European studies on prevalence and risk of autism spectrum disorders according to immigrant status—a review

Kawa, Rafał; Sæmundsen, Evald; Jónsdóttir, Sigríður Lóa; Hellendoorn, Annika; Lemcke, Sanne; Canal‐Bedia, Ricardo; García-Primo, Patricia; Moilanen, Irma

doi:10.1093/eurpub/ckw206

Cited by 33 publications

(34 citation statements)

References 48 publications

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“…Our results indicating that the combination of low levels of language acquisition and high M‐CHAT scores is more likely to occur in children of immigrant than nonimmigrant mothers, and that this excess risk varies according to the mother's region of origin, is concordant with prior studies based on clinical diagnoses [Abdullahi et al, ; Crafa & Warfa, ; Dealberto, ; Kawa et al, ; Ng & de Montigny, ]. Of note, after adjustment for covariates we found that children of first generation North African or francophone Sub‐Saharan African mothers had higher MB‐CDI mean scores than their nonimmigrant French counterparts.…”

Section: Discussionsupporting

confidence: 92%

“…Studying immigrants' children in nonclinical samples is particularly important as there is evidence of ethnic diagnostic/referral bias in medical practice [Begeer, Bouk, Boussaid, Terwogt, & Koot, ]. The associated risk of late diagnosis and underdiagnosis [Kawa et al, ] might lead to a higher likelihood of missing problems in immigrants' children when using routine clinical data, and hence result in underestimates of neurodevelopmental inequalities in the population. Furthermore, most children diagnosed with neurodevelopmental conditions, such as ASD, first receive a diagnosis when aged 3 years or older, although signs may be present earlier [Chlebowski et al, ].…”

Section: Introductionmentioning

confidence: 99%

“…Mounting evidence suggests that children of immigrant and ethnic minority parents are at increased risk of various neurodevelopmental problems, such as Attention Deficit and Hyperactivity Disorder [ADHD; Lehti, Chudal, Suominen, Gissler, & Sourander, 2016], impaired language development [Lehti, Gyllenberg, Suominen, & Sourander, 2018], intellectual disability [Abdullahi et al, 2018[Abdullahi et al, , 2019, and ASD [Abdullahi et al, 2018[Abdullahi et al, , 2019Crafa & Warfa, 2015;Dealberto, 2011;Kawa et al, 2017]. While the strength of the association between parental immigrant status and offspring neurodevelopmental problems, including ASD, varies across studies, systematic reviews have found support for this association [Abdullahi et al, 2018;Crafa & Warfa, 2015;Dealberto, 2011;Kawa et al, 2017;Ng, de Montigny, Ofner, & Docé, 2017]. There is suggestion that elevations in ASD risk in children of immigrants are mainly attributable to particular neurodevelopmental phenotypes, characterized by intellectual disability and language delay [Abdullahi et al, 2019;Dealberto, 2013].…”

Section: Introductionmentioning

confidence: 99%

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Maternal immigrant status and signs of neurodevelopmental problems in early childhood: The French representative ELFE birth cohort

et al. 2019

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A growing body of evidence suggests that children of immigrants may have increased risks of neurodevelopmental disorders. However, evidence based on parent report and on very young children is lacking. We therefore investigated the association between maternal immigrant status and early signs of neurodevelopmental problems in a population‐based sample of 2‐year‐old children using standardized parent‐report instruments. We used data from the French representative Étude Longitudinale Française depuis l'Enfance birth cohort, initiated in 2011. The study sample included 9,900 children of nonimmigrant French, 1,403 children of second, and 1,171 children of first generation immigrant women followed‐up to age 2 years. Neurodevelopment was assessed using the Modified Checklist for Autism in Toddlers (M‐CHAT) and an adaptation of the MacArthur‐Bates Communicative Development Inventories (MB‐CDI). In fully adjusted linear regression models, maternal immigrant status was associated with M‐CHAT scores, with stronger associations in children of first (β‐coefficient: 0.19; 95% CI 0.08–0.29) than second generation immigrants (0.09; 0.01–0.17). This association was especially strong among children of first generation immigrant mothers native of North Africa (vs. nonimmigrant French: 0.33; 0.16–0.49) and French‐speaking Sub‐Saharan Africa (0.26; 0.07–0.45). MB‐CDI scores were lowest among children of first generation immigrant mothers, particularly from mostly non‐francophone regions. Children of first generation immigrant mothers were most likely to have simultaneously low MB‐CDI and high M‐CHAT scores. Our findings suggest that maternal immigrant status is associated with early signs of neurodevelopmental difficulties, with strong variations according to maternal region of origin. Further research is necessary to test whether these associations persist and to determine the underlying mechanisms. Autism Res 2019, 12: 1845–1859. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary We asked immigrant and nonimmigrant mothers in France about early signs of neurodevelopmental problems in their 2‐year‐old children. Overall, we found that children of immigrants may be at higher risk of showing these early warning signs, as compared to children of nonimmigrants. This is in line with previous studies, which were based on doctors' diagnoses at later ages. However, our results differed depending on the mothers' regions of origin. We found the highest risks in children of first generation immigrants from North and French‐speaking Sub‐Saharan Africa, who also seemed especially at risk of neurodevelopmental problems combined with low language development.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maternal immigrant status and signs of neurodevelopmental problems in early childhood: The French representative ELFE birth cohort

et al. 2019

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confidence: 99%

A Conceptual Framework for Understanding the Cultural and Contextual Factors on Autism Across the Globe

