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Covello M, Pelella MR, Bennett A, Gerdes M, Guthrie W, Wallis KE, Wong ZM, Miller JS, Truong DM. Missing Ethnicity and Language Information in Healthcare Records of Patients from the Asian Diaspora. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02059-0. [PMID: 38969925 DOI: 10.1007/s40615-024-02059-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/10/2024] [Accepted: 06/17/2024] [Indexed: 07/07/2024]
Abstract
The electronic health record (EHR) should contain information to support culturally responsive care and research; however, the widely used default "Asian" demographic variable in most US social systems (including EHRs) lacks information to describe the diverse experience within the Asian diaspora (e.g., ethnicities, languages). This has a downstream effect on research, identifying disparities, and addressing health equity. We were particularly interested in EHRs of autistic patients from the Asian diaspora, since the presence of a developmental diagnosis might call for culturally responsive care around understanding causes, treatments, and services to support good outcomes. The aim of this study is to determine the degree to which information about Asian ethnicity, languages, and culture is documented and accessible in the EHR, and whether it is differentially available for patients with or without autism. Using electronic and manual medical chart review, all autistic and "Asian" children (group 1; n = 52) were compared to a randomly selected comparison sample of non-autistic and "Asian" children (group 2; n = 50). Across both groups, manual chart review identified more specific approximations of racial/ethnic backgrounds in 54.5% of patients, 56% for languages spoken, and that interpretation service use was underestimated by 13 percentage points. Our preliminary results highlight that culturally responsive information was inconsistent, missing, or located in progress notes rather than a central location where it could be accessed by providers. Recommendations about the inclusion of Asian ethnicity and language data are provided to potentially enhance cultural responsiveness and support better outcomes for families with an autistic child.
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Affiliation(s)
- Maxine Covello
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Maggie Rose Pelella
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amanda Bennett
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Marsha Gerdes
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Whitney Guthrie
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kate E Wallis
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Zoe M Wong
- Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - Judith S Miller
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Dieu M Truong
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Kim SY, Song DY, Bottema-Beutel K, Gillespie-Lynch K. Time to level up: A systematic review of interventions aiming to reduce stigma toward autistic people. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:798-815. [PMID: 37886792 DOI: 10.1177/13623613231205915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
LAY ABSTRACT How non-autistic people think about autistic people impacts autistic people negatively. Many studies developed trainings to reduce autism stigma. The existing trainings vary a lot in terms of study design, content, and reported effectiveness. This means that a review studying how the studies have been conducted is needed. We also looked at the quality of these studies. We collected and studied 26 studies that tried to reduce stigma toward autistic people. The studies often targeted White K-12 students and college students. Most trainings were implemented once. Trainings frequently used video or computer. Especially, recent studies tended to use online platforms. The study quality was poor for most studies. Some studies made inaccurate claims about the intervention effectiveness. Studies did not sufficiently address study limitations. Future trainings should aim to figure out why and how interventions work. How intervention changes people's behavior and thoughts should be studied. Researchers should study whether the training can change the societal stigma. Also, researchers should use a better study design.
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Affiliation(s)
| | - Da-Yea Song
- Seoul National University Bundang Hospital, South Korea
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3
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Smith J, Rabba AS, Cong L, Datta P, Dresens E, Hall G, Heyworth M, Lawson W, Lee P, Lilley R, Syeda N, Ma E, Wang J, Wang R, Yeow CT, Pellicano E. "They Were Saying That I Was a Typical Chinese Mum" : Chinese Parents' Experiences of Parent-Teacher Partnerships for Their Autistic Children. J Autism Dev Disord 2023; 53:4888-4900. [PMID: 36149615 PMCID: PMC9510549 DOI: 10.1007/s10803-022-05748-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 11/20/2022]
Abstract
Effective parent-teacher partnerships improve outcomes for autistic students. Yet, we know little about what effective partnerships look like for parents of autistic children from different backgrounds. We conducted interviews with 17 Chinese parents of autistic children attending Australian kindergartens/schools to understand their experiences. Parents appreciated the acceptance, opportunities and supports they received in Australia. They had high expectations of children; expectations not often shared by educators. Parents were respectful of teachers' expertise and polite and undemanding in interactions. Nevertheless, parents were frustrated by inconsistent teaching quality and inadequate communication. Navigating systems was also challenging and parents faced discrimination from teachers and their community. Recommendations include fostering open home-school communication, proactively seeking parents' expertise about children and explicitly scaffolding parents' self-advocacy.
