Cultural differences and their impact on Autism
by Helan Pereira
Autism occurs in people of all backgrounds, cultures and heritages. Different cultural norms and values can change how individuals experience Autism in everyday life, influencing their interactions with family, community, schools and health services. Cultural factors can also impact how Autism is understood, interpreted and accepted in different communities. Cultural myths about Autism and other disabilities can deter people from seeking help. Information that may be helpful for one person might be too much, or too little, or even confusing for another. There can even be many cultural differences within the same ethnic group, due to factors like country of birth and number of years in their country of residence.
In her research, Anne de Leeuw writes that Autism research is primarily conducted in Western countries with a limited but growing research base on the impact of culture on the conceptualisation, assessment and interpretation of Autism. Therefore, Autism screening and assessment tools and processes are based on data from Western cultures. Culture also impacts therapeutic strategies when working with people from culturally diverse backgrounds and their families.
In some cultures where introversion is valued, having little or no interest in other children may be interpreted as modest or shy rather than an autistic trait. Hence, differences in what are considered socially appropriate behaviours within a particular culture can impact the interpretation of these behaviours when assessing Autism.
In some cultures, stigma and shame may deter some families from seeking an assessment. Despite wanting the best for their child, families often fear being judged by others in that society, and this may impact families approaching services for support. Disparities in accessing and utilising services by people from culturally diverse backgrounds have been noted in Australia. The NDIS has acknowledged that in the past it has not recognised the cultural and language needs of participants from culturally diverse backgrounds and developed the Cultural and Linguistic Diversity Strategy 2024-2028 to support families from diverse backgrounds, increase access and participation to the NDIS and increase the utilisation of their NDIS plans.
Treatment Goals
Treatment goals are also influenced by differences in culture. In a growing diverse society, it is important to note how we perceive and provide therapeutic interventions to these families.
Understanding the cultural nature of emotions and their development is important in having an unbiased understanding of children’s emotional development. Similarly, understanding the meaning of different emotions in each culture is crucial to also understanding family and caregiver’s emotions and behaviours as well as recognising and understanding our own biases.
Nangyeon Lim notes that Western cultures or cultures that value independence and self-sufficiency tend to value “high arousal emotions” and these are promoted more than low arousal emotions. Thus, being upbeat or enthusiastic tends to be more valued in Western culture. Importantly, how does this impact our intervention strategies? When working with culturally diverse individuals, we may need to be flexible in our goal setting and service delivery, adapting our usual therapy approaches to suit the context. For example, a treatment plan that attempts to teach an individual from a culturally diverse family to express their emotions within their family may contradict the values of the person’s family and culture. This could create a rupture within that family if not handled with sensitivity. Hence, it is important that therapists take the time to investigate the values of the person and the family. At times, this may also mean examining the conflict between the person’s family of origin values versus the person's actual values and modifying accordingly.
In summary, understanding how emotions and behaviours are interpreted and valued from different cultural perspectives is a key factor when undertaking assessment and providing therapeutic supports to autistic individuals. Some key reminders are:
Learn about the client’s culture and the impact of their culture on their current everyday life.
Get to know what people consider “normal” in different cultures.
Recognise that there may be a language barrier.
Take the time to listen.
References
Bernier, R., Mao, A., & Yen, J. (2010). Psychopathology, Families, and Culture: Autism. Child and Adolescent Psychiatric Clinics of North America, 19(4), 855–867.
Liu, F., Scheeren, A. M., Grove, R., Hoekstra, R. A., Wang, K., Guo, D., Wang, C., & Begeer, S. (2022). Exploring Cultural Differences in Autistic Traits: A Factor Analytic Study of Children with Autism in China and the Netherlands. Journal of Autism and Developmental Disorders, 52(11), 4750–4762.
Lim, N. (2016). Cultural differences in emotion: differences in emotional arousal level between the East and the West. Integrative Medicine Research, 5(2), 105–109.
National Disability Insurance Scheme. (2024). Cultural and Linguistic Diversity (CALD) Strategy 2024-28.
