972ed86d0230b24ec6cd66354be97dcb" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Noviyanti</surname>
            <given-names>Dina</given-names>
          </name>
          <email>hermanernandi@umsida.ac.id</email>
          <xref ref-type="aff" rid="aff-1" />
        </contrib>
        <contrib id="person-97c62ae1ac919a94876a8e617722630b" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Ernandi</surname>
            <given-names>Herman</given-names>
          </name>
          <email>hermanernandi@umsida.ac.id</email>
          <xref ref-type="aff" rid="aff-2" />
        </contrib>
      </contrib-group>
      <aff id="aff-1">
        <country>Indonesia</country>
      </aff>
      <aff id="aff-2">
        <country>Indonesia</country>
      </aff>
      <history>
        <date date-type="received" iso-8601-date="2024-10-25">
          <day>25</day>
          <month>10</month>
          <year>2024</year>
        </date>
      </history>
      <abstract />
    </article-meta>
  </front>
  <body id="body">
    <sec id="heading-27ce975941e93625c73d92398e3843a0">
      <title>
        <bold id="_bold-1">Introduction</bold>
      </title>
      <p id="_paragraph-4">Autism spectrum disorder (ASD), a neurodevelopmental disorder characterized by limited, repetitive activities or interests and deficits in social communication, affects 2.2% of adults and 2.3% of 8-year-old children in the United States. The estimated frequency of ASD in the United States has been increasing, growing from 1.1% in 2008 to 2.3% in 2018. This increase is most likely the result of improved screening and diagnostic equipment performance, more public awareness, and changes in diagnostic standards. As of right now, there are no biomarkers specific to the diagnosis of ASD. During the first two years of life, a child's lack of imaginative play, limited or nonexistent use of gestures in communication, and failure to react to a name when called are all common early signs and symptoms of ASD. Depression (20% vs. 7%), anxiety (11% vs. 5%), sleep problems (13% vs. 5%), and seizures (21% with co-occurring intellectual disability vs. 0.8%) are all more common in those with ASD than in those without. Intense behavioral therapies, such as the Early Start Denver Model, help children under the age of five by enhancing their language, play, and social communication (small to medium impact size based on standardized mean difference) [1].</p>
      <p id="_paragraph-5">The severity of ASD is categorized based on limited, repetitive patterns of behavior, interests, or hobbies, as well as the degree of support required to address social communication and interaction difficulties. However, when there are diverse levels of impairment across cognitive, adaptive, and autism-related symptoms, there are concerns that conceptualizing severity based on support levels required could result in site-specific uses of ASD categories and discrepancies [2].</p>
      <p id="_paragraph-6">Autism is caused by a difference in the way your child's brain functions, which affects how they engage with their environment. They are born with this distinction; it is unrelated to your parenting style, the meals you feed them, the vaccines they receive, or everything else your child experiences after birth. Although we don't fully understand why some people are autistic and others aren't, we do know that autism is a spectrum disorder, neurodivergent, and frequently misinterpreted [3].</p>
      <p id="_paragraph-7">Autism spectrum disorders can cause changes in a person's demands and abilities over time. While some autistic people manage to live independently, others face major challenges and require lifelong care and support. Autism often affects educational and employment opportunities. Families that support and care for others may also be under a lot of pressure. Social attitudes and the level of support provided by local and federal authorities have a substantial impact on the quality of life for people with autism [4].</p>
      <p id="_paragraph-8">Researchers are unsure about the precise causation of autism. There are likely numerous causes of autism because the condition is so complicated, and no two individuals with autism are exactly alike [5]. The whole family is impacted when someone has ASD. Families who have to meet the complicated requirements of an individual with ASD may experience extreme emotional, financial, and occasionally even physical hardship [6].</p>
    </sec>
    <sec id="heading-b372f41d557030f46540916445684f74">
      <title>
        <bold id="_bold-2">Methods</bold>
      </title>
      <p id="_paragraph-10">Parents of children with autism spectrum disorder were the subjects of a descriptive cross-sectional study to assess their knowledge regarding the disorder's symptoms and how they deal with their children. The study began on 16 October 2024 to 30 March 2025.</p>
      <p id="_paragraph-11">The study included a sample of 100 male and female parents, collected from (My Family Center of autism and Enunciation in Al-Basrah city. The research data were collected by distributing a questionnaire to the parents of children. The questionnaire was accepted by the competent experts and created by scientific references about the research topic. The questionnaire consisted of 2 parts, the first part included questions about demographic information of parents and their children, while the second part contained 27 questions about the autism symptoms and dealing with autism children with autism. The results of the questionnaire questions, after being collected, were stored in tables in the Excel program for statistical analysis. The answer scores for the questions were [3] for the correct answer, [2] for the middle answer, and [1] for the wrong answer.</p>
