Why autism seems to cluster in some immigrant groups

For any family, navigating an autism diagnosis is a long process full of paperwork, questions and decisions. When those conversations happen in a foreign language within an unfamiliar healthcare and educational system, the confusion can escalate — especially among people from cultures that stigmatize mental illness or have no concept of autism at all.

Those complexities, experts say, make it difficult to interpret the evidence that certain immigrant communities have an unusually high or low prevalence of autism. As some researchers dig into possible explanations, from stress to environmental factors, others say the true issue may be societal: a mix of diagnostic challenges, communication barriers and culture clashes that lead clinicians to misdiagnose or miss children on the spectrum in these communities.

Some teams are trying to develop or assess screening tools tailored for certain ethnic groups in the U.S. and elsewhere — for example, a picture-based tool for use in Sri Lanka — and these efforts may lead to more accurate numbers among different populations. If the figures reveal true differences in prevalence among these communities, they might offer clues about the potential causes of autism. The vast majority of research on autism today, after all, is limited to mostly white and middle-class families. At the very least, getting a better handle on prevalence may help identify populations with the greatest needs for culturally adapted services.

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29th November 2017