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Madsen J, Jobson L, Slewa-Younan S, Li H, King K. Mental health literacy among Arab men living in high-income Western countries: A systematic review and narrative synthesis. Soc Sci Med 2024; 346:116718. [PMID: 38489937 DOI: 10.1016/j.socscimed.2024.116718] [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] [Received: 07/01/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 03/17/2024]
Abstract
While interest in mental health literacy (MHL) is growing rapidly, cross-cultural research focusing on MHL is developing more slowly. This inaugural systematic review explored the recognition and beliefs about the causes of mental health disorders amongst Arab men living in high income Western countries (HIWC), their help-seeking beliefs, behaviors, and sources of help, as well as barriers and facilitators to help-seeking. Six electronic database searches were conducted using Medline, Embase, ProQuest Dissertations & Theses Global, PsycINFO, Scopus, and Web of Science. These searches yielded a total of 9,460 citations. After applying inclusion criteria through both database and manual hand searches, 46 studies were identified. The findings corresponded with four of the socioecological model's five factors: intrapersonal, interpersonal, societal, and institutional. Intrapersonal factors included attributing mental health illness to life and migration stressors, and religious reasons. Interpersonal and societal factors included men favoring informal help-seeking sources as stigma was a barrier to formal help-seeking. Institutional factors around the perceived cultural competence of healthcare professionals and access difficulties were obstacles to seeking formal help. The growth in Arab migration to HIWC highlights the need for culturally tailored care. Research is needed to understand the perspectives of healthcare providers working with Arab men in addition to how men's stigmatizing attitudes are an obstacle to formal help-seeking. Interventions should be designed to address the unique mental health needs of Arab men, recognizing that some explanatory beliefs may not align with current Western models of mental health. Moreover, efforts should be made to integrate men's informal sources of support into treatment planning.
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Affiliation(s)
- Julian Madsen
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
| | - Laura Jobson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
| | - Shameran Slewa-Younan
- Macarthur Clinical School, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 275, Australia.
| | - Haoxiang Li
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
| | - Kylie King
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
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Ermansons G, Kienzler H, Schofield P. Somali refugees in urban neighborhoods: an eco-social study of mental health and wellbeing. Front Psychiatry 2024; 15:1307509. [PMID: 38439798 PMCID: PMC10910043 DOI: 10.3389/fpsyt.2024.1307509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
Background Impact of pre-migration trauma and post-migration settlement on refugee mental health and wellbeing is well-documented. However, little research has focused on the specific places where refugees settle and spend their daily lives within the post-migration context. This study adopts an eco-social perspective to explore the relationship between urban neighborhoods and refugee mental health and wellbeing. Methods We conducted twenty-six qualitative interviews with Somali refugees in London and Bristol in the UK. The transcripts were coded using an inductive approach and analyzed through thematic analysis. Results Somali refugees navigate a complex urban environment comprising various neighborhood features which include important places near home, interactions with neighbors, and community spaces. While these features afford them resources to improve mental health and wellbeing, they also present challenges such as high urban density, exposure to violence or discrimination, and neighborhood disorder. Conclusion The societal and physical features of urban neighborhoods intersect with refugee experiences of adversity, trauma and stress over time. As eco-social niches, urban neighborhoods are both accommodating, safe and familiar, as well as alien, threatening and unwelcoming. To support mental health and wellbeing and ensure successful settlement, it is essential to recognize the agency of refugees and provide continuous support throughout the entire asylum process and after, ensuring stable and safe living conditions.
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Affiliation(s)
- Guntars Ermansons
- Department of Global Health & Social Medicine, Faculty of Social Science & Public Policy, King’s College London, London, United Kingdom
| | - Hanna Kienzler
- Department of Global Health & Social Medicine, Faculty of Social Science & Public Policy, King’s College London, London, United Kingdom
| | - Peter Schofield
- Department of Population Health Sciences, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
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Duale HA, Gele A. Exploring knowledge of autism, its causes and treatment among immigrant and nonimmigrant parents in Somalia\Somaliland. Child Adolesc Psychiatry Ment Health 2024; 18:22. [PMID: 38326911 PMCID: PMC10851585 DOI: 10.1186/s13034-024-00713-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The prevalence of autism spectrum disorders (ASDs) has increased over the recent years; however, little is known about the experience of parents of children with autism in Africa such as Somalia. The aim of this study is to understand the knowledge on autism of Somali parents of children with autism and their perceptions of causes and treatment of ASD. METHODS We conducted a qualitative study involving 22 parents of children with autism who lived in Mogadishu and Hargeisa; the two largest cities in Somalia. In-depth interviews were used to collect the data. Of the 22 participants, 9 were returned immigrants and 13 were local people (non-immigrants). Data were analysed using thematic analysis. RESULTS The data revealed that most of the parents hold the belief that their children's autism were caused by the measles vaccine. The findings demonstrated that parents sought diagnosis and treatment care from outside Somalia due to the lack of experience of health providers in the diagnosis and treatment of autism. The data also revealed a lack of knowledge about autism among the public with resultant stigma and discrimination against children with autism and their families. CONCLUSIONS Efforts to increase public knowledge on autism, its causes and treatments are of paramount importance, while a public health campaign designed to eliminate the stigma subjected to children with autism is necessary to improve the quality of life of children with autism and their caregivers. Finally, to counteract vaccine hesitancy, particularly in response to the measles vaccine, health policy makers should take steps to separate the cooccurrence of the onset of autism symptoms and the provision of the measles vaccine.
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Affiliation(s)
- Hodan A Duale
- Department of Maternal and Child Health, Somali Institute for Health Research (SIHR), Hargeisa, Somaliland.
| | - Abdi Gele
- Department of Maternal and Child Health, Somali Institute for Health Research (SIHR), Hargeisa, Somaliland.
- Department of Health Service Research, Norwegian Institute of Public Health, Skøyen, 222, 0213, Oslo, Norway.