      <p id="_paragraph-12">The data were collected, sorted, and subjected to statistical analysis using the program of SPSS version 26. Statistics included a T-test to calculate data rates, standard deviation, P-values, and significant differences.</p>
      <table-wrap id="_table-figure-1">
        <label>Table 1</label>
        <caption>
          <title>Likert scale interval for evaluating the score of knowledge</title>
          <p id="_paragraph-13" />
        </caption>
        <table id="_table-1">
          <tbody>
            <tr id="table-row-5a054dceae8064c6fca8ef556cc13e6c">
              <th id="table-cell-17aae680ee8b530396a62f0ef78f2c0c">Interval</th>
              <th id="table-cell-d579094c98eb121c05f36cdbced509a8">Cut-off Point</th>
              <th id="table-cell-77d70cf37423d3455bb07875958fd034">Assessment</th>
            </tr>
            <tr id="table-row-01e1eba39e0ac1c815e7c318bc2ed14f">
              <td id="table-cell-3a55158520afe3406f9d1c83c261deaf">-11.66</td>
              <td id="table-cell-a52e8bb665645103a0979c0b72f137ff">0.66</td>
              <td id="table-cell-5a9ea8df2591c068bc58a0bf263e22b8">Poor</td>
            </tr>
            <tr id="table-row-815945206950b8e43271bbdfd27c35dd">
              <td id="table-cell-88c391766f0c0a8b6c3a6bf13d77425e">1.67-2.33</td>
              <td id="table-cell-9d462b8a927a44f3476c707359357359">0.66</td>
              <td id="table-cell-eb22b677ec3c12f0440adbb71f9e260f">Moderate</td>
            </tr>
            <tr id="table-row-ed3cdf45e724a948b937367725c8fd9c">
              <td id="table-cell-1647ccaff7ba00583735d077c03724b2">2.34-3</td>
              <td id="table-cell-68afc541651624d7a058f504b524425a">0.66</td>
              <td id="table-cell-0db623edb713a8d6b59ee53ca4a5fc15">Good</td>
            </tr>
          </tbody>
        </table>
      </table-wrap>
    </sec>
    <sec id="heading-022fde46b6d5c518914a36f1259383d2">
      <title>
        <bold id="_bold-7">Results</bold>
        <bold id="_bold-8">and Discussion</bold>
      </title>
      <sec id="heading-105c846dd77371e393abafa7e514082e">
        <title>
          <bold id="_bold-11">A. </bold>
          <bold id="_bold-12">Results</bold>
        </title>
        <table-wrap id="table-figure-f2699a6ff89fe3e56f380566e2f07279">
          <label>Table 2</label>
          <caption>
            <title>Demographic information of parents who participated in the study</title>
            <p id="paragraph-94a78792e2cdcf6ffb014ec377ffcfe3" />
          </caption>
          <table id="table-c17f08d6a71e3b43cf028f94a4dfb6d3">
            <tbody>
              <tr id="table-row-f2c277a701b527ebb33e704f9ae4ac4b">
                <th id="table-cell-08ca4aafc2a22f08cf79ab99629ae64b">Demographic variables</th>
                <th id="table-cell-23c710829ecc8f0e991ea4235dc2afbe">Classes</th>
                <th id="table-cell-f348a79b127d99451d59fb3f4401947a">F</th>
                <th id="table-cell-2cccc36848eb8ae53fbbde4e89649fea">%</th>
              </tr>
              <tr id="table-row-138a3b08a7d11cfc7c91db2eedc3b5ba">
                <td id="table-cell-040fe6befd140e827dd98432114e525a" rowspan="4">Father work</td>
                <td id="table-cell-f71a0a0929d4d703a8544cf2b34e7d09">Employee</td>
                <td id="table-cell-d09cd96a1c822255ac0d8f5474d1464d">61</td>
                <td id="table-cell-fbe3b87d449e2aff2d0263d0792dfb55">61.0</td>
              </tr>
              <tr id="table-row-b6bc2587efaa404e7849516ba077b381">
                <td id="table-cell-3ee575aebfde3a34e484c170b1d06984">Military</td>
                <td id="table-cell-c923063d13e3b304810916e5881e7148">7</td>
                <td id="table-cell-7e73e1621735796a31db4780fb009f8a">7.0</td>
              </tr>
              <tr id="table-row-2da404bbe84eb0037d07ae3c34b593bb">
                <td id="table-cell-f7999f6dd555cc736ae55b888c729e08">Free job</td>
                <td id="table-cell-026ad0e07e89948cd24531a1f54788c5">32</td>
                <td id="table-cell-f955f111cf48244c58ea39a6316bee71">32.0</td>
              </tr>
              <tr id="table-row-007b2999bb694734c289a22d651f24db">
                <td id="table-cell-2534530036f2a68c06334c4ca529867d">Total</td>
                <td id="table-cell-569df7e91867bedb225073b38e0d958a">100</td>
                <td id="table-cell-1478c4188b720f7453674ef7d819d35e">100.0</td>
              </tr>
              <tr id="table-row-9da59a7df99adeb1f286c7f76407b68b">
                <td id="table-cell-eb8dca8950f9a718bdc0cc5633fcf3c3" rowspan="5">Study of the father</td>
                <td id="table-cell-63e8e6e20e43582fd175be9c79386d96">Primary</td>
                <td id="table-cell-4e14f0fa5d38b58c4a83415ee6fe097f">15</td>
                <td id="table-cell-e1fed5eb8c5ce5ae1b73f7480e74e79b">15.0</td>
              </tr>
              <tr id="table-row-f8681ea5609d5ede3c70ec314fe7a190">
                <td id="table-cell-0ed0c963ebdff03d447f72d4305e2ebc">Middle</td>
                <td id="table-cell-294db98be91828353adfa2bbbf041ea0">17</td>
                <td id="table-cell-5cdc13780e1e28c8818516a423a08fe1">17.0</td>
              </tr>
              <tr id="table-row-df4e2a1c208bdf4e2c9aa2d81aab908b">
                <td id="table-cell-79e3f2be343a938ff572da25e361daa1">Second</td>
