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Monday, December 4, 2017

Cultural barriers lead clinicians to misdiagnose or miss children with autism in immigrant communities.

Gboro and Nabunyi sat on a sofa in the living room of their apartment and watched as the women from a community health clinic offered the toddler various objects. The women’s goal was to observe how Baraka would play with the objects — standard protocol for an autism evaluation. But the protocol seemed geared toward a child with a typical American upbringing. There was a pretend birthday cake, but Baraka had not yet been to an American birthday party. They gave him a plastic bag of Cheerios, the popular American breakfast cereal, but a typical breakfast in the Congo — and in Gboro’s household — is cheese, bread and milk, or sometimes porridge. And there was an African interpreter, too, but he spoke an unfamiliar French dialect and gave the boy instructions with words his parents never used. Sometimes, the clinicians spoke directly to Baraka in English, which he didn’t understand 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.

Read more here at Spectrum.