A Review of Barriers Experienced by Immigrant Parents of Children with Autism when Accessing Services
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REVIEW PAPER
A Review of Barriers Experienced by Immigrant Parents of Children with Autism when Accessing Services Nataly Lim 1
&
Mark O’Reilly 1 & Jeff Sigafoos 2 & Giulio E. Lancioni 3 & Neyda J. Sanchez 1
Received: 24 May 2020 / Accepted: 24 June 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Immigrants have poorer health outcomes due in part to limited access to health care. Children with autism spectrum disorder (ASD) who have immigrant parents are diagnosed at a later age and those whose parents have limited English proficiency receive fewer hours of services. What contributes to these health care and support services disparities? This review examined eight qualitative studies published between 2010 and 2020 that explored barriers experienced by immigrant parents of children with ASD with regard to accessing diagnostic and/or intervention services. Key barriers included long wait times, language barriers, and limited health literacy. Recommendations for practice and future research are discussed. Keywords Immigrants . Autism spectrum disorder . Parents . Service delivery . Barriers and challenges
More than 258 million people in the world live in a country that is different from the one in which they were born (United Nations 2017). Immigrants have been identified to be at risk of poorer health outcomes due in part to inadequate health care (Derose et al. 2007). For example, when compared with nonimmigrants, immigrants in the USA are less likely to be insured, which reduces access to health care (Ku and Matani 2001). Even when comparing insured immigrants with nonimmigrants, immigrants persistently have less access to health care due to non-financial barriers, the most prominent being language barriers (Ku and Matani 2001). In fact, immigrants who experience language barriers in the USA have higher levels of stress and poorer health outcomes (Ding and Hargraves 2008). Stress has been identified as one of the main factors associated with immigrants’ health outcomes (Pumariega et al. 2005). Major stressors experienced by immigrants include discrimination, poverty, acculturation, and trauma (Pumariega et al. 2005). Refugees are immigrants who are forcibly displaced from their home countries, and pre-
* Nataly Lim [email protected] 1
The University of Texas at Austin, Austin, USA
2
Victoria University of Wellington, Kelburn, New Zealand
3
University of Bari Aldo Moro, Bari, Italy
migration is often marked by experiences such as violence, deaths of family members, and persecution (Henley and Robinson 2011). According to the DSM-5 (American Psychiatric Association 2013), these experiences qualify as traumatic events, which can precipitate the onset of posttraumatic stress disorder (PTSD). Unsurprisingly, refugees have been found to be 10 times more likely to have PTSD than the general population in host countries, such as Australia, Italy, and Norway (Fazel et al. 2005). In addition to the stressors related to the process of immigration itself, immigrant parents of ch
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