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Affiliation(s)
- Jodie Smith
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia.
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Aspasia Stacey Rabba
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Melbourne, Australia
| | - Lin Cong
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Poulomee Datta
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | | | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
- Reframing Autism, Sydney, Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | | | - Rozanna Lilley
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | | | - Emily Ma
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Julia Wang
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Rena Wang
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Chong Tze Yeow
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
| | - Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, 2109, Sydney, NSW, Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Pei F, Yoon S, Zhai F, Gao Q. Environment matters: How are neighborhood structural indexes associated with parenting stress among Asian immigrant families? PLoS One 2023; 18:e0293594. [PMID: 38019764 PMCID: PMC10686471 DOI: 10.1371/journal.pone.0293594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
The Asian immigrant population is the fourth largest immigrant population in the United States, and its parenting stress issues have been consistently recognized in previous studies. However, little attention has been paid to neighborhood-level factors and their parenting stress. Using the Study of Asian American Families and 2016 American Community Survey 5-year estimates, this study examined the association between neighborhood structural indexes and Asian immigrant parents' parenting stress, along with the mechanism driving the relationship. We found that cultural orientation and social support fully mediated the effects of economic disadvantages on parenting stress among Asian immigrant parents. Only cultural orientation mediated the direct effects of ethnic heterogeneity on Asian parents' parenting stress. Improving Asian immigrants' living environment, including economic status and ethnic diversity, would be critical to relieve the parenting stress of Asian immigrant families. Interventions and preventions to increase social support, and inform cultural orientation and acculturation are emphasized.
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Affiliation(s)
- Fei Pei
- David B. Falk College of Sport and Human Dynamics, School of Social Work, Syracuse University, Syracuse, NY, United States of America
| | - Susan Yoon
- College of Social Work, The Ohio State University, Columbus, OH, United States of America
- Department of Social Welfare, College of Social Sciences, Ewha Womans University, Seoul, South Korea
| | - Fuhua Zhai
- Graduate School of Social Service, Fordham University, Bronx, New York, United States of America
| | - Qin Gao
- School of Social Work, Columbia University, New York, New York, United States of America
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Smith J, Rabba AS, Ali A, Datta P, Dresens E, Faragaab N, Hall G, Heyworth M, Ige K, Lawson W, Lilley R, Syeda N, Pellicano E. 'Somali parents feel like they're on the outer': Somali mothers' experiences of parent-teacher relationships for their autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023:13623613221146077. [PMID: 36680459 DOI: 10.1177/13623613221146077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
LAY ABSTRACT Good relationships between parents and schools can improve autistic children's school success. There are many reasons why families from different cultural backgrounds find it harder to develop good relationships with schools, such as language barriers, discrimination and unfamiliarity with education systems. We know little about what 'good relationships' look like for these families. Here, we worked with a team of autistic and non-autistic researchers as well as an Advisory Group of Somali parents to conduct interviews with 15 Somali mothers of kindergarten and school-age autistic children. We asked mothers about their experiences of their child's education, communication with teachers and what a good relationship with schools would look like. We also asked how they felt the Somali community understood autism. We looked for common things that mothers said. We found that mothers were very proud of their children. They had high expectations, particularly about what children could do by themselves. Mothers found it frustrating that teachers had low expectations, that schools were not good at communicating with them and that autism-specific skills and experience were uncommon in schools. They also reported racist attitudes towards their children. Mothers experienced stigma and lacked resources, but support was gained from their daughters and their religion. Mothers themselves were proactively increasing community awareness and knowledge about autism in the hope that they and their autistic children would be valued and better supported. Our work has implications for how teachers and schools can work together with Somali parents to forge better futures for autistic children.
