Autism Disparities: A Systematic Review and Meta-Ethnography of Qualitative Research

Abstract

Racial, ethnic, and socioeconomic disparities associated with autism spectrum disorder (ASD) are evident across many service domains including access to early assessment, diagnosis, and therapeutic interventions. To better understand the complex social and structural factors contributing to these disparities, this article offers a systematic review of peer-reviewed qualitative research conducted from 2010 to 2016 in the United States that investigates autism disparities experienced by marginalized communities. Based on these criteria, we identified 24 qualitative research studies and conducted an analysis using meta-ethnography and an intersectional interpretive lens. We identified three interdependent themes contributing to autism disparities, including familial, cultural, and structural barriers. Omissions in the literature were also evident, including a lack of research on underserved adults with ASD and the gendered inequities of caregiving. We discuss the implications of our findings and offer new questions that take an intersectional approach using qualitative research to investigate autism disparities.

Considerations in implementing evidence-based early autism spectrum disorder interventions in community settings

“…Some researchers have begun to develop culturally relevant ASD interventions to meet the needs of diverse communities in the US, including Black and Latinx children with ASD, as racial and ethnic disparities persist even after controlling for socioeconomic differences (29,31,79). The majority of US studies have investigated service disparities between Black, Latinx, and White children and their families, although emerging research has identified barriers for Asian immigrant communities as well (80,81). Globally, researchers have culturally adapted EBPs, for example using a task-shifting approach in South Asia, and a combined parent-teacher training model for refugee families in Turkey (27,82).…”

Implementing early intervention for autism spectrum disorder: a global perspective

“…However, ASD research has disproportionately low representation from populations outside of the United States and Europe (7). Even in countries such as the United States, where the majority of ASD research has been conducted, there is limited representation from minority groups, multilingual families, and participants with lower socioeconomic status (8).…”

Psychoeducational Interventions for Adults With Level 3 Autism Spectrum Disorder: A 50-Year Systematic Review

“…Females with ASD–3 have been suspected as having different clinical phenotypes and psychosocial factors from males with the same diagnosis (Lai et al, 2015) and arguably are exposed to different sociocultural environments and expectations in most cultures (Lips, 2017). Gender, ethnic/cultural, and socioeconomic differences are, therefore, likely to be worthwhile factors for investigation, specifically in terms of how these differences may moderate intervention efficacy (Gerber et al, 2017; Singh and Bunyak, 2019).…”