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Pang RCC, Ho MSH, Wong PWC. A Review of the Literature on the Multiple Forms of Stigmatization of Caregivers of Children with Autism Among Ethnic Minority Groups. J Racial Ethn Health Disparities 2024; 11:545-559. [PMID: 36877377 DOI: 10.1007/s40615-023-01540-6] [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] [Received: 03/03/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 03/07/2023]
Abstract
Multiple forms of stigmatization are experienced by caregivers of children with autism among ethnic minority (EM) groups in various countries. Such forms of stigmatization can lead to delayed assessment and services for mental health among children and caregivers. This review identified the research literature on the types of stigmatization experienced by caregivers of children with autism with an EM background. A total of 19 studies published after 2010 (i.e., 12 from the USA, 2 from the UK, 1 from Canada, and 1 from New Zealand) of caregivers of 20 ethnicities were identified and reviewed, and their reporting qualities systematically also assessed. Four main themes: (1) self-stigma, (2) social stigma, (3) stigma towards EM parents of children on the autism spectrum, and (4) service utilization stigma, and nine sub-themes were identified. The discrimination experienced by caregivers were extracted, synthesized, and further discussed. While the reporting quality of the studies included is good, the depth of the understanding of this under-researched yet important phenomenon is very limited. The multiple forms of stigmatization experiences are complex, and it may be difficult to disentangle whether the causes of stigmatization were autism and/or EM related, and the types of stigmatization can vary enormously among different ethnic groups in different societies. More quantitative studies are needed to quantify the impacts of multiple forms of stigmatization on families of children with autism in EM groups so that more socially inclusive support for caregivers with an EM background in host countries can be developed.
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Affiliation(s)
| | - Mimi S H Ho
- Department of Special Education and Counselling, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, Hong Kong
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Davis R, Zaki FBM, Sargent L. Autism and bilingualism: A thematic analysis of practitioner perspectives in the United Kingdom. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:205-222. [PMID: 37518984 DOI: 10.1111/1460-6984.12939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 07/06/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND At least 25% of autistic children worldwide have the potential to grow up in a bilingual environment. However, many autistic children are being denied opportunities to access additional languages and the cultural, familial and community connections that come with this. There is little evidence identifying the barriers to language learning and access, and no research addressing the perspectives of speech and language therapists (SLTs), who are crucial in supporting parents to make informed choices about bilingualism with their child. AIMS The aim of this research was to understand the experiences of SLTs working with autistic bilingual children, to understand the main considerations when working with families, and the opportunities and barriers for training, including the sources of information that current practice is based on. METHODS AND PROCEDURES Twelve SLTs from across the United Kingdom were recruited for this study. All participants were experienced in working with autistic bilingual children and their families (M = 7 years, range 4-23 years). Semi-structured interviews were conducted and focused on the experiences of SLTs regarding familial bilingual experiences, the effect of sociocultural factors of practice, and the extent to which practice is based on current research. OUTCOMES AND RESULTS Data were analysed using reflexive thematic analysis. Three central themes were identified from the interviews: (1) participants discussed parental uncertainties as to whether they were doing the right thing for their child, (2) while participants were in support of bilingualism, they were not always confident that they were providing the right advice and found it difficult to in keep up to date with relevant, evidence-based research, and (3) participants highlighted a need to shift towards a more inclusive and culturally diverse practice. CONCLUSIONS AND IMPLICATIONS This is the first qualitative study to understand the perspectives of SLTs working with autistic bilingual children. We identify several key difficulties in supporting access to language learning, and these findings have immediate and longer-term implications for supporting SLTs, and in turn, the children and families they support. WHAT THIS PAPER ADDS What is already known on the subject Research suggests that autistic children currently have fewer opportunities to maintain bilingualism compared to neurotypical peers. Despite the lack of evidence, many families remain concerned that bilingualism will have a negative impact on their child's development. To date, little is known about the perspectives of speech and language therapists (SLTs) who play a significant role in supporting the development of autistic bilingual children. This is the first study to provide an in-depth qualitative analysis of the experiences of SLTs working with autistic bilingual children and their families in the United Kingdom. What this study adds The results highlight a number of reoccurring barriers in providing optimal support: first, frequently cited concerns about bilingualism from parents that link to a lack of understanding about autism and the role of SLTs more generally. Second, SLTs do not have confidence in the assessments and tools available and described a lack of emphasis on cultural factors in practice. Many SLTs were concerned about the limited options for resources and interventions available in other languages, which could be challenging for parents who were less proficient or confident communicating in English. Third, SLTs reported having limited opportunities to keep up to date with relevant research to support their decision-making processes. What are the clinical implications of this work? These results have several important implications for practice-they highlight the need for more inclusive practices where possible, a need for more diversity within the profession and further opportunities to be provided with evidence-based advice around good practice. The results also suggest a benefit of providing accessible, evidence-based resources for parents about autism and bilingualism, to ensure that research key findings are reaching families.
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Affiliation(s)
- Rachael Davis
- Division of Psychology, Sociology & Education, Queen Margaret University, Edinburgh, UK
| | | | - Lesley Sargent
- East Lothian and Midlothian Speech and Language Therapy Department, NHS Lothian, Edinburgh, UK
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Fong VC, McLaughlin J, Schneider M. "We are exhausted, worn out, and broken": Understanding the impact of service satisfaction on caregiver well-being. Autism Res 2023; 16:2198-2207. [PMID: 37700632 DOI: 10.1002/aur.3024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/16/2023] [Indexed: 09/14/2023]
Abstract
Few studies exist that have examined the impact of service-related factors and system-level disruptions (i.e., the pandemic) on families of autistic children in Canada using large sample sizes. To address this gap, the goal of this research was to examine the impact of satisfaction with autism services on caregiver stress, controlling for important demographic variables, such as family income, marital status, and child level of support needs. The impact of navigating and accessing services on parent well-being was also explored. A total of 1810 primary caregivers of autistic children or youth living in Ontario, Canada completed a survey with both closed- and open-ended questions in the summer of 2021. A hierarchical multiple regression was conducted to examine the impact of satisfaction with autism services on caregiver stress. Open-ended responses on the survey from a subset of the sample (n = 637) were coded using thematic analysis to understand the impact of navigating and accessing services on parent well-being. Satisfaction with services significantly predicted caregiver stress after controlling for marital support, family income, and child level of support needs. Qualitative analysis revealed impacts of navigating and accessing services in three areas: (1) Physical, (2) Emotional/Psychological, and (3) Financial Well-being. Understanding parent perceptions of satisfaction with services can shed light on strategies for improving services that support parent well-being.
