From womb to world
From womb to world
Autism research has largely been conducted in Western settings. As a result, less is known about how culture, social circumstances, and access to healthcare influence the identification and expression of autistic traits and the experiences of families. This thesis of Anne de Leeuw examines these factors among migrant families in the Netherlands and families in Ethiopia.
A new framework shows how cultural and contextual factors can influence different stages of autism identification and diagnosis: how autistic traits are expressed, recognised, interpreted, and reported. Factors such as cultural norms, mental health literacy, stigma, and access to healthcare may all play an important role.
Research among 4,727 mother-child pairs in Rotterdam showed that children of mothers with a migration background had higher levels of autistic traits, particularly when mothers were born outside Europe, had migrated themselves, or had migrated more recently. Part of this difference was related to conditions during pregnancy. In particular, experiences of discrimination and psychological stress, as well as low levels of folate and vitamin D, appeared to play a role.
In Ethiopia, families raising a child with autism or another developmental disability reported a substantially lower quality of life than families of children with a physical health condition. Limited access to healthcare, stigma, and reduced social support may further increase this burden.
Overall, the findings show that autism cannot be understood separately from the social and cultural environment. More inclusive and culturally sensitive healthcare, equitable access to support, and efforts to reduce discrimination and stigma are needed to address health inequalities.