Autism Diagnosis and Service Delivery for Immigrant Families

There are often misconceptions about who immigrants are. In Canada, the majority of immigrants hold a bachelor’s degree or higher. Most are not refugees but rather come in through the Family Class, which means an immediate family member already in Canada has sponsored them. Mandarian is the third most spoken language in Canada after English and French. Canada accepts 250,000 immigrants a year; the most popular cities to settle in are Toronto, Montreal, Vancouver and Calgary. By the year 2017, 1 in 5 Canadians will be a visible minority person.

• language barriers
• adjustments to living in a new country
• employment (it takes 10 years to catch up to a Canadian peer with the same qualifications)
• lack of knowledge of the new country’s systems
• lack of knowledge about services and supports

Add to this list the unique vulnerability of cultural context; in other words, how did their home country view disabilities? In some countries, disabilities are kept a secret. There can be denial, feelings of guilt, or the child can be seen as a burden. Some countries do not even have a word for autism. Not all societies are inclusive or offer inclusive educational settings. If a family has extended family living with them, they can be influencing how the parents think, act, and feel about disabilities.

When working with an immigrant family, find out what the beliefs are for the cause of a disability. Some cultures believe it’s bad luck, an accident, punishment for an earlier act, the influence of evil spirits, a curse, or a medical mistake. These beliefs will influence decisions made on the child’s behalf or what kind of interventions will be accepted. It’s also important to know how the home country handles and views disabilities. What services and supports were offered back home? How did the education system treat the child?

How can we best help immigrant families who have a child with a disability?

Teachers need to know:

• what the cultural values and beliefs are from the home country and how those will influence a parent’s parenting style and access support
• parents may not expect the child to become independent
• know the child’s background and how this will impact their development (how they immigrated, do they have family members here, religious beliefs)
• acknowledge the barriers and successes of families who’ve gone through a great deal to adapt
• parents want their children to succeed and be happy
• parents may fear they will be blamed for the child’s disabilty and may have the child taken away from them (again, this goes back to beliefs)
• some cultures believe the teacher should fix the problem; others may not accept help or advice from a teacher because they are not a doctor
• explain confidentiality to parents as they may fear the community may found out about their child

Service providers need to implement culturally appropriate service delivery. This means taking into account expectations of the family, the length of time for service, and the understanding of the language. For example, it may not be appropriate to have in-home support if the grandparents are the ones supervising therapy and they don’t speak the language. A coordinated effort has to happen between settlement agencies, the disability-serving sector and the cultural community. In other words, think about all the different groups that support that family in their adaptation to their new country and work with them. Develop cultural competency as a staff through professional development opportunities.

Think about developing a parent-mentor program. This would involve having a parent from the new country or one who has lived in this country for a long time and is further along in their disabilities journey and knows the system to mentor the new parent. It’s not paramount that the parent be from the same country as the family. In fact, it can be a drawback if the same beliefs/views are there about a disability. In my travels all over the world, I have never met another mother who doesn’t have the same worries or wish for their child as I do – that we all want the best possible outcome for our children.

In order to be effective in helping immigrant families seek diagnosis and provide the right services, on-going assessment and re-evaluation of service delivery and supports need to happen. Immigration has been a positive thing for Canada in providing much needed population and economic growth. Cultural diversity enhances countries. We need to support those who are vulnerable and deserve a chance at a better life.