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Affiliation(s)
- Vanessa C Fong
- Department of Health Studies, Wilfrid Laurier University, Brantford, Ontario, Canada
| | - Janet McLaughlin
- Department of Health Studies, Wilfrid Laurier University, Brantford, Ontario, Canada
| | - Margaret Schneider
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
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Gur A, Reich A. Psychological flexibility of parents of children with disabilities: A systematic literature review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 136:104490. [PMID: 36966545 DOI: 10.1016/j.ridd.2023.104490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/27/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Psychological flexibility, a popular concept in clinical psychology, is still evolving in the context of studying parents of children with disabilities. This study systematically reviewed the literature on the psychological flexibility of parents of children with disabilities to identify contributions of the literature and make recommendations for practice and future study. MATERIALS AND METHODS The systematic review was conducted according to the PRISMA guidelines and identified studies on the psychological flexibility of parents of children with disabilities using five electronic databases: PsychNet, PubMed, ERIC, Social Services Abstracts, and EBSCO. Twenty-six articles met the criteria and were included. A thematic analysis was conducted to extract major themes. RESULTS Three major themes emerged from the data: (1) psychological flexibility is associated with various aspects of mental health; (2) psychological flexibility is associated with parental functioning in caring for children with a disability; (3) acceptance and commitment therapy (ACT) based interventions effectively enhance the psychological flexibility of parents of children with disabilities. CONCLUSIONS The study concludes that psychological flexibility is extremely relevant to disability studies and should be further explored in relation to different parental well-being and functioning aspects. Professionals are encouraged to incorporate principles of acceptance and commitment therapy into their work with parents of children with disabilities.
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Affiliation(s)
- Ayelet Gur
- Social Work Department, Tel-Hai College, Upper Galilee, Israel.
| | - Ari Reich
- Faculty of Education, Bar Ilan University, Ramat Gan, Israel
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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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Perceptions of the Professionals and Parents of Children with Autism Spectrum Disorders About Autism Services; A Qualitative Study. J Autism Dev Disord 2023; 53:96-109. [PMID: 34982323 DOI: 10.1007/s10803-021-05388-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 02/03/2023]
Abstract
In this qualitative study, we aimed to explore the challenges of providing services and supports for children with autism spectrum disorders (ASD) and their families from the perceptions of professionals and parents of children with ASD. We classified the results of the study into three key categories including shortcomings in the management of children with ASD; shortcomings of supportive programs and facilities for children with ASD and their families; and organizational challenges in providing services for these children. We analyzed data using the content analysis method. The results showed that there is a wide range of challenges in providing sufficient and high-quality services for children with ASD and empowerment programs for their parents.
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Smith J, Rabba AS, Datta P, Dresens E, Wang R, Cong L, Dang N, Hall G, Heyworth M, Lawson W, Lee P, Lilley R, Ma E, Nguyen HTT, Nguyen KV, Nguyen P, Yeow CT, Pellicano E. 'It's really important to be collaborating': Experiences of participatory research for Chinese and Vietnamese parents of autistic children. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2023; 8:23969415231210482. [PMID: 38028582 PMCID: PMC10644728 DOI: 10.1177/23969415231210482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background and aims Participatory research involves academic partners working together with the community that is affected by research to make decisions about that research. Such approaches often result in research that is more respectful of, and responsive to, community preferences - and is vital in the context of autism research with culturally and linguistically diverse (CALD) communities. Whilst participatory approaches are becoming more commonplace within CALD autism research, no studies have explored the experiences of being involved in autism research from the perspectives of CALD community partners over the course of a study. This paper intended to address this gap by reporting on the experiences of CALD parents of autistic children who were community partners in a 1-year Australian research project exploring home-school partnerships for CALD parents of autistic children. We aimed to: (1) report on how parents' involvement in the research process shaped the home-school partnerships study over time and (2) understand their experiences of being community partners on the home-school partnerships project. Methods Using key principles of participatory approaches, we established Chinese and Vietnamese parent advisory groups to contribute to a project exploring home-school partnerships for parents of autistic children from CALD backgrounds in Australia. Advisory groups included parents of autistic children from Chinese/Vietnamese backgrounds, as well as interpreters, professionals and researchers. We documented how parents' participation as community partners shaped the home-school partnerships study over the course of the project. We also elicited parents' own views and experiences of being community partners through informal, open-ended questions at the beginning and end of the study. Results We found that parents' input fundamentally shaped the broader home-school partnership study, from meaningful, accurate translation of interview schedules through to making decisions regarding community-specific recommendations and dissemination plans. Parents themselves reported being keen to collaborate and to hear and share opinions for the purpose of the home-school partnership study - although they noted how emotionally difficult sharing their stories could be. While they initially had some concerns about combining being involved as a community partner with their existing responsibilities, ultimately, parents were surprised by the scope of the home-school partnership study and their level of involvement as community partners. Through hearing others' stories and sharing their own in advisory group meetings, parents reported ancillary benefits of their involvement, including increased self-advocacy and well-being. Conclusions These findings show how research that is conducted in partnership with diverse members of the autism community has the capacity to improve the quality of the research and benefit community partners. Implications This study clearly documents the benefits and potential challenges of participatory approaches with CALD communities. These findings emphasise to researchers and funders the importance of including extra time and money within budgets in order to produce meaningful research that is respectful and responsive to communities.
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Affiliation(s)
- Jodie Smith
- Macquarie School of Education, Macquarie University, Sydney, 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, Sydney, Australia; Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Faculty of Education, School of Educational Psychology and Counselling, Monash University, Melbourne, Australia
| | - Poulomee Datta
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Emma Dresens
- Positive Partnerships, Chatswood, NSW, Australia
| | - Rena Wang
- Macquarie School of Education, Macquarie University, Sydney, Australia; Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University,
Melbourne, Australia
| | - Lin Cong
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Ngoc Dang
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, Sydney, Australia; Reframing Autism,
Sydney, Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Curtin University, Curtin Autism Research Group, Perth WA
| | - Patricia Lee
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Positive Partnerships, Forestville, NSW, Australia
- Positive Partnerships, Chatswood, NSW, Australia
| | - Rozanna Lilley
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Emily Ma
- Macquarie School of Education, Macquarie University, Sydney, Australia; Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University,
Melbourne, Australia
| | - Hau T T Nguyen
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Kim-Van Nguyen
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Phuc Nguyen
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Chong Tze Yeow
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, Australia; Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Herzig van Wees S, Dini S. The silent shot: An analysis of the origin, sustenance and implications of the MMR vaccine - autism rumour in the Somali diaspora in Sweden and beyond. Glob Public Health 2023; 18:2257771. [PMID: 37750434 DOI: 10.1080/17441692.2023.2257771] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/06/2023] [Indexed: 09/27/2023]
Abstract
This article traces the origin, sustenance and implications of a persistent rumour that is responsible for low measles mumps and rubella (MMR) vaccination uptake in the Somali diaspora in a number of countries across the globe. The rumour stipulates that the MMR vaccine - the silent shot - causes autism spectrum disorder (ASD). Although the association between MMR and ASD is non-causal, and various public health initiatives have promoted health information campaigns, the rumour continues to circulate in the Somali diaspora in many countries, including Sweden. This paper shows that there are valid reasons for this. The findings from this paper draw on a systematic scoping review and qualitative interview data from Sweden. The results show that the Somali community experiences higher than average rates of ASD compared to the general population. Moreover, ASD does not exist in the Somali language or their home country, is considered a Western disease that only affects Somali children in the diaspora, and is a highly stigmatised disease. Also, the Somali diaspora has had negative experiences with ASD diagnosis and care. The rumour has been sustained by the absence of an answer to their ASD fear and through active diaspora networks on social media. The network that surrounds the rumour has arguably further helped to create an epistemic community for a community whose concerns have been silenced.
