Minority outreach

Many obstacles line the road to early diagnosis and treatment for children with autism, including a lack of both awareness and access to medical care.

One of these roadblocks can be parents’ own inability — or refusal — to recognize their child’s symptoms. A new study published in the May issue of the Journal of the Canadian Academy of Child and Adolescent Psychiatry shows that some immigrant parents of children with autism attribute their child’s problems to a simple developmental delay or communication problem.

That may be because these parents wish to envision a happy future for their child, the researchers suggest.

The researchers surveyed 32 mothers and 12 fathers of 35 children; the parents are Canadian immigrants from 33 countries across four continents. The children, ranging in age from 2 to 15 years, were referred by educators, speech therapists or pediatricians to a health center in Montreal; 21 of the children were under 5. Clinicians assessed the children with several tests, including the Autism Diagnostic Observation Schedule, which is known to be culturally sensitive.

Of the 35 children, 16 have a diagnosis of autism and 13 have pervasive developmental disorder-not other specified (PDD-NOS), which is characterized by features of autism such as repetitive behavior or impaired social interactions. Five children have Asperger syndrome, a milder form of autism, or receptive-expressive language disorder, meaning they have trouble understanding others. One child does not have a diagnosis.

A few parents in the study said their child does not have any problems, and considered any mention of autism or delays insensitive. Two mothers from South Asia appeared to be afraid when the interviewer used the word ‘problem,’ the researchers say. These children tended to be aged 5 or older and have less severe symptoms that their parents often attributed to shyness.

Mothers from Asia, Latin America and the Caribbean are more likely than those from the Arab world, Africa, Europe and North America to say that their children have developmental delays, communication issues or no problems at all.

In an effort to raise awareness among immigrant and minority families, the nonprofit advocacy and research organization Autism Speaks has created a public service campaign.

The ads are intended specifically for African-American and Hispanic families: Children from these minority groups and those from low-income families are diagnosed with autism at older ages than children in the general population.

The ads show children with autism behaviors, such as avoiding eye contact and not smiling or babbling, and their parents making excuses for that behavior. By recognizing the signs of autism, the ads say, “Early diagnosis can make a lifetime of difference.”

Intervening early, between the ages of 18 and 30 months, helps children improve their language and behavioral skills, according to some studies.

All families need access to community services that provide accurate information about child development and autism. Immigrant families, who are often coping with culture shock and a new language, may especially benefit from these services, the researchers say.