2020

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Autism research is heavily skewed towards western high-income countries. Culturally appropriate screening and diagnostic instruments for autism are lacking in most low-and middle-income settings where the majority of the global autism population lives. To date, a clear overview of the possible cultural and contextual factors that may affect the process of identifying and diagnosing individuals with ASD is missing. This study aims to outline these factors by proposing a conceptual framework. A multidisciplinary review approach was applied to inform the development of the conceptual framework, combining a systematic review of the relevant autism research literature with a wider literature search spanning key texts in global mental health, cultural psychiatry, cross-cultural psychology and intellectual disability research. The resulting conceptual framework considers the identification, helpseeking and diagnostic process at four interrelated levels: i) the expression, ii) recognition, iii) interpretation and iv) reporting of autism symptoms, and describes the cultural and contextual factors associated with each of these levels, including cultural norms of typical and atypical behaviour, culture-specific approaches to parenting, mental health literacy, cultural beliefs, attitudes and stigma, as well as the affordability, availability, accessibility and acceptability of services. This framework, mapping out the cultural and contextual factors that can affect the identification, help-seeking and diagnosis of ASD, may function as a springboard for the development of culturally appropriate autism screening and diagnostic instruments, and inform future cross-cultural autism research directions. The framework also has relevance for clinicians and policy makers aiming to improve support for underserved autism populations worldwide. Lay summaryThe vast majority of autism research is conducted in western high-income settings. We therefore know relatively little of how culture and context can affect the identification, helpseeking and diagnosis of autism across the globe. This paper synthesises what is known from the autism research literature and a broader literature and maps out how culture and context may affect i) the expression, ii) recognition, iii) interpretation and iv) reporting of autism symptoms.

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“…To illustrate, a study amongst a Somali population living in the UK (Fox, Aabe, Turner, Redwood, & Rai, 2016) reported findings that echo reports from populations resident in the horn or East of Africa (Gona et al, 2016;Tekola et al, 2016;Tilahun et al, 2016) regarding the perceptions of autism, experiences of stigma and unmet needs. Ethnic minority groups in high-income countries tend to be under-diagnosed for ASD and under-represented in autism research populations (Decoteau, 2017;Kawa et al, 2016;Sandy Magaña & Vanegas, 2017). Improving our understanding of the cultural dimensions of autism may thus inform initiatives to improve the identification, diagnosis and access to services of ethnic minority populations within high-income countries(La Roche, Bush, & D'Angelo, 2018).…”

Section: <Table 1 Here>mentioning

confidence: 99%

A conceptual framework for understanding the cultural and contextual factors on autism across the globe

Leeuw¹,

Happé²,

Hoekstra³

2019

Preprint

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Autism research is heavily skewed towards western high-income countries. Culturally appropriate screening and diagnostic instruments for autism are lacking in most low- and middle-income settings where the majority of the global autism population lives. To date, a clear overview of the possible cultural and contextual factors that may affect the process of identifying and diagnosing individuals with ASD is missing. This study aims to outline these factors by proposing a conceptual framework. A multidisciplinary review approach was applied to inform the development of the conceptual framework, combining a systematic review of the relevant autism research literature with a wider literature search spanning key texts in global mental health, cultural psychiatry, cross-cultural psychology and intellectual disability research. The resulting conceptual framework considers the identification, help-seeking and diagnostic process at four interrelated levels: i) the expression, ii) recognition, iii) interpretation and iv) reporting of autism symptoms, and describes the cultural and contextual factors associated with each of these levels, including cultural norms of typical and atypical behaviour, culture-specific approaches to parenting, mental health literacy, cultural beliefs, attitudes and stigma, as well as the affordability, availability, accessibility and acceptability of services. This framework, mapping out the cultural and contextual factors that can affect the identification, help-seeking and diagnosis of ASD, may function as a springboard for the development of culturally appropriate autism screening and diagnostic instruments, and inform future cross-cultural autism research directions. The framework also has relevance for clinicians and policy makers aiming to improve support for underserved autism populations worldwide.

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European studies on prevalence and risk of autism spectrum disorders according to immigrant status—a review

Cited by 33 publications

References 48 publications

Maternal immigrant status and signs of neurodevelopmental problems in early childhood: The French representative ELFE birth cohort

Maternal immigrant status and signs of neurodevelopmental problems in early childhood: The French representative ELFE birth cohort

A Conceptual Framework for Understanding the Cultural and Contextual Factors on Autism Across the Globe

A conceptual framework for understanding the cultural and contextual factors on autism across the globe

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