Title: “Out of Sight out of Mind”: Attentional Characteristics in Mothers Who Have Children
with Autism
Version: 2 Date: 17 Jul 2024
Reviewer's report:
Review of the Manuscript: “Out of Sight out of Mind”: Attentional Characteristics in Mothers
Who Have Autistic Children
General Overview
The manuscript titled “Out of Sight out of Mind”: Attentional Characteristics in Mothers Who
Have Autistic Children" investigates the attentional biases in mothers of children with autism
spectrum disorder (ASD) compared to mothers of typically developing (TD) children using a
modified dot-probe task. This study aims to shed light on the mental health and well-being of
these mothers, an important research area given the rising prevalence of ASD and its significant
impact on families.
Strengths of the Manuscript
Relevance and Importance: The study addresses a crucial and under-researched topic—the
psychological well-being of mothers who are primary caregivers to children with ASD. This has
significant implications for clinical practices and support interventions.
Methodology: The use of a modified dot-probe task is well-suited for assessing attentional
biases. Incorporating established measures such as the Autism Spectrum Quotient (AQ-Child)
and the Chinese Attention to Positive and Negative Inventory (APNI) enhances the study's
methodological rigor.
Results: The findings that mothers of autistic children show attentional avoidance of negative
emotional words offer new insights into their cognitive-emotional processing. These insights
can be pivotal in developing targeted interventions to support these mothers.
Areas for Improvement
Literature Review and Theoretical Framework: The introduction needs a more comprehensive
review of existing literature on attentional biases in caregivers of children with disabilities.
Expanding the theoretical framework would better position the study within the broader context
of cognitive and emotional processing research.
Sample Size and Recruitment: The sample size, although justified, is relatively small.
The recruitment process should be described in more detail to ensure transparency and
reproducibility. Addressing potential sampling biases and their impact on the generalizability
of the findings is also crucial.
Data Analysis and Interpretation: While the statistical analyses are sound, the interpretation of
the results could be more nuanced. The discussion should delve deeper into the implications
of the attentional bias findings and explore alternative explanations. Additionally, considering
uncontrolled variables such as the mothers' mental health status or socio-economic background
is important.
Limitations and Future Directions: The limitations section should be more detailed. For example,
the cross-sectional design limits causal inferences. The authors should suggest specific future
research directions, such as longitudinal studies to examine changes in attentional biases over
time or using neuroimaging techniques to understand underlying neural mechanisms.
Ethical Considerations: While the manuscript mentions ethical approval, a more detailed account
of how ethical considerations were addressed, particularly regarding informed consent and the
handling of sensitive data, would be beneficial.
Conclusion and Recommendation
Overall, the manuscript addresses a significant and relevant research question with appropriate
methodology and meaningful findings. However, substantial revisions to the literature review,
data interpretation, and discussion sections are needed to strengthen its theoretical grounding and
practical implications. Given these considerations, I recommend a revise and resubmit decision
for BMC Women’s Health.