                <td id="table-cell-46e4a316b37b41980f1effa4c096dec5">13</td>
                <td id="table-cell-c4c8f0e0398baf74fbf8f354d8191082">13.0</td>
              </tr>
              <tr id="table-row-cad61ad86a1650010c425f8b8e2aff2c">
                <td id="table-cell-0608987d68101e82c53212c8bc7d5a37">University</td>
                <td id="table-cell-8b596f76522a77acbb6569ad6324311b">55</td>
                <td id="table-cell-d2cfba9b89345c6a538139c59e2c206a">55.0</td>
              </tr>
              <tr id="table-row-13257b7221701268e90c7392e66a313f">
                <td id="table-cell-365e342d94573ad2471ab59b605b4835">Total</td>
                <td id="table-cell-9ce1ab3eaf29d743ada5608b6a4c59b6">100</td>
                <td id="table-cell-7cb8f10e900db94df2418e8f25ef5094">100.0</td>
              </tr>
              <tr id="table-row-48cddd1e65f13a7f8f2af449f12e522c">
                <td id="table-cell-1bc52f40d910711f057dfe92e22d5192" rowspan="3">Mother work</td>
                <td id="table-cell-f30eb70d232846f7c5573ddcedd2a6b5">Employee</td>
                <td id="table-cell-4bd874f2e382d89bd50cb1035e0dcb37">34</td>
                <td id="table-cell-e8ed062f824cc9f099781a77cb927107">34.0</td>
              </tr>
              <tr id="table-row-a9da800e4e1aa5c5d57e2e654532613d">
                <td id="table-cell-c47b0d58fcb395b949e0c091e35e9080">Housewife</td>
                <td id="table-cell-740a3f77e5b1496d61409e14d0e1964d">66</td>
                <td id="table-cell-26ea73f9a5a7128a916d39bb5ec41576">66.0</td>
              </tr>
              <tr id="table-row-50847fc7be2388774476fec6a49ab570">
                <td id="table-cell-722fbb7f86f9ed8766724d99c7e732cf">Total</td>
                <td id="table-cell-cc87b67e9d33739b29abad46c4aad18a">100</td>
                <td id="table-cell-587fd44356ab2e7bcc782cf07d7f3cb2">100.0</td>
              </tr>
              <tr id="table-row-eb0cf87d48f852df2e1eff86860be3b9">
                <td id="table-cell-7668a250e3080a8ffd3792991f9c3a7f" rowspan="5">Study mother</td>
                <td id="table-cell-f4dbd2dd3abf18f2baf8e6f63d6fced2">Primary</td>
                <td id="table-cell-c002dbd8f7960e1ec55f2551c6259c05">17</td>
                <td id="table-cell-fd15ca4b5d057aba764f7fbe1e91af81">17.0</td>
              </tr>
              <tr id="table-row-623213f997b56e48b306d8532e45ca0d">
                <td id="table-cell-159050624b0edcb56417c151a48de7f7">Middle</td>
                <td id="table-cell-eb6dfb31545af114b04be39ef3c36ab8">21</td>
                <td id="table-cell-480dff81759c1a46ea75b6053c347fd6">21.0</td>
              </tr>
              <tr id="table-row-36b591e8f7a54ab6c594323308ce89eb">
                <td id="table-cell-0bc2991cc6028ccfa9af3774adf92e9b">Secondary</td>
                <td id="table-cell-49c0d6537af27b2e4a3119f3de98a1ee">13</td>
                <td id="table-cell-d196ce48fcf11996a1dfec6aadfa4c7e">13.0</td>
              </tr>
              <tr id="table-row-db1e50daf63759db1a3350b94c68f8d0">
                <td id="table-cell-e32491d80909785a7a6b4be275147781">University</td>
                <td id="table-cell-fc6adf69df4a979df1f25de691386948">49</td>
                <td id="table-cell-01be33d58fe77b36202f7ae8b84c0419">49.0</td>
              </tr>
              <tr id="table-row-cd82e2a582635e4ca327fd9b1cb03a25">
                <td id="table-cell-c996735f5b21ef29addf791584c67d6f">Total</td>
                <td id="table-cell-66a4f635b5a57d38273ed18753a11e6b">100</td>
                <td id="table-cell-6516bd29bda5547b614fdfc207252d34">100.0</td>
              </tr>
              <tr id="table-row-3ed40655bd188ce59d180e8e8479a494">
                <td id="table-cell-cfe659c534b38fc94f9d31ea6355c724" rowspan="3">Address</td>
                <td id="table-cell-75f19259c813ad90af6b640ddfaf31dd">Rural</td>
                <td id="table-cell-ab36ab4e8a02464a751b547610a09790">14</td>
                <td id="table-cell-5fe2f45465d73545c582c571e277b9da">14.0</td>
              </tr>
              <tr id="table-row-0d090bff114df569165d03acd80a7355">
                <td id="table-cell-5482b943938bb73987e9433709e887e3">City center</td>
                <td id="table-cell-c3f999a7686c96fb94c4846e7d5b06ac">86</td>
                <td id="table-cell-f33ad240833244f919c75b53b10b0e47">86.0</td>
              </tr>
              <tr id="table-row-d46afe314088b5b4094a51b175129c4f">
                <td id="table-cell-0597e6ef5495432e75882d37ffd5b956">Total</td>
                <td id="table-cell-fa7c07f33ebb98b77981f10f457fbf31">100</td>
                <td id="table-cell-f5264dbc286e26c1e976941cd789a4dc">100.0</td>
              </tr>
              <tr id="table-row-4ea8df3f164d2c92c1facb09422ec212">
                <td id="table-cell-c3922658b0e074c3473e1d4f64a5ef59" rowspan="3">Marital status</td>
                <td id="table-cell-5ee46bcf47a274cfbe48c0facbd29c61">Married</td>
                <td id="table-cell-0dc72f6e0c287d60c9f52803756cc13f">92</td>
                <td id="table-cell-0e15ccda5511dbd050edb9b95b979b23">92.0</td>
              </tr>
              <tr id="table-row-5b45e425d05d8282b7991555827cf732">
                <td id="table-cell-057d3802381f4ad0eb50db5cd365c953">Single</td>
                <td id="table-cell-749724ff15192c873deeb3dc88e00e74">8</td>
                <td id="table-cell-01ce33b3f9e92a5d977945eb107fbdc3">8.0</td>
              </tr>
              <tr id="table-row-6a731ff2cf4e014ae03d5a895cd1005b">
                <td id="table-cell-5ddf1bee868b248a2057f37e4f4c5f7c">Total</td>
