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Diagnosing autism and cultural diversity

How culturally specific are our ideas about autism? An article in the Nov 1st issue of Nature discusses the way that behavioural norms vary between cultures and how this variation should be taken into account when thinking about autism. The author compares Western expectations of childhood behaviours with those found in non-Western societies. For example, in some societies it is disrespectful for a child to maintain direct eye contact with an adult and yet a Western clinician may look for this behaviour when diagnosing autism. While it is likely that rates of autism are similar throughut the world, the way that this condition is expressed may vary between cultures. The article discusses these variations with particular reference to South Korea and South Africa. For example:
'...part of the Autism Diagnostic Observation Schedule (ADOS)...for the disorder, involves observing a child having a pretend birthday party — singing 'Happy Birthday', cutting and distributing slices of cake, and so on. But in rural areas of South Africa, birthdays often aren't celebrated, so even typically developing children might be unfamiliar with this ritual. So, for a study of early autism diagnosis in KwaZulu-Natal province, researchers developed an alternative scenario of shared excitement, involving a traditional African song. “It's finding the intention of what you're trying to elicit, and then finding an alternative,” says Amy Wetherby, director of the Autism Institute in the College of Medicine at Florida State University in Tallahassee, who led the work.'
These cultural variations in the expression of autism occur later in infancy, as the child becomes adapted to its culture; of course, the earlier we look, the more similar are the early signs of autism. Cultural differences and lack of knowledge about autism may lead parents to become concerned about their child at different stages of their development. The article mentions studies in Goa, India, and amongst Latino migrant workers in Florida, showing different ways in which parents became concerned about their child. Another significant variation between cultures lies in the stigma attached to having an autistic child. In South Korea, for example, the article claims that having a diagnosis of autism can affect the marriage prospects of siblings and the parents' careers. Such stigma can affect the reported rates of incidence. The take home message is, the later a diagnosis of autism is made, the more that cultural variations need to be taken into account. Nature 491, S18–S19 (01 November 2012)
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Welcome to ourNews, where we keep up-to-date with research and other news related to infant mental health. These articles can be of interest to both parents and professionals.
We are keen to know your views and so please do comment on our articles.
Is there a topic that you would like us to write about? Just send us a message via 'Contact us'.

ourAdvice, our other blog, has brief posts with advice for parents.

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