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Affiliation(s)
| | - Samira Dini
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
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12
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An Intersectional Examination of Disability and Race Models in Behavior-Analytic Practice. BEHAVIOR AND SOCIAL ISSUES 2022. [DOI: 10.1007/s42822-022-00116-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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A qualitative study on the experience of stigma for Chinese parents of children with autism spectrum disorder. Sci Rep 2022; 12:19550. [PMID: 36379973 PMCID: PMC9666461 DOI: 10.1038/s41598-022-23978-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Experiencing stigma related to having a child with autism spectrum disorder (ASD) can be difficult and is detrimental to parent well-being. Since the research on stigmatized experiences among parents of children with ASD in non-Western communities is limited, this qualitative study examined the experiences, reactions and impacts of stigma on parents of children with ASD in Hong Kong. In-depth interviews were conducted with 54 Chinese parents/caregivers of children with ASD aged between 35 and 73 years old. Data were analyzed using an inductive approach. The participants reported stigma which stemmed from negative labelling of their children by schools and healthcare professionals, bullying by peers, stereotypes of ASD and stigma linked to autistic children's behavior in the community. The reactions of participants towards stigmatization were classified into internalizing reactions including apologizing, ignoring and concealing ASD and externalizing reactions such as fighting back. The participants also reported impacts of stigma on both personal and emotional levels. The results point to the urgent need for the government to allocate resources and make concerted efforts to reduce stigma by educating the community to foster more positive attitudes towards individuals with ASD and offer support and counselling services to parents.
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Lyu QY, Yu XX, Wang JL, Wang XY, Ke QQ, Liu D, Yang QH. Self-esteem and family functioning mediates the association of symptom severity and parental affiliate stigma among families with children with ASD. J Pediatr Nurs 2022; 66:e122-e129. [PMID: 35537979 DOI: 10.1016/j.pedn.2022.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the level of affiliate stigma among parents of children with autism spectrum disorder and to explore the mediating role of self-esteem and family functioning. DESIGN AND METHODS A cross-sectional study was conducted in a large regional hospital and two childhood rehabilitation centers in Guangdong, China. Data related to demographics, parental self-esteem, family functioning, and affiliate stigma were collected from 180 parents of children diagnosed with ASD. We used t-tests, analysis of variance, and correlation analysis to explore the related factors of parental affiliate stigma. Path analysis was used to determine the mediating roles of self-esteem and family functioning in the relationship between symptom severity and affiliate stigma. RESULTS Parents of children with autism spectrum disorder in China experienced low self-esteem, family functioning, and high affiliate stigma. Symptom severity was negatively correlated with self-esteem and family functioning. Self-esteem and family functioning were significantly negatively correlated with affiliate stigma. Symptom severity was positively correlated with affiliate stigma. Self-esteem and family functioning mediated the relationship between symptom severity and affiliate stigma. CONCLUSIONS Symptom severity affects parental affiliate stigma among families with children with ASD. Self-esteem and family functioning are the two mediators in the relationship. We should take steps to improve self-esteem and family functioning in order to alleviate parental affiliate stigma. PRACTICE IMPLICATIONS This study emphasizes the importance of the influence of ASD severity and family functioning on affiliate stigma. In clinical practice, psychological support should be provided for parents of children with ASD to improve their mental health.
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Affiliation(s)
- Qi-Yuan Lyu
- School of Nursing, Jinan University, Guangzhou, China
| | - Xiao-Xue Yu
- School of Nursing, Jinan University, Guangzhou, China
| | - Jia-le Wang
- School of Nursing, Jinan University, Guangzhou, China
| | - Xin-Yu Wang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Qi-Qi Ke
- School of Nursing, Jinan University, Guangzhou, China
| | - Dan Liu
- Tianyu Education Training Center, Chancheng District, Foshan, Guangdong, China
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15
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Turnock A, Langley K, Jones CR. Understanding Stigma in Autism: A Narrative Review and Theoretical Model. AUTISM IN ADULTHOOD 2022; 4:76-91. [PMID: 36605561 PMCID: PMC8992913 DOI: 10.1089/aut.2021.0005] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The experience of stigma by autistic people is relatively understudied, despite contributing to a range of poor outcomes and having an overarching impact on well-being. The current review of the literature synthesizes research to determine what is currently known and presents a theoretical model of autism stigma. Autism stigma is primarily influenced by a public and professional understanding of autism in combination with interpretation of visible autistic traits. Moderating factors include the quality and quantity of contact with autistic people, cultural factors, sex and gender, individual differences, and diagnostic disclosure. Stigma can reduce well-being as well as increase the presence of camouflaging behaviors, which mask autistic traits. Caregivers of autistic people can experience stigma by association, that is, affiliate stigma, which can impact their own well-being. A variety of interventions and approaches to reduce stigma are discussed, including "autism friendly" spaces, positive media representation, educational and psychosocial training for the public and professionals, as well as cultural and systemic shifts that foster inclusivity and recognize neurodiversity.
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Affiliation(s)
- Alice Turnock
- School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, United Kingdom
| | - Kate Langley
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Catherine R.G. Jones
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom
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16
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Sims R, Michaleff ZA, Glasziou P, Thomas R. Consequences of a Diagnostic Label: A Systematic Scoping Review and Thematic Framework. Front Public Health 2022; 9:725877. [PMID: 35004561 PMCID: PMC8727520 DOI: 10.3389/fpubh.2021.725877] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/29/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: To develop a thematic framework for the range of consequences arising from a diagnostic label from an individual, family/caregiver, healthcare professional, and community perspective. Design: Systematic scoping review of qualitative studies. Search Strategy: We searched PubMed, Embase, PsycINFO, Cochrane, and CINAHL for primary studies and syntheses of primary studies that explore the consequences of labelling non-cancer diagnoses. Reference lists of included studies were screened, and forward citation searches undertaken. Study Selection: We included peer reviewed publications describing the perceived consequences for individuals labelled with a non-cancer diagnostic label from four perspectives: that of the individual, their family/caregiver, healthcare professional and/or community members. We excluded studies using hypothetical scenarios. Data Extraction and Synthesis: Data extraction used a three-staged process: one third was used to develop a preliminary framework, the next third for framework validation, and the final third coded if thematic saturation was not achieved. Author themes and supporting quotes were extracted, and analysed from the perspective of individual, family/caregiver, healthcare professional, or community member. Results: After deduplication, searches identified 7,379 unique articles. Following screening, 146 articles, consisting of 128 primary studies and 18 reviews, were included. The developed framework consisted of five overarching themes relevant to the four perspectives: psychosocial impact (e.g., positive/negative psychological impact, social- and self-identity, stigma), support (e.g., increased, decreased, relationship changes, professional interactions), future planning (e.g., action and uncertainty), behaviour (e.g., beneficial or detrimental modifications), and treatment expectations (e.g., positive/negative experiences). Perspectives of individuals were most frequently reported. Conclusions: This review developed and validated a framework of five domains of consequences following diagnostic labelling. Further research is required to test the external validity and acceptability of the framework for individuals and their family/caregiver, healthcare professionals, and community.