                <td id="table-cell-c02be3db91bf17ab3e5b1959abf3cd1e">100</td>
                <td id="table-cell-b3ce44b9d59825a4be662810ea1e52f3">100.0</td>
              </tr>
              <tr id="table-row-6db280caee5392dd1105a6dafd509971">
                <td id="table-cell-8b383787c8207afc7c35e066a301280a" rowspan="3">Gender of the child</td>
                <td id="table-cell-d8f59ce74e161c002ae4a85b6b462c9a">Male</td>
                <td id="table-cell-71ad5a05bb71b05923a4f09feedb80e6">74</td>
                <td id="table-cell-107a74270801c7d12930f8b99cb0c9e9">74.0</td>
              </tr>
              <tr id="table-row-f5f87f389b736ea3e3ce2d01bd49ec66">
                <td id="table-cell-8434f5472692be5172e4cb818cfb4ee7">Female</td>
                <td id="table-cell-6117c39dd525b88dacfccc1af4b87cf4">26</td>
                <td id="table-cell-058025e4a1434a57381a8161ae1635ec">26.0</td>
              </tr>
              <tr id="table-row-763fe340d9c70d1b4c71023e964ef7f4">
                <td id="table-cell-09dd44f04c44dfa2ba31e54f4f167df4">Total</td>
                <td id="table-cell-9a6e9aba46575098c0c2336f34aaf1da">100</td>
                <td id="table-cell-baa2c967bbfd2483cb102eadc9d54814">100.0</td>
              </tr>
              <tr id="table-row-4c061fce95c172182e25a07d6aa86c99">
                <td id="table-cell-aac7d3eef4fb2cd1668088cc4eec7907" rowspan="4">Economic</td>
                <td id="table-cell-2f94cc54f8b9a1f623ad6b1158537a41">High</td>
                <td id="table-cell-291c5aff2e2e07afb61d8fce43e12cb5">3</td>
                <td id="table-cell-93c5382013a24e612eb90b7542b25dd3">3.0</td>
              </tr>
              <tr id="table-row-7c9d339ba75b7a9b64337322be47d492">
                <td id="table-cell-a26555102cfb4923fe7a7cc229996b96">Mild</td>
                <td id="table-cell-fcc9eedef1acf0eaa434b5166b4afe2f">85</td>
                <td id="table-cell-1f4308a471c58a8c510e1bf3bf499f56">85.0</td>
              </tr>
              <tr id="table-row-44c3917dd348b7728e87844a271b2d89">
                <td id="table-cell-09a711d204d6f40fa85231d63d0c3b18">Poor</td>
                <td id="table-cell-89f0c41169dff9e48fced97925ce191e">12</td>
                <td id="table-cell-fb8ff2c9eae7f9c6bb21df958d41e74e">12.0</td>
              </tr>
              <tr id="table-row-ddb0ef985e57d08c69638e1745f10731">
                <td id="table-cell-a63fa9ea5032423f7913f264bf0c1c8f">Total</td>
                <td id="table-cell-72d1f4b8d91b27796c047c593ac62fcf">100</td>
                <td id="table-cell-31e30e0568643440a40f40abb0dae7a5">100.0</td>
              </tr>
              <tr id="table-row-aaa91e6fbd6e2c06d5db3e3c6672806d">
                <td id="table-cell-c98807db27cf37e9edb74664253a01bc" rowspan="3">Study of the child</td>
                <td id="table-cell-b0bc581c7eecd31e6a7269b5efe74e20">Continuous</td>
                <td id="table-cell-8566f2b7dd7dd130af056f1b340dfc78">18</td>
                <td id="table-cell-ba0ea97b77d59cd3aac96fea66f9e6c0">18.0</td>
              </tr>
              <tr id="table-row-5d36f7f3f4d7ba4386e7be51b7094dc4">
                <td id="table-cell-0fec3b75e50129037bf4a5ab0df0d375">Not continuous</td>
                <td id="table-cell-00684aec157e698788482130da2f92ce">82</td>
                <td id="table-cell-b0d8b34a872a860243f9b6fca1a21cd1">82.0</td>
              </tr>
              <tr id="table-row-af52195bc4b8a4682986add6050424d5">
                <td id="table-cell-9530ba690a760713067a8525072a5c17">Total</td>
                <td id="table-cell-7c7de7a429b9c019cabd556ceb0534dc">100</td>
                <td id="table-cell-d061fd33d0c95cbd9da85c53a58de432">100.0</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p id="_paragraph-19">This table shows the demographic characteristics of the parents who participated in the study project. The sample consisted of 100 fathers and mothers of children diagnosed with autism spectrum disorder (ASD). Among them, 61 were employed, 7 were in the military, and 32 were self-employed. Regarding education, 55 fathers and 49 mothers held university degrees. 92 participants were married, and 86 of the families resided in urban areas, while 14 were from rural regions. The majority of the children (74) were male, and 26 were female. Economically, 85 families were of a moderate level. Only 18 children were continuing their education, while 82 were not.</p>
        <table-wrap id="_table-figure-3">
          <label>Table 3</label>
          <caption>
            <title>Distribution of Parents’ Awareness of ASD Symptoms</title>
            <p id="_paragraph-20" />
          </caption>
          <table id="_table-3">
            <tbody>
              <tr id="table-row-da0b8d1ca9c5193555a1683a8813613b">
                <th id="table-cell-ec4c8d6eac452b77d6e6d9876c57b61e">%</th>
                <th id="table-cell-6e12af7c6357bffa2e84ec3f25c7909f">No. of Questions</th>
                <th id="table-cell-9e393ab6bb174339761abab4efb909c5">Assessment</th>
              </tr>
              <tr id="table-row-d3d287419879792d0e4754179b3cd5dd">
                <td id="table-cell-ab7665306d0429b2135736bce657fc95">25%</td>
                <td id="table-cell-ccbf7798ec95cc36048d1154dee6a1be">5</td>
                <td id="table-cell-4708958ef95239cd534ad0020a3b63e8">Poor</td>
              </tr>
              <tr id="table-row-42ec4077f6d9361cd85e4ae1d897fe0c">
                <td id="table-cell-a337ee9e4561f35f06f2a562d41840b1">50%</td>
                <td id="table-cell-48a29c2257864e6c4bc3a5949e4f9650">10</td>
