Autism Spectrum and Other Neurodevelopmental Disorders in Children of Immigrants: A Brief Review of Current Evidence and Implications for Clinical Practice

Abstract

Children of immigrants may have higher neurodevelopmental risks than those of non-immigrant populations. Yet, some evidence suggests that this group may receive late diagnosis, and therefore miss beneficial early interventions. Clinicians may misattribute symptoms of disorders to other social, behavioral or language problems. Likewise, there might be cultural differences in parents' likelihood of perceiving or reporting first developmental concerns to clinicians. Population-based standardized screening may play an important role in addressing ethnic inequalities in the age at diagnosis, although further research focusing on cross-cultural use is necessary. Once children are diagnosed, clinicians may rely on culturally sensitive procedures (translation services, cultural mediators) to increase the accessibility of interventions and improve adherence among immigrant families. In this brief review, we provide an overview about what is currently known about the epidemiology and risk factors of neurodevelopmental disorders, paying special attention to autism spectrum disorder (ASD), in children of immigrants and suggest the necessity of population-based screening and culturally sensitive care.

Migration is associated with baseline severity and progress over time in autism spectrum disorder: Evidence from a French prospective longitudinal study

“…Stigma and discrimination are common elements in the community that culminate in shame and guilt. Therefore, the parents of children with ASD might feel embarrassed of their situation, prompting the withdrawal of the child from the public eye [ 6 ]. A lack of social support also means that parents might not have the right structure to deal with their children with ASD.…”

“…A lack of social support also means that parents might not have the right structure to deal with their children with ASD. If the community is not well-structured to embrace such cases of disabilities, access to care might be a challenge [ 6 ]. Based on the nature of migrant communities, their beliefs might be different from those of the health service providers within the host countries.…”

“…Likewise, in France, immigrant families are more likely to report ASD than native families: children of migrant backgrounds appear to be at an increased risk of autism [ 3 ] and often show more severe autism symptomatology and comorbid intellectual disorder (ID) [ 4 ]. Despite the need to receive appropriate interventions in time [ 5 ], immigrant parents of children with ASD often fail to receive timely care due to several barriers in the health care system [ 6 ]. Thus, members of minority groups do not tend to receive evidence-based interventions at appropriate ages, which points to a significant gap in equity in relation to the cross-ethnic and cross-racial treatment of ASD [ 7 ].…”

TV, computer, tablet and smartphone use and autism spectrum disorder risk in early childhood: a nationally-representative study

“…Although genetics play an important role with regard to the risk of ASD and symptoms of neurodevelopmental delay, evidence suggests that certain environmental exposures could also be involved [ 7 ]. Media screen exposure is a candidate, as children who early on in life spend a lot of time watching screens – particularly if their content is poor and/or if they are unsupervised—are less likely to play, be physically active, and engage in interactions with other children and adults, all of which could be related to worse neurodevelopmental outcomes [ 3 , 5 ].…”

Socio-cultural and school barriers that Latino Spanish-speaking and Mixteco-speaking families with a preschool child with autism experienced in the special education referral process in Santa Barbara County, California

“…Research has confirmed that children from immigrant backgrounds were at higher risk of having neurodevelopment disorders, including autism (Becerra et al, 2014;Schmengler et al, 2021). Research has been limited and inconsistent regarding the risk level for children of immigrants related to other disabilities (Schmengler et al, 2021).…”