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Affiliation(s)
- Rebecca Sims
- Institute for Evidence-Based Healthcare (IEBH), Health Science and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Zoe A Michaleff
- Institute for Evidence-Based Healthcare (IEBH), Health Science and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare (IEBH), Health Science and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Rae Thomas
- Institute for Evidence-Based Healthcare (IEBH), Health Science and Medicine, Bond University, Gold Coast, QLD, Australia
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17
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Čolić M. Clarification of stigma concepts in research with families of individuals with neurodevelopmental disabilities. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:621-627. [PMID: 37346251 PMCID: PMC10281341 DOI: 10.1080/20473869.2021.1989978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 06/23/2023]
Abstract
Stigma concepts among families of individuals with neurodevelopmental disabilities have received increased attention from researchers in the past decade. With a growing number of studies published, there are also notable discrepancies in conceptualizations and uses of stigma terms among scholars. These variations may result in inadequate comparisons of findings across studies and a failure to generalize the results. Therefore, I have compared various stigma concepts and offered key features of each term as well as suggested methodology for facilitating stigma research.
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Affiliation(s)
- Marija Čolić
- Department of Special Education, University of Hawaiʻi at Mānoa, Honolulu, HI, USA
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18
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Davis R, Fletcher-Watson S, Digard BG. Autistic People's Access to Bilingualism and Additional Language Learning: Identifying the Barriers and Facilitators for Equal Opportunities. Front Psychol 2021; 12:741182. [PMID: 34630254 PMCID: PMC8492951 DOI: 10.3389/fpsyg.2021.741182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/23/2021] [Indexed: 12/01/2022] Open
Abstract
Bilingualism is a valuable tool that enriches and facilitates cultural, social and lived experiences for autistic and non-autistic people alike. Research consistently finds no negative effects of bilingualism and highlights the potential for positive effects across cognitive and socio-cultural domains for autistic and non-autistic children. Yet parents of autistic children remain concerned that bilingualism will cause delays in both cognitive and language development and are still frequently advised by practitioners to raise their child monolingually. Evidently, findings from research are not reflected in practice or subsequent advice, and it is essential to identify ways to ensure equal access to additional language learning. We briefly summarise the existing literature on bilingualism and autism, considering perspectives from the bilingual autistic community, and experimental research. We identify the most pertinent barriers to participation for autistic bilingual children in terms of familial, clinical and educational perspectives. We propose novel solutions to promote additional language learning and suggest changes to practice that will contribute to an evidence base for families and practitioners. This commentary makes innovative recommendations at both the individual and societal level to ensure that autistic bilingual people have equal rights and opportunities to language learning and are optimally supported in accessing them.
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Affiliation(s)
- Rachael Davis
- Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Sue Fletcher-Watson
- Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, United Kingdom
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19
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Attitudes and Perceptions of Muslim Parents Toward Their Children with Autism: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Vahedparast H, Khalafi S, Jahanpour F, Bagherzadeh R. The Actor-Partner Effects of Parenting Stress on Quality of Life Among Parents of Children with ASD: The Mediating Role of Mental Quality of Life. J Autism Dev Disord 2021; 52:142-149. [PMID: 33649881 DOI: 10.1007/s10803-021-04919-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 11/29/2022]
Abstract
The present study investigated the actor-partner effects of parenting stress (PS) on quality of life (QoL) among parents (96 couples) of children with autism spectrum disorder (ASD). Data were collected using the QoL Scale and the PS Index. Structural equation modeling was also utilized to test the hypothesis. The results revealed the effects of PS in each parent on mental QoL of that parent. Maternal PS further shaped physical QoL in mothers. However, PS in one parent did not influence QoL of his or her partner. Accordingly, mental QoL had a mediating role between PS and physical QoL. It was ultimately suggested to take account of QoL among parents in addition to the treatment of children with ASD.
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Affiliation(s)
- Hakimeh Vahedparast
- Department of Nursing, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Islamic Republic of Iran
| | - Saeedeh Khalafi
- Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Islamic Republic of Iran
| | - Faeze Jahanpour
- Department of Nursing, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Islamic Republic of Iran
| | - Razieh Bagherzadeh
- Department of Midwifery, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Islamic Republic of Iran.
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21
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Self-Stigma of Families of Persons with Autism Spectrum Disorder: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-020-00228-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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22
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Bizzego A, Lim M, Schiavon G, Setoh P, Gabrieli G, Dimitriou D, Esposito G. Child disability and caregiving in low and middle income countries: Big data approach on open data. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 107:103795. [PMID: 33142260 DOI: 10.1016/j.ridd.2020.103795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/28/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The presence of child disabilities might affect the amount of caregiving attention the child receives, with potential ramifications on the development of the child and increasing the likelihood of developing a more severe condition. Little is known about the association between child disabilities and caregiving practices in less developed countries, penalized by both lack of data and a research bias toward western societies. METHOD In this study, we apply data mining methods on a large (N = 29,525) dataset from UNICEF to investigate the association between caregiving practices and developmental disabilities of the children, and highlight the differences between intellectual and other disabilities. RESULTS Our results highlight that, compared to other types of disabilities, intellectual disabilities increased the risk of being neglected by the caregiver in those activities oriented to the cognitive development. The education of the caregiver and the socioeconomical development of the country are actively involved in the moderation of the risk. CONCLUSION We demonstrated that educational policies of parental training, such as psychoeducation regarding intellectual disabilities and destigmatization campaigns, are needed to benefit parental practices in low- and middle-income countries.