                <td id="table-cell-dfa083789d12ce8e1b664a5fbbbd2093">Moderate</td>
              </tr>
              <tr id="table-row-748f56891994acce0318403434db91f7">
                <td id="table-cell-ed11573778f6cf58621b58005b43f905">25%</td>
                <td id="table-cell-781e6e442a0910a5629a35e963021696">5</td>
                <td id="table-cell-a9941c255a1b40c2a2bb12c68907da19">Good</td>
              </tr>
              <tr id="table-row-6f735d1f5f2a7fecb3ab9f4b87ca7ffc">
                <td id="table-cell-e9cb851e8a9e5c9f1d8af20663ab36a0">100%</td>
                <td id="table-cell-94da0e0ebce983a4d4615ed009c134b7">20</td>
                <td id="table-cell-38118e4228de973d441ea125cb314888">Total</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p id="_paragraph-22">This table presents the levels of parents’ awareness regarding the symptoms of autism spectrum disorder. The answers were categorized based on scoring into three levels: poor, moderate, and good. 25% of parents showed a good level of knowledge, 50% had moderate knowledge, and 25% had poor knowledge.</p>
        <table-wrap id="_table-figure-4">
          <label>Table 4</label>
          <caption>
            <title>Mean Score and Standard Deviation for Symptoms part</title>
            <p id="_paragraph-23" />
          </caption>
          <table id="_table-4">
            <tbody>
              <tr id="table-row-8002f2e106e355e05fd0492793578070">
                <th id="table-cell-22c2e2f0061cbf7245dab0650205a2ad" colspan="5">Mean Score</th>
              </tr>
              <tr id="table-row-6cc43bab18c9338af212a1f3b5057601">
                <th id="table-cell-7e1753a0a01593624eddbad4fd64f52b">Assessment</th>
                <th id="table-cell-07fccbe58a1f727905c3462e2a5af7d5">N</th>
                <th id="table-cell-f9c67df0483e12ec699041cbac5645bf">Mean score </th>
                <th id="table-cell-59d2a646971b4f1130bfab9e74503f71">Std. Deviation</th>
                <th id="table-cell-6691beb3fdbc90c4d5138477d6075378">Std. Error</th>
              </tr>
              <tr id="table-row-e1a963038405d167cc5f2b9f504b600d">
                <td id="table-cell-d2f24f1e5ddde5e60b87ae15d81d1b3e">Poor</td>
                <td id="table-cell-fc387a392e8639ae068626322d4fb17b">20</td>
                <td id="table-cell-9f96939d2e8b1fe995764a74bcb6a5b9">1.50</td>
                <td id="table-cell-6208ee7d7b0e5e2acad1624173f6a9be">0.108</td>
                <td id="table-cell-626c5da9cdd56c1cad55707e75f72440">0.024</td>
              </tr>
              <tr id="table-row-2fbb77de0a8ed9fdadb4e561664a9fd5">
                <td id="table-cell-af79c6b3c696e7849d7850391cff2253">Moderate</td>
                <td id="table-cell-2956f323e221f321c7e2c5ec61aafb4f">54</td>
                <td id="table-cell-02423bbf2d2c6b72c05a3ca1753540c5">1.99</td>
                <td id="table-cell-71c3554b882537d930135e71a3bd8b3e">0.161</td>
                <td id="table-cell-27e8ab21ca11ce9f38aee153c38e5781">0.021</td>
              </tr>
              <tr id="table-row-1e9203253a2de2308fc63ea5d232896c">
                <td id="table-cell-ec027e99da4ad777b7a3b57f75387f3f">Good</td>
                <td id="table-cell-ca0ea39ff522c7bfc0dc8f1e28b08b2f">26</td>
                <td id="table-cell-0a9fb90fdadaee84fc619ff61405a1c6">2.73</td>
                <td id="table-cell-6f20ef0603c0e536c7724489d85d42d8">0.224</td>
                <td id="table-cell-73ffabfa81039dadce3e3d3d18419845">0.043</td>
              </tr>
              <tr id="table-row-5a75115c6eaa576ecd76b65f7e8a7bfb">
                <td id="table-cell-03fcdeafd5b90c7de638118211340f7a">Total</td>
                <td id="table-cell-7ec825aaf02c4d98f8b27f67889508c8">100</td>
                <td id="table-cell-f9f9731f770a6cfe188787067821d7cc">2.08</td>
                <td id="table-cell-ead3bf990a5c9cea9853aa0ccf2605bb">0.459</td>
                <td id="table-cell-ecdaf5e9e953cbb9188c769b923159b2">0.045</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p id="_paragraph-25">This table summarizes the statistical measures related to parents’ answers in the symptoms section, showing the mean scores, standard deviation, and standard error for each category.</p>
        <table-wrap id="_table-figure-5">
          <label>Table 5</label>
          <caption>
            <title>ANOVA Test – Awareness of ASD Symptoms</title>
            <p id="_paragraph-26" />
          </caption>
          <table id="_table-5">
            <tbody>
              <tr id="table-row-457cb909f2aa1fb103e9a7eea174aed7">
                <th id="table-cell-bfd1ead6bda1a8b75920017a678d0399" colspan="6">ANOVA test</th>
              </tr>
              <tr id="table-row-c11da157ebd5a281c1ec83df66344c42">
                <th id="table-cell-d007c6e1b26e2e88aaf50bd7250c3d33" colspan="3">Significant</th>
              </tr>
              <tr id="table-row-86552b587e72475d54d5bfd31356ea03">
                <th id="table-cell-46e95e296f5cc34011a548c62bf15b83">Assessment </th>
                <th id="table-cell-706aa1e0179f73f2b533631704fad261">Frequency</th>
                <th id="table-cell-d1cdea728c6c1f8fd8b423b96cd5d3fe">Percent</th>
                <th id="table-cell-7e1fbdfeff7b2df61353da8ced351aeb">F – value</th>
                <th id="table-cell-35d1b171d82ba3d2f9a236ba27101c22">P – value</th>
                <th id="table-cell-8c00ad629a0b558e43e6fe329bd99223">Sig.</th>
              </tr>
              <tr id="table-row-880333d8f0afe342b29ce7909a2d1d8d">
                <td id="table-cell-6bcdb8c601a80f8f02ecf2cb119533a2">Poor</td>