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Affiliation(s)
- Jodie Smith
- Macquarie University, Australia.,La Trobe University, Australia
| | | | | | | | | | - Nadia Faragaab
- Macquarie University, Australia.,Positive Partnerships, Australia
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Huang M, Zhou Z. Factors contributing to parental stress among Chinese families of children with autism: A qualitative study. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Mary Huang
- Department of Psychology St. John's University New York City New York USA
| | - Zheng Zhou
- Department of Psychology St. John's University New York City New York USA
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Kim I, Dababnah S, Wang Y, Reyes C. Diagnostic Process and Barriers Among Chinese-American and Korean-American Parents of Children with Autism. J Dev Behav Pediatr 2022; 43:327-334. [PMID: 35880793 DOI: 10.1097/dbp.0000000000001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/07/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We sought to understand the experiences of Chinese-American and Korean-American parents of children with autism, including their initial concerns regarding their child's development, reported health professionals' responses to these concerns, diagnostic barriers, and factors associated with early autism diagnosis. METHOD We designed a survey with support from an expert advisory group and Asian-American parents of children with autism. We measured 3 time points of diagnostic history, areas of parents' concerns, professionals' responses to their concerns, 15 types of diagnostic barriers, and professionals' helpfulness. We used descriptive and independent t tests to analyze data from 28 parents of children with autism. RESULTS Most of the parents (86%) had early concerns about their children's developmental delays and expressed their concerns to health professionals. However, approximately 60% of the parents reported that the professionals did not conduct developmental screenings or make referrals to specialists. The most common diagnostic barrier was the stress of the diagnostic process, followed by navigating health care systems. Parents who required interpreters noted poor quality and unavailability. Early child developmental concerns were associated with early autism diagnoses. CONCLUSION Although many Chinese-American and Korean-American parents had early concerns regarding their child's development and shared their concerns with health care professionals, parents encountered many barriers, including the stress of the diagnostic process. Chinese-American and Korean-American parents with limited English proficiency required additional support. Health care professionals' active listening and responses to parents' concerns can promote early diagnosis.
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Affiliation(s)
- Irang Kim
- School of Social Work, Tulane University, New Orleans LA
| | - Sarah Dababnah
- School of Social Work, University of Maryland-Baltimore, Baltimore, MD; and
| | - Yao Wang
- School of Social Work, University of Maryland-Baltimore, Baltimore, MD; and
| | - Charina Reyes
- Developmental-Behavioral Pediatrics, University of Maryland, Baltimore, MD
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Xu Y, Chen F, Mirza M, Magaña S. Culturally adapting a parent psychoeducational intervention for Chinese immigrant families of young children with autism spectrum disorder. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022. [DOI: 10.1111/jppi.12432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yue Xu
- Department of Health Sciences Education University of Illinois College of Medicine Rockford Illinois USA
| | - Feifei Chen
- Illinois Leadership Education in Neurodevelopmental Disorder Fellow Chicago Illinois USA
| | - Mansha Mirza
- Department of Disability and Human Development University of Illinois at Chicago Chicago Illinois USA
- Department of Occupational Therapy University of Illinois at Chicago Chicago Illinois USA
| | - Sandy Magaña
- Steve Hicks School of Social work University of Texas at Austin Austin Texas USA
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Dababnah S, Kim I, Wang Y, Reyes C. Brief Report: Impact of the COVID-19 Pandemic on Asian American Families with Children with Developmental Disabilities. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2021; 34:491-504. [PMID: 34483637 PMCID: PMC8408012 DOI: 10.1007/s10882-021-09810-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
Discrimination against Asians and Asian Americans increased during the COVID-19 pandemic. Yet, even prior to the pandemic, little research explored the experiences of Asian American families of children with autism and other developmental disabilities. This brief report summarizes the results of a survey conducted between May and July 2020, in the immediate aftermath of state and local lockdowns due to the pandemic. Twenty-five Asian American caregivers of children with autism and other developmental disabilities completed the survey and reported on the pandemic's impact on their household. Most of the caregivers were mothers, immigrants, Chinese, raising children with autism, and highly educated. Participants' primary concerns were the disruption of their children's educational and therapeutic services. We discuss research limitations and implications.
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Affiliation(s)
- Sarah Dababnah
- University of Maryland School of Social Work, Baltimore, MD USA
| | - Irang Kim
- Tulane University School of Social Work, New Orleans, LA USA
| | - Yao Wang
- University of Maryland School of Social Work, Baltimore, MD USA
| | - Charina Reyes
- University of Maryland School of Medicine, Baltimore, MD USA
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Facilitators and Barriers to Positive Experiences for Families of Individuals with Autism. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00290-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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