title: Employment impact and financial burden for families of children with fragile X syndrome: findings from the National Fragile X Survey.
abstract: BACKGROUND
  The employment impact and financial burden experienced by families of children with fragile X syndrome (FXS) has not been quantified in the USA.
  
  
  METHODS
  Using a national fragile X family survey, we analysed data on 1019 families with at least one child who had a full FXS mutation. Out-of-pocket expenditures related to fragile X were reported. We used logistic regression to examine the role of insurance, number of affected children, and number of total co-occurring conditions in predicting the financial burden and employment impact of FXS, while adjusting for race, education, marital status and other sociodemographic predictors.
  
  
  RESULTS
  Almost half of families affected by FXS reported that they had experienced an increased financial burden and nearly 60% stated that they had had to change work hours or stop work because of FXS. Families with health insurance that met family needs were significantly less likely to report an excess financial burden. The type of insurance (private or public) was not associated with the reported financial burden. Affected children's mutation status, especially male children with the full mutation, was associated with employment impact. The total number of co-occurring conditions was associated with both financial burden and employment impact.
  
  
  CONCLUSIONS
  Families affected by FXS experienced a significant employment impact and financial burden. Policies designed to help families with FXS need to take into consideration the dimension of co-occurring conditions.
authors.affiliation: Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. eop9@cdc.gov
authors.forename: L
authors.initials: L
authors.lastname: Ouyang
authors.forename: S
authors.initials: S
authors.lastname: Grosse
authors.forename: M
authors.initials: M
authors.lastname: Raspa
authors.forename: D
authors.initials: D
authors.lastname: Bailey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004651:Employment / Q000706:statistics & numerical data*; D005192:Family Health; D017407:Family Leave / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005600:Fragile X Syndrome / Q000191:economics* / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult