Journal of Autism and Developmental Disorders

, Volume 49, Issue 10, pp 4355–4362 | Cite as

The Internet’s Effect on Parental Trust in Pediatrician Diagnosis of Autism and Likelihood of Seeking a Second Opinion

  • Tammy Pham
  • Anna Kuznetsova
  • Haelynn Gim
  • Kyla Cordrey
  • Ruth MilanaikEmail author
Brief Report


This study assessed how web-based information affects parental trust in physician’s diagnosis of autism (PDA) and likelihood of seeking a second opinion. Participants of an online survey were randomly allocated to one of three hypothetical scenarios, all were given a vignette of a non-verbal 18-month-old child followed by (1) not viewing Internet results, (2) viewing results suggesting autism, or (3) viewing results suggesting language delay and rated their trust and likelihood of seeking a second opinion. When Internet results contradicted PDA, parents reported less trust in PDA and greater likelihood of seeking a second opinion. Due to the Internet’s influence on parents’ response to PDA, clinicians should discuss their differential diagnosis with parents, address Internet-related concerns, and recommend trustworthy sources.


Physician trust Internet Autism Parents 



No external sources of funding were secured for this study.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.


  1. Allen, K., & Rainie, L. (2002). Parents online. Pew Internet and American Life Project.Google Scholar
  2. Altiere, M. J., & von Kluge, S. (2009). Searching for acceptance: Challenges encountered while raising a child with autism. Journal of Intellectual & Developmental Disability, 34(2), 142–152. Scholar
  3. Beykikhoshk, A., Arandjelović, O., Phung, D., Venkatesh, S., & Caelli, T. (2015). Using twitter to learn about the autism community. Social Network Analysis and Mining, 5(1), 22. Scholar
  4. Bhandari, N., Shi, Y., & Jung, K. (2014). Seeking health information online: Does limited healthcare access matter? Journal of the American Medical Informatics Association, 21(6), 1113–1117. Scholar
  5. Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon’s mechanical Turk: A new source of inexpensive, yet high-quality, data? Perspectives on Psychological Science, 6(1), 3–5.CrossRefGoogle Scholar
  6. CDC. (2018). Autism spectrum disorder (ASD) research & tracking.
  7. Chou, W.-Y. S., Oh, A., & Klein, W. M. P. (2018). Addressing health-related misinformation on social media. JAMA, 320(23), 2417–2418. Scholar
  8. Cox, E. D., Smith, M. A., & Brown, R. L. (2007). Evaluating deliberation in pediatric primary care. Pediatrics, 120(1), e68–e77.CrossRefPubMedGoogle Scholar
  9. Da Paz, N. S., Siegel, B., Coccia, M. A., & Epel, E. S. (2018). Acceptance or despair? Maternal adjustment to having a child diagnosed with autism. Journal of Autism and Developmental Disorders, 48(6), 1971–1981. Scholar
  10. Diaz, J. A., Griffith, R. A., Ng, J. J., Reinert, S. E., Friedmann, P. D., & Moulton, A. W. (2002). Patients’ use of the internet for medical information. Journal of General Internal Medicine, 17(3), 180–185.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54(7), 580–587. Scholar
  12. Eysenbach, G., & Köhler, C. (2002). How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. BMJ, 324(7337), 573–577.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Halbert, C. H., Armstrong, K., Gandy, O. H., & Shaker, L. (2006). Racial differences in trust in health care providers. Archives of Internal Medicine, 166(8), 896–901.CrossRefPubMedGoogle Scholar
  14. Hesse, B. W., Nelson, D. E., Kreps, G. L., et al. (2005). Trust and sources of health information: The impact of the internet and its implications for health care providers: Findings from the first health information national trends survey. Archives of Internal Medicine, 165(22), 2618–2624. Scholar