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Affiliation(s)
- Andrea Bizzego
- Department of Psychology and Cognitive Science, University of Trento, Italy
| | - Mengyu Lim
- School of Social Sciences, Nanyang Technological University, Singapore
| | - Greta Schiavon
- Department of Psychology and Cognitive Science, University of Trento, Italy
| | - Peipei Setoh
- School of Social Sciences, Nanyang Technological University, Singapore
| | - Giulio Gabrieli
- School of Social Sciences, Nanyang Technological University, Singapore
| | - Dagmara Dimitriou
- UCL Institute of Education, University College London, London, United Kingdom
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Italy; School of Social Sciences, Nanyang Technological University, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
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23
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"Crazy person is crazy person. It doesn't differentiate": an exploration into Somali views of mental health and access to healthcare in an established UK Somali community. Int J Equity Health 2020; 19:190. [PMID: 33109227 PMCID: PMC7592587 DOI: 10.1186/s12939-020-01295-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 10/06/2020] [Indexed: 11/30/2022] Open
Abstract
Background Mental health conditions have been shown to disproportionately affect those from Black, Asian and Minority Ethnic (BAME) communities. Somali communities globally have relatively high levels of mental illness, but low levels of mental health service use, with numerous barriers to care identified. This study was conducted in an established UK Somali community in the South West of England and aimed to explore community beliefs and views about the causes of mental illness, treatment for mental illness, and access to medical services in general. Participants were asked about how mental health and illness are understood and conceptualised, along with the cultural meaning of mental illness and its manifestations in relation to men, women and young people. Design Using a community-based participatory research design, in partnership with local Somali community organisations, the research team conducted four focus groups with a total of 23 participants aged over 18. Open-ended questions were used to facilitate discussion. Transcripts were analysed thematically. Results The participants discussed the role of migration and associated stress from the civil war and how that could contribute to mental illness. Participants tended to view the symptoms of mental illness as physical manifestations such as headaches and to describe a strong community stigma where those with mental health conditions were viewed as “crazy” by others. Barriers to accessing healthcare included language barriers, waiting times and a mistrust of doctors. Various ideas for improvements were discussed, including ideas to reduce stigma and ideas for community initiatives. Conclusion Cultural considerations and reducing stigma are vital in improving understanding of mental illness and improving access to mental health services, along with building relationships and trust between the Somali community and health care workers.
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24
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Linney C, Ye S, Redwood S, Mohamed A, Farah A, Biddle L, Crawley E. "Crazy person is crazy person. It doesn't differentiate": an exploration into Somali views of mental health and access to healthcare in an established UK Somali community. Int J Equity Health 2020; 19:190. [PMID: 33109227 PMCID: PMC7592587 DOI: 10.1186/s12939-020-01295-0#citeas] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Mental health conditions have been shown to disproportionately affect those from Black, Asian and Minority Ethnic (BAME) communities. Somali communities globally have relatively high levels of mental illness, but low levels of mental health service use, with numerous barriers to care identified. This study was conducted in an established UK Somali community in the South West of England and aimed to explore community beliefs and views about the causes of mental illness, treatment for mental illness, and access to medical services in general. Participants were asked about how mental health and illness are understood and conceptualised, along with the cultural meaning of mental illness and its manifestations in relation to men, women and young people. DESIGN Using a community-based participatory research design, in partnership with local Somali community organisations, the research team conducted four focus groups with a total of 23 participants aged over 18. Open-ended questions were used to facilitate discussion. Transcripts were analysed thematically. RESULTS The participants discussed the role of migration and associated stress from the civil war and how that could contribute to mental illness. Participants tended to view the symptoms of mental illness as physical manifestations such as headaches and to describe a strong community stigma where those with mental health conditions were viewed as "crazy" by others. Barriers to accessing healthcare included language barriers, waiting times and a mistrust of doctors. Various ideas for improvements were discussed, including ideas to reduce stigma and ideas for community initiatives. CONCLUSION Cultural considerations and reducing stigma are vital in improving understanding of mental illness and improving access to mental health services, along with building relationships and trust between the Somali community and health care workers.
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Affiliation(s)
- Catherine Linney
- grid.5337.20000 0004 1936 7603Centre for Academic Child Health, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU UK
| | - Siyan Ye
- grid.5337.20000 0004 1936 7603Centre for Academic Child Health, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU UK
| | | | | | | | - Lucy Biddle
- ARC West, Bristol, UK ,grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Esther Crawley
- grid.5337.20000 0004 1936 7603Centre for Academic Child Health, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU UK
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25
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Salway S, Such E, Preston L, Booth A, Zubair M, Victor C, Raghavan R. Reducing loneliness among migrant and ethnic minority people: a participatory evidence synthesis. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background
To date, there has been little research into the causes of, and solutions to, loneliness among migrant and ethnic minority people.
Objectives
The objectives were to synthesise available evidence and produce new insights relating to initiatives that aim to address loneliness among these populations, plus the logic, functioning and effects of such initiatives.
Data sources
Electronic database searches (MEDLINE, Applied Social Sciences Index and Abstracts and Social Science Citation Index via Web of Science – no date restrictions were applied), grey literature searches, and citation and reference searching were conducted. Data were generated via nine workshops with three consultation panels involving 34 public contributors, and one practitioner workshop involving 50 participants.
Review methods
Guided by ‘systems thinking’, a theory-driven synthesis was combined with an effectiveness review to integrate evidence on the nature and causes of loneliness, interventional types and programme theory, and intervention implementation and effectiveness.
Results
The theory review indicated that common conceptualisations of ‘loneliness’ can be usefully extended to recognise four proximate determinants when focusing on migrant and ethnic minority populations: positive social ties and interactions, negative social ties and interactions, self-worth, and appraisal of existing ties. A total of 170 interventions were included. A typology of eight interventions was developed. Detailed logic models were developed for three common types of intervention: befriending, shared-identity social support groups and intercultural encounters. The models for the first two types were generally well supported by empirical data; the third was more tentative. Evaluation of intervention processes and outcomes was limited by study content and quality. Evidence from 19 qualitative and six quantitative studies suggested that social support groups have a positive impact on dimensions of loneliness for participants. Evidence from nine qualitative and three quantitative studies suggested that befriending can have positive impacts on loneliness. However, inconsistent achievements of the befriending model meant that some initiatives were ineffective. Few studies on intercultural encounters reported relevant outcomes, although four provided some qualitative evidence and three provided quantitative evidence of improvement. Looking across intervention types, evidence suggests that initiatives targeting the proximate determinants – particularly boosting self-worth – are more effective than those that do not. No evidence was available on the long-term effects of any initiatives. UK intervention (n = 41) and non-intervention (n = 65) studies, together with consultation panel workshop data, contributed to a narrative synthesis of system processes. Interlocking factors operating at individual, family, community, organisational and wider societal levels increase risk of loneliness, and undermine access to, and the impact of, interventions. Racism operates in various ways throughout the system to increase risk of loneliness.