                <td id="table-cell-4d46874573839dfafc4eeec854aca78a">20</td>
                <td id="table-cell-ee3e6c3c4d1f6e9a85e73520dcd3ce3b">20 %</td>
                <td id="table-cell-4240cf994ca94c91d4b78a90740e2bd0" rowspan="3">305.5</td>
                <td id="table-cell-d36c97a2c11c3a61c4c3afb1368e508e" rowspan="3">0.00</td>
                <td id="table-cell-647f398388a569e9f8b1718a724e4c36" rowspan="3">S</td>
              </tr>
              <tr id="table-row-9fb3052d926b0e89b09e7915ece90fc3">
                <td id="table-cell-4cf27ed90a1adac023e853adc94b2a08">Moderate</td>
                <td id="table-cell-ebdd8a1fb715a7182619e777be806d76">54</td>
                <td id="table-cell-b4c1725509ff4afb0c46f21ca2717468">54 %</td>
              </tr>
              <tr id="table-row-b2934ea84801a63cfb56408114ab37b1">
                <td id="table-cell-2a6a05e7dc0a85ee926cd6c90a500a89">Good</td>
                <td id="table-cell-255dae3afa7972e78887e1ddfc12805e">26</td>
                <td id="table-cell-45d84c40a91b81652c706f206439c2bb">26 %</td>
              </tr>
              <tr id="table-row-ef9a00284f5e902416cf49db033d9f39">
                <td id="table-cell-d9f9b71a831b9af0129ff162105bf656">Total</td>
                <td id="table-cell-f0ab93009095a1aa2b03539cb648c246">100</td>
                <td id="table-cell-a12edc0373a6fec3472d14258769a9d0">100 %</td>
                <td id="table-cell-5145c677e4c0cae5d728cd6fff090efa" colspan="3" />
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p id="_paragraph-28">This table presents the ANOVA test results, which show a statistically significant difference (P=0.00) among the parents’ awareness levels of autism symptoms.</p>
        <table-wrap id="_table-figure-6">
          <label>Table 6</label>
          <caption>
            <title>Distribution of Parents’ Knowledge of ASD Management Strategies</title>
            <p id="_paragraph-29" />
          </caption>
          <table id="_table-6">
            <tbody>
              <tr id="table-row-d07ac912d51f391676510f3711127239">
                <th id="table-cell-2513788ff1c3fd04a5fbabacba316bba">%</th>
                <th id="table-cell-7ac3039cd269b29cc77aaecf5d0284ba">No. of Questions</th>
                <th id="table-cell-ecdb1dc274374894545cf2ac0f14dd3d">Assessment</th>
              </tr>
              <tr id="table-row-c26a4754f1110e1aab1c4311627ca42c">
                <td id="table-cell-5388db8269012f4a76a35063fc962547">29%</td>
                <td id="table-cell-81293477809cfc2a0af0541844487edc">2</td>
                <td id="table-cell-5b67308442f201f890e6512e7e9da5b2">Poor</td>
              </tr>
              <tr id="table-row-fd426de90c2590bf9aef2b4ba7acfd76">
                <td id="table-cell-a8730fd67d9c83787e5fe77f18b03802">29%</td>
                <td id="table-cell-822674e1fe228e5838c22e5922c9db2a">2</td>
                <td id="table-cell-d76e438addfbabc36287b18d03c42d72">Moderate</td>
              </tr>
              <tr id="table-row-11bd8ad3b9440a746f38d68881d85208">
                <td id="table-cell-441365444160800095ae1a6e092bbb18">43%</td>
                <td id="table-cell-c0a65a3173c59520145ec26b438c2543">3</td>
                <td id="table-cell-66e2578a71b356b1ac6566a8436754a9">Good</td>
              </tr>
              <tr id="table-row-a85227b21085214f1f225ba250e83ecc">
                <td id="table-cell-40254ab19362105fa6849f1b7cc3dd7d">100%</td>
                <td id="table-cell-61be76bcb5a64c53fe56a1973cc7dfcd">7</td>
                <td id="table-cell-d768e0d7ab59f7d9d1d253c61c161a44">Total</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p id="_paragraph-31">This table displays parents’ responses to the questionnaire regarding strategies for dealing with ASD. 43% of parents revealed good knowledge, 29% had moderate knowledge, and 29% had poor knowledge.</p>
        <table-wrap id="_table-figure-7">
          <label>Table 7</label>
          <caption>
            <title>Mean Score and Standard Deviation for the Management Part</title>
            <p id="_paragraph-32" />
          </caption>
          <table id="_table-7">
            <tbody>
              <tr id="table-row-97d4177ebc034fc4693969668a70aa05">
                <th id="table-cell-4fdee113a7a7f58ca5b32ae20e03853e" colspan="5">Mean Score</th>
              </tr>
              <tr id="table-row-be77ff2b7cba12ac75ef1a9b661878b0">
                <th id="table-cell-a126fd48acecbc13537a971dd8bf2404">Assessment </th>
                <th id="table-cell-348841697f0b4f282d0248e53218e921">N</th>
                <th id="table-cell-30afb7571c866ab7061c727051b24294">Mean</th>
                <th id="table-cell-ee9d210735b14f1aa7bdf311e9f6579f">Std. Deviation</th>
                <th id="table-cell-386be98022e7dcca5ac44fa8d137d50e">Std. Error</th>
              </tr>
              <tr id="table-row-5d378ffc806bdae819b45f401bd111cb">
                <td id="table-cell-0cf4e65de37d6a7aa9ecc2338518d8bd">Poor</td>
                <td id="table-cell-905b5338c1a58155838aa3fe4c128853">20</td>
                <td id="table-cell-fabae0c97294727167e7f995f69539fa">1.50</td>
                <td id="table-cell-50e125ebbd8de03e668141ba8f88feaf">0.108</td>
                <td id="table-cell-7196c29aabda7db712c7be2a34519736">0.024</td>
              </tr>
              <tr id="table-row-b0f4c684b745791282cac7443e6588b5">
                <td id="table-cell-336711ea373691ca0c1fb4feca4b7263">Moderate</td>
                <td id="table-cell-171d9b7de9453872754f265976fc4e0b">54</td>