  15. Internet World Stats. (2019).
  16. Kuehn, B. M. (2013). More than one-third of US individuals use the internet to self-diagnose. JAMA, 309(8), 756–757.CrossRefPubMedGoogle Scholar
  17. Liptak, G. S., Orlando, M., Yingling, J. T., Theurer-Kaufman, K. L., Malay, D. P., Tompkins, L. A., et al. (2006). Satisfaction with primary health care received by families of children with developmental disabilities. Journal of Pediatric Health Care, 20(4), 245–252. Scholar
  18. Mehta, S. K., & Richards, N. (2002). Parental involvement in pediatric cardiology outpatient visits. Clinical Pediatrics, 41(8), 593–596.CrossRefPubMedGoogle Scholar
  19. Moseley, K. L., Clark, S. J., Gebremariam, A., Sternthal, M. J., & Kemper, A. R. (2006). Parents’ trust in their child’s physician: Using an adapted trust in Physician Scale. Ambulatory Pediatrics, 6(1), 58–61.CrossRefPubMedGoogle Scholar
  20. Murray-García, J. L., Selby, J. V., Schmittdiel, J., Grumbach, K., & Quesenberry, C. P., Jr. (2000). Racial and ethnic differences in a patient survey: Patients’ values, ratings, and reports regarding physician primary care performance in a large health maintenance organization. Medical Care, 38, 300–310.CrossRefPubMedGoogle Scholar
  21. Paolacci, G., & Chandler, J. (2014). Inside the Turk: Understanding mechanical Turk as a participant pool. Current Directions in Psychological Science, 23(3), 184–188. Scholar
  22. Pehora, C., Gajaria, N., Stoute, M., Fracassa, S., Serebale-O’Sullivan, R., & Matava, C. T. (2015). Are parents getting it right? A survey of parents’ internet use for children’s health care information. Interactive Journal of Medical Research, 4(2), e12. Scholar
  23. Scullard, P., Peacock, C., & Davies, P. (2010). Googling children’s health: Reliability of medical advice on the internet. Archives of Disease in Childhood, 95(8), 580–582. Scholar
  24. Siklos, S., & Kerns, K. A. (2007). Assessing the diagnostic experiences of a small sample of parents of children with autism spectrum disorders. Research in Developmental Disabilities, 28(1), 9–22. Scholar
  25. Sillence, E., Briggs, P., Harris, P., & Fishwick, L. (2007). Going online for health advice: Changes in usage and trust practices over the last five years. Interacting with Computers, 19(3), 397–406. Scholar
  26. Sood, N., Jimenez, D. E., Pham, T. B., Cordrey, K., Awadalla, N., & Milanaik, R. (2019). Paging Dr. Google: The effect of online health information on trust in pediatricians’ diagnoses. Clinical Pediatrics, 58(8), 889–896. Scholar
  27. Suma, K., Adamson, L. B., Bakeman, R., Robins, D. L., & Abrams, D. N. (2016). After early autism diagnosis: Changes in intervention and parent-child interaction. Journal of Autism and Developmental Disorders, 46(8), 2720–2733. Scholar
  28. Tang, H., & Ng, J. H. K. (2006). Googling for a diagnosis—Use of google as a diagnostic aid: internet based study. BMJ, 333(7579), 1143–1145. Scholar
  29. Ulrich, C. M., & Ratcliffe, S. J. (2007). Hypothetical vignettes in empirical bioethics research. In L. Jacoby & L. A. Siminoff (Eds.), Empirical methods for bioethics: A primer (Advances in Bioethics, Vol. 11, pp. 161–181). Bingley: Emerald Group Publishing Limited.Google Scholar
  30. Wise, M. D., Little, A. A., Holliman, J. B., Wise, P. H., & Wang, C. J. (2010). Can state early intervention programs meet the increased demand of children suspected of having autism spectrum disorders? Journal of Developmental and Behavioral Pediatrics, 31(6), 469–476. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Tammy Pham
    • 1
  • Anna Kuznetsova
    • 1
  • Haelynn Gim
    • 1
  • Kyla Cordrey
    • 1
  • Ruth Milanaik
    • 1
    Email author
  1. 1.Division of Developmental and Behavioral PediatricsSteven and Alexandra Cohen Children’s Medical Center of New YorkLake SuccessUSA

Personalised recommendations