Autism Across Cultures: Perspectives From Non‐Western Cultures and Implications for Research

Abstract

Autism exists worldwide across geographical and cultural boundaries. Even though the situation is changing for the better, far less research on autism has been conducted to date in non‐Western cultures compared to Western cultures. Research evidence clearly demonstrates that culture impacts behavior relevant to autism. It is therefore important to understand how culture influences the expression of autism, as well as the effect of culture on how autism is perceived, understood, diagnosed, supported, and treated. This chapter reviews current perspectives on autism from non‐Western cultures and suggests that further work in this area will lead to improved understanding of the universality of autism, the causes, the cognitive and behavioral profile, and how best to improve outcomes for those affected.

Sleep Disturbances and Associated Factors in Chinese Children with Autism Spectrum Disorder: A Retrospective and Cross-Sectional Study

“…The observed cross-cultural differences between Chinese children and their Western counterparts might help to identify culturally-specific risk and protective factors for sleep disturbances. Currently, ASD treatment in China is limited, expensive, often not evidence-based [35]. This study indicates a promising and culturally-tailored treatment focus on sleep disturbances and associated sociodemographic factors and emotional/behavioral problems to improve outcomes for Chinese children with ASD.…”

“…These include profoundly undeveloped healthcare and education resources, high child-rearing cost to families, limited knowledge of sleep disturbances and ASD among professionals, teachers and parents, and stigmatization of problems in children that may contribute to parental unwillingness to report problems or to seek help [31][32][33][34]. In recent years, the increasing recognition that culture has great impact on ASD [35] highlights the importance of investigating characteristics and associated risk factors of sleep disturbances in Chinese children with ASD utilizing a cross-cultural perspective.…”

Wellbeing of mothers of children with “A-U-T-I-S-M” in Malaysia: An interpretative phenomenological analysis study

“…Research on parents of children with ASD has largely been limited to families in Western or developed countries (Daley, 2002;Freeth et al, 2014), but more recently, researchers have highlighted the importance of cross-cultural research (e.g., Daley et al, 2013;Norbury & Sparks, 2013). Given the limited ASD research in South-East Asia and in particular Malaysia, researchers have noted that there is a tremendous need for more investigation (e.g., Clark et al, 2012;Golden & Liaw, 2015;Ilias, Ponnusamy, & Normah, 2008;Neik et al, 2014).…”

“…Problematically, however, limited research has examined ASD within developing, low-to-middle income, and non-Western countries (Daley, Singhal, & Krishnamurthy, 2013;Freeth, Milne, Sheppard, & Ramachandran, 2014). In Malaysia, a developing, middleincome country with a multi-ethnic population comprised of three ethnicities as well as indigenous tribes, very limited awareness and support resources for raising a child with ASD are available (Clark, Brown, & Karrapaya, 2012;Neik, Lee, Low, Chia, & Chua, 2014;Toran, 2011).…”

Cultural Adaptation and Translation of Outreach Materials on Autism Spectrum Disorder

“…While there have been attempts to translate autism-related screening and diagnostic materials into different languages, and while it is widely recognized that cultural beliefs about diagnosis, treatment and causes influence family decision making about healthcare, and ASD specifically (Spicer 2010; Stahmer et al 2011; Ravindran and Myers 2012; Guinchat et al 2012; Freeth et al 2013) few researchers describe the processes of cultural adaptation or employ ethnographic methods. Guo et al (2011: 715), for example, report on the clinical results of a translation and validation of the Autism Spectrum Screening Questionnaire (ASSQ) into Mandarin but do not report on the process beyond noting that the tool was translated by native-speaking experts who made “minor changes” to ensure the translation was “more culturally appropriate.” Similarly, Canal-Bedia et al (2010), in a study of the Modified Checklist for Autism in Toddlers (M-CHAT) in Spain, write that “some modifications were made to items 3, 5, and 23, after the short pilot study and prior to the validity study, in order to overcome cultural differences linked to the use of different toys in Spain (including new examples, and Spanish colloquialisms), but do not describe how those decisions were made, or how differences in types of toys between Spain and the U.S. constitute “cultural” difference.…”