                <td id="table-cell-4389b6a63b5b8d31c20a9b6a08f122c1">1.99</td>
                <td id="table-cell-8d10172abf82cceb13292f180fd2d0a1">0.161</td>
                <td id="table-cell-fd9d481a2ebd9f04fea70ec163c76be1">0.021</td>
              </tr>
              <tr id="table-row-e4bff99c853898ffbca4d6ba7d63b596">
                <td id="table-cell-975d7660b9f2ceb6c17b36d8692575cc">Good</td>
                <td id="table-cell-e8146400dc637f8cc546068da5cf6fcf">26</td>
                <td id="table-cell-37dbdb72c0fd85b22543696d7b953756">2.73</td>
                <td id="table-cell-ac64df581ff7fd1ca68dabe4ef03b6a2">0.224</td>
                <td id="table-cell-3a69ddfcaf3f41a52d7bc3c464d4351e">0.043</td>
              </tr>
              <tr id="table-row-4d986760ea51cee919340283eeb15076">
                <td id="table-cell-71bdcd3937323b7116f4a98bd18ceb80">Total</td>
                <td id="table-cell-8ddf3d3d0b8c49055559445660a785b4">100</td>
                <td id="table-cell-99095ee060b078cece65e20fcdbe2674">2.08</td>
                <td id="table-cell-8383d3f8d37f39f41a56e5ac1fc88405">0.459</td>
                <td id="table-cell-6a0fa5375d03ae826ae98069c0e2e423">0.045</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p id="_paragraph-34">This table presents the statistical analysis of parents’ knowledge and awareness regarding ASD management strategies, including the average scores and variation within each category.</p>
        <table-wrap id="_table-figure-8">
          <label>Table 8</label>
          <caption>
            <title>ANOVA Test – Knowledge of ASD Management Strategies</title>
            <p id="_paragraph-35" />
          </caption>
          <table id="_table-8">
            <tbody>
              <tr id="table-row-60c928e5dd9edaea2ba70c2cfabf67c1">
                <th id="table-cell-08b13db0717ce07a5b4f8ea088652738" colspan="6">ANOVA test</th>
              </tr>
              <tr id="table-row-adf5e3c007d68731511f8a1e6ea7f322">
                <th id="table-cell-3b8effd24a646c53dbf78934e93cf406" colspan="3">Significant </th>
              </tr>
              <tr id="table-row-397fb4b72aa6f4183ade91beb882ba59">
                <th id="table-cell-dd9a738006144b1e1334440ac912acf0">Assessment</th>
                <th id="table-cell-2031595b6bda26a7c87ea776798a4949">Frequency</th>
                <th id="table-cell-9fddb5a039e6c40a7cd8051f9ea47bff">Percent</th>
                <th id="table-cell-da080cdc79fad48096d4c90432319738">F - value</th>
                <th id="table-cell-68c719c748fff02999c0c53d7c49d3e7">P – value</th>
                <th id="table-cell-4dc57742da648cb4ad62aaed461fb22b">Sig.</th>
              </tr>
              <tr id="table-row-34d27e5d809a3923d4a36584c531e7ea">
                <td id="table-cell-7ebc816960a347e72bb235b5eb168cd0">Poor</td>
                <td id="table-cell-c855e2df6257458e75aa64d3ab4b3464">30</td>
                <td id="table-cell-03d40be5fd46b018fe23731bbd8994d0">30 %</td>
                <td id="table-cell-4f877184a711fad71f2462b86016fcf0" rowspan="3">1.18</td>
                <td id="table-cell-3bc88f593ebe9112e4de65b59c9e3d72" rowspan="3">0.00</td>
                <td id="table-cell-85fe91537f1254800e0608363ad4fe41" rowspan="3">S</td>
              </tr>
              <tr id="table-row-aa4f7b88b35802f22701d543bac3e40e">
                <td id="table-cell-301312408004fe7058fe64703d3988e4">Moderate</td>
                <td id="table-cell-b5dfbe95c7de39c44dd9ac10bc5baea2">33</td>
                <td id="table-cell-7b66cd348cc52ca3e524eb98ebfcb9a8">33 %</td>
              </tr>
              <tr id="table-row-7acd0d6330b51f753b9ee62c93d8348f">
                <td id="table-cell-8c8716e36aaa978dca380aca21c13c9e">Good</td>
                <td id="table-cell-36c41f0a24e0bab5e46d8f2d4c81fe57">37</td>
                <td id="table-cell-ad62a2ed1c121ea58a1e0c1848022885">37 %</td>
              </tr>
              <tr id="table-row-cf079a6e1e48a6f20bdeac11e6d852c5">
                <td id="table-cell-6b84b228bebcfe7e9a8a439f82123c9d">Total</td>
                <td id="table-cell-021372a02ee774e69bf5f764c4df9f59">100</td>
                <td id="table-cell-b0b430dc11e927058692dc7f1a03f9fc">100 %</td>
                <td id="table-cell-395e210ebacf29ae95ca70e03a248dc7" colspan="3" />
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p id="_paragraph-37">This table presents the ANOVA test results, which show a statistically significant difference (P = 0.00) among the parents’ knowledge and awareness levels of autism management strategies.</p>
      </sec>
      <sec id="heading-253d75a13077af67e9b560e3b4aa8ee2">
        <title>
          <bold id="_bold-65">B. </bold>
          <bold id="_bold-66">Discussion</bold>
        </title>
        <p id="_paragraph-39">Raising awareness about autism spectrum disorder (ASD) plays a crucial role in early diagnosis, intervention, and long-term management of the condition. When parents are well-informed about the symptoms of autism and support strategies, the overall quality of life and outcomes for children with autism significantly improve [7].</p>
        <p id="_paragraph-40">Our study, which is based on a sample of 100 participants, showed that 20% of parents had poor awareness of autism symptoms, 54% had moderate awareness, and only 26% were strongly aware. This result aligns with a study conducted in Saudi Arabia, where many parents were able to recognize some symptoms but lacked comprehensive knowledge about the disorder [8].</p>