Limitations
There was a lack of high-quality quantitative studies, and there were no studies with longer-term follow-up. UK evidence was very limited. Studies addressing upstream determinants operating at the community and societal levels did not link through to individual outcome measures. Some elements of the search approach may mean that relevant literature was overlooked.
Conclusions
Theory regarding the causes of loneliness, and functioning of interventions, among migrant and ethnic minority populations was usefully developed. Evidence of positive impact on loneliness was strongest for shared-identity social support groups. Quantitative evidence was inadequate. The UK evidence base was extremely limited.
Future work
UK research in this area is desperately needed. Co-production of interventional approaches with migrant and ethnic minority people and evaluation of existing community-based initiatives are priorities.
Study registration
This study is registered as PROSPERO CRD42017077378.
Funding
This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 10. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Sarah Salway
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Elizabeth Such
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Louise Preston
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Maria Zubair
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Christina Victor
- College of Health and Life Sciences, Brunel University London, London, UK
| | - Raghu Raghavan
- School of Nursing and Midwifery, De Montfort University, Leicester, UK
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Papoudi D, Jørgensen CR, Guldberg K, Meadan H. Perceptions, Experiences, and Needs of Parents of Culturally and Linguistically Diverse Children with Autism: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00210-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AbstractA scoping review of studies carried out in the UK and the USA was conducted to explore the perceptions, experiences, and needs of culturally and linguistically diverse families of children with autism. Overall, 32 articles met the inclusion criteria, 25 studies were conducted in the USA and 7 studies in the UK. Four themes emerged including (a) knowledge and beliefs about autism and their impact on the family; (b) autism and family life; (c) family experiences of accessing services and support, and parents’ needs; and (d) multilanguage. Findings highlighted that family perceptions of autism are influenced by an often-reported lack of knowledge; experiences include social stigma as well as difficulties in having access to services. Needs indicate the development of culturally sensitive interventions, information in multiple languages, and parent–professional collaboration. Implications for research, policy, and practice are included.
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Gentles SJ, Nicholas DB, Jack SM, McKibbon KA, Szatmari P. Coming to understand the child has autism: A process illustrating parents' evolving readiness for engaging in care. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:470-483. [PMID: 31508991 PMCID: PMC6985991 DOI: 10.1177/1362361319874647] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
LAY ABSTRACT What is already known about the topic? Parents of children with autism often learn about their child's autism before diagnosis and can spend long periods seeking care (including assessment) before receiving a diagnosis. Meanwhile, parents' readiness to engage in care at this early stage can vary from parent to parent. What this paper adds? This study revealed how parents come to understand their child has autism-on their own terms, rather than from just talking to professionals. It also explained how parents' growing awareness of their child's autism leads them to feel more motivated to engage in care by seeking information and pursuing services. Four "optional steps" described how parents' growing readiness to engage in care at this early stage can vary, depending on their personal process. Implications for practice, research, or policy The results suggest ways that professionals can be more sensitive (a) to parents' varying awareness of autism and (b) to their varying readiness for being involved in early care. They also suggest ways to tailor parent supports to their individual situation and design care that is more family centered. Not all parents want high levels of involvement. Depending on their personal process, some parents may need care and support that is directed at them before feeling ready for professionals to engage them in care directed at the child.
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28
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Gonzalez M, Phoenix M, Saxena S, Cardoso R, Canac-Marquis M, Hales L, Putterman C, Shikako-Thomas K. Strategies used to engage hard-to-reach populations in childhood disability research: a scoping review. Disabil Rehabil 2020; 43:2815-2827. [DOI: 10.1080/09638288.2020.1717649] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Miriam Gonzalez
- Department of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Research Institute of the McGill University Health Centre, McGill University, Montréal, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science and CanChild, McMaster University, Hamilton, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Shikha Saxena
- Department of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Roberta Cardoso
- Research Institute of the McGill University Health Centre, McGill University, Montréal, Canada
| | - Michelle Canac-Marquis
- Centre for Innovative Medicine, Research Institute of the McGill University Health Centre, Montréal, Canada
| | - Lindsay Hales
- McConnell Resource Centre, McGill University Health Centre, Montréal, Canada
| | - Connie Putterman
- CHILDBRIGHT Knowledge Translation Committee, CHILD-BRIGHT Network, Montréal, Canada
- Canada-Israel Autism Research Initiative, Toronto, Canada
| | - Keiko Shikako-Thomas
- Department of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Research Institute of the McGill University Health Centre, McGill University, Montréal, Canada
- Canada Research Chair in Childhood Disability: Participation and Knowledge Translation, McGill University, Montréal, Canada
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29
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Aabe NO, Fox F, Rai D, Redwood S. Inside, outside and in-between: The process and impact of co-producing knowledge about autism in a UK Somali community. Health Expect 2019; 22:752-760. [PMID: 31318129 PMCID: PMC6737832 DOI: 10.1111/hex.12939] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 11/29/2022] Open
Abstract
Background Co‐production is predicated on equal power‐sharing and responsibility in research partnerships. However, relatively few accounts exist that explore the subjective experience of how co‐researchers achieve such equality, from the perspectives of public contributors and researchers. Aim This paper aims to provide a unique insight into the process of co‐production, by weaving personal reflections with principles to evaluate the impact arising from co‐produced knowledge. It is based upon participatory research that was initiated by a ‘lay’ person, on behalf of a community organization, seeking support for Somali families who are affected by autism. The paper explores the evolving partnerships that began with community theatre and qualitative research and leading to extensive dissemination and impact, all of which has been jointly owned and negotiated by the co‐researchers and community organizations. Discussion Initially, this paper reflects on the process, drawing on principles defined for co‐production in health research and combining it with the co‐researcher's personal reflections of their experiences as insiders and outsiders, stepping in and out of each other's worlds. The value of reciprocity, flexibility and continuous reflection is illustrated. The latter part of the paper explores the impact of this co‐produced knowledge using a theoretical framework, to assess the specific impacts and its broader transformative potential. It demonstrates how (1) opportunities for all partners to be equitably involved to the maximum degree possible throughout the research process can affect social change and (2) co‐produced research can become a catalyst that is dynamic and complex, achieving multi‐layered impact.
