Asian American Immigrant Parents Supporting Children with Autism: Perceptions of Fathers and Mothers.

Introduction According to the U.S. Census Bureau (2012a: 2012b), 57 million or 20% of people spoke more than just English and 38 million or 12.5% people who resided in the United States were foreign-born. Nearly seven million U.S. residents or 17% of these foreign-born people arrived after 2005 (Walters & Trevelyan, 2011). This implies that a significant number of U.S. children had families were recent immigrants or spoke primarily or exclusively a language other than English. However, very little is known about immigrant and refugee children in their new country of residence, especially if they had a disability. Research suggests that immigrant status may be a risk factor for autism spectrum disorders (ASD). Specifically, several researchers found increased risk for having a child diagnosed with ASD when