        <p id="_paragraph-41">Some of the main symptoms of autism include a lack of eye contact, delayed speech, repetitive behaviors, and unusual sensory responses [9]. Early recognition of these symptoms is crucial, as studies have shown that early diagnosis and intervention can improve cognitive and behavioral outcomes for children with autism [10].</p>
        <p id="_paragraph-42">However, the moderate awareness among parents in our sample highlights the need for organized educational programs to increase knowledge about autism [11].</p>
        <p id="_paragraph-43">Our results showed variation in parents’ knowledge of autism management strategies: 30% had poor knowledge, 33% had moderate knowledge, and 37% had strong knowledge of strategies such as Applied Behavior Analysis (ABA) and speech therapy. This is consistent with previous literature emphasizing the importance of parent training and increased awareness to ensure effective intervention in autism cases [12].</p>
        <p id="_paragraph-44">Applied Behavior Analysis (ABA) is a widely recognized treatment that uses structured reinforcement to encourage positive behaviors in children with autism [13]. In addition to ABA, other effective treatments include speech therapy and occupational therapy, which help improve communication and daily functioning [14]. Research also shows that creating structured environments at home promotes adaptability and reduces anxiety in children with autism [15].</p>
        <p id="_paragraph-45">In the Iraqi context, as in many cultures, misconceptions and social stigma affect how autism is perceived. Some common misconceptions among parents include the belief that vaccines cause autism or that individuals with autism cannot lead an independent life. These misconceptions are not unique to Iraq; global studies point to similar cultural beliefs that hinder early diagnosis and intervention [16].</p>
        <p id="_paragraph-46">These misconceptions require nationwide awareness campaigns and culturally sensitive educational programs to dispel myths and encourage early treatment [17]. Parents in our study frequently mentioned feelings of stress, anxiety, and emotional burden. These results support global research indicating that families often face high psychological pressure and social isolation [18].</p>
        <p id="_paragraph-47">The financial challenge is also a major issue due to the cost of treatment and specialized care. This is reflected in our participants’ responses, where many highlighted the need for support from governments or NGOs. Studies show that providing psychological counseling and support groups for parents can significantly reduce these burdens [19]. Our results are consistent with global literature. A comparative study in Europe showed that most parents lack detailed knowledge about autism, especially regarding management techniques [20].</p>
        <p id="_paragraph-48">These global challenges reflect those present in our Iraqi sample and emphasize the need for comprehensive and locally tailored solutions that align with cultural and social dynamics [21]. Improving awareness among parents and management strategies is crucial for early detection of autism and better outcomes for affected children. Based on our study and global evidence, we recommend:</p>
        <p id="_paragraph-49">Implementing community-level awareness campaigns for parents [17].</p>
        <p id="_paragraph-50">Providing training programs on evidence-based interventions such as ABA. Combating misconceptions through culturally sensitive public health strategies [22]. Offering psychological and financial support to families with children with autism [18].</p>
        <p id="_paragraph-51">The study concludes that a knowledge gap exists, necessitating enhanced awareness efforts, especially among individuals with limited education and access to resources.</p>
      </sec>
    </sec>
    <sec id="heading-903fd905049b85876440bb76c9ad8f83">
      <title>
        <bold id="_bold-67">Conclusion</bold>
      </title>
      <p id="_paragraph-53">Out of 100 participating parents, the majority of mothers were housewives, and more than half of all participants held a university degree. Parents’ knowledge of ASD symptoms varied: one-quarter demonstrated good knowledge, half of the parents had a moderate level, and one-quarter showed poor understanding. In terms of management strategies, one-quarter had good knowledge, half of the parents had moderate knowledge, and one-quarter of the parents had poor knowledge.</p>
      <p id="_paragraph-54">
        <bold id="_bold-68">Recommendations</bold>
      </p>
      <p id="_paragraph-55">Enhancing Parental Awareness – Raise parents’ awareness of autism spectrum disorder (ASD) and emphasize the importance of early intervention through educational programs and media campaigns. Improving Understanding and Interaction – Provide training sessions on effective communication techniques and behavioral strategies to better support children with ASD. Promoting Awareness Programs – Launch community-based awareness campaigns aimed at reducing stigma and promoting the social inclusion of children with autism. Providing Reliable Resources – Ensure parents have access to accurate, evidence-based information through specialized centers and educational platforms. Encouraging Research and Studies – Support ongoing research focused on advanced diagnostic methods and innovative intervention strategies to improve the quality of autism care.</p>
    </sec>
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