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Affiliation(s)
| | - Fiona Fox
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) and Bristol Medical School, University of Bristol, Bristol, UK
| | - Dheeraj Rai
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sabi Redwood
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) and Bristol Medical School, University of Bristol, Bristol, UK
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Broder-Fingert S, Carter A, Pierce K, Stone WL, Wetherby A, Scheldrick C, Smith C, Bacon E, James SN, Ibañez L, Feinberg E. Implementing systems-based innovations to improve access to early screening, diagnosis, and treatment services for children with autism spectrum disorder: An Autism Spectrum Disorder Pediatric, Early Detection, Engagement, and Services network study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:653-664. [PMID: 29633852 PMCID: PMC6167204 DOI: 10.1177/1362361318766238] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In 2013, the National Institute of Mental Health funded five trials of unique, multicomponent, systems-based innovations designed to improve access to early screening, diagnosis, and treatment of autism spectrum disorder-collectively known as the Autism Spectrum Disorder Pediatric, Early Detection, Engagement, and Services Network. As part of an ongoing effort to pool data and learn from shared experience, we collected information across all studies about innovation components and implementation strategies. First, each study group completed standardized checklists based on the Template for Intervention Description and Replication and the Expert Recommendation for Implementing Change. Then, we interviewed principal and co-investigators of each study (n = 9) to further explore innovation components and assess barriers and facilitators to implementation. Innovation strategies were diverse (five different autism spectrum disorder screeners were used, 40% included early intervention trainings, 60% involved new technology). Common implementation strategies included developing stakeholder relationships and provider trainings. Barriers included inefficient systems of care, difficulty engaging families in the innovations, provider attitudes, and organizational culture (e.g. difficulty changing clinic processes). These findings suggest that-despite diverse settings and a variety of innovation content-common facilitators and challenges exist in implementing innovations to enhance access to early autism spectrum disorder screening, diagnosis, and treatment.
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Affiliation(s)
| | - Alice Carter
- Department of Psychology, University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA
| | - Karen Pierce
- Department of Neurosciences, University of California San Diego, La Jolla, CA
| | - Wendy L. Stone
- Department of Psychology, University of Washington, Seattle, WA
| | - Amy Wetherby
- Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, FL
| | | | | | - Elizabeth Bacon
- Department of Neurosciences, University of California San Diego, La Jolla, CA
| | | | - Lisa Ibañez
- Department of Psychology, University of Washington, Seattle, WA
| | - Emily Feinberg
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
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Crane L, Jones L, Prosser R, Taghrizi M, Pellicano E. Parents' views and experiences of talking about autism with their children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1969-1981. [PMID: 30915857 DOI: 10.1177/1362361319836257] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The way an autism diagnosis is disclosed to parents has been found to play a crucial role in their acceptance of, and the way they cope with, their child's diagnosis. Yet, research into parents' subsequent experiences of disclosing a diagnosis to their children, and talking to their families about autism more generally, is limited. Using an online survey, the current study examined 558 parents' experiences of talking about autism with their autistic and non-autistic children. Results demonstrated that most parents (n = 379, 67.9%) had told their autistic children about their diagnosis. Despite few parents (n = 163, 20.4%) receiving advice or support regarding the disclosure of the diagnosis, those that had disclosed felt satisfied with the process (n = 319, 84.2%) and felt confident in talking about autism with their children (n = 339, 92.4%). Those who had not told their autistic children about the diagnosis largely planned to discuss this with their child in the future (n = 100, 73.5%), felt confident in doing so (n = 95, 70.9%) and were satisfied with their decision (n = 95, 70.4%). Analysis of open-ended data, using thematic analysis, highlighted the importance of openness and the need to tailor explanations to individual children's needs, while acknowledging that disclosure could often be challenging for parents.
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'Like a life in a cage': Understanding child play and social interaction in Somali refugee families in the UK. Health Place 2019; 56:191-201. [PMID: 30825824 DOI: 10.1016/j.healthplace.2019.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 01/14/2019] [Accepted: 01/28/2019] [Indexed: 01/06/2023]
Abstract
Migration to a different culture may affect opportunities for play and social interaction, essential for children's developing cognitive and social skills. We asked Somali migrant women about experiences of childhood (both while growing up themselves, and subsequent observations) in Somalia and the UK. In Somalia, they described a supportive, connected community and safe environment enabling children to play and learn together. In the UK, by contrast, multiple local stressors constrained children's opportunities to play and interact. Understanding and improving neighbourhood geography, as experienced and shaped by parents and children, would seem important for promoting early child development in refugee families.
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Hussein AM, Pellicano E, Crane L. Understanding and awareness of autism among Somali parents living in the United Kingdom. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:1408-1418. [PMID: 30486651 DOI: 10.1177/1362361318813996] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Using vignettes and interviews, this study examined understanding and awareness of autism, and (a)typical development more broadly, among 32 Somali parents living in the United Kingdom. Results demonstrated that parents of both autistic (n = 16) and non-autistic (n = 16) children were just as likely to identify vignettes of typically developing children, yet parents of autistic children appeared more astute to signs of atypical development. Across the whole sample, parents commonly identified and labelled vignettes of autistic children, but experienced more difficulty labelling vignettes that described children with other forms of atypical development, sometimes mislabeling these children as autistic. This suggests that there is a need for greater support in recognising and identifying different types of atypical development in the Somali community (to mitigate the risk that the term 'autism' may take on its own meaning within the Somali community, becoming a euphemism for a range of developmental conditions). Analysis of interview data identified key sociocultural factors that either helped or hindered the inclusion of families with autistic children within the community, including the Somali community's: (1) perceptions of disability, (2) beliefs about the causes of autism in the Western world and (3) strong reliance on religious beliefs in understanding and accepting an autism diagnosis.
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Fox F, Aabe N, Turner K, Redwood S, Rai D. "It was like walking without knowing where I was going": A Qualitative Study of Autism in a UK Somali Migrant Community. J Autism Dev Disord 2017; 47:305-315. [PMID: 27858263 PMCID: PMC5309314 DOI: 10.1007/s10803-016-2952-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Increasing recognition of autism in Somali migrant communities means that appropriate support services are needed. Attitudes to autism and barriers related to help-seeking in these communities are poorly understood. We aimed to assess what families affected by autism need, and how health, education and social care services can support them. In partnership with the local Somali community the research team conducted 15 in-depth interviews with parents affected by autism. Two themes are reported; 'Perceptions of Autism' and 'Navigating the System'. Our research shows the importance of understanding cultural views of autism and the need to raise awareness, reduce stigma and provide support to encourage families not to delay seeking help for their children.
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Affiliation(s)
- Fiona Fox
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust, 9th floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Nura Aabe
- Autism Independence, Silai Centre, 176 Easton Road, Bristol, BS5 0ES, UK
| | - Katrina Turner
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust, 9th floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Sabi Redwood
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust, 9th floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Dheeraj Rai
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- Bristol Autism Spectrum Service, Avon & Wiltshire Partnership NHS Mental Health Trust, 3 Petherton Road, Bristol, BS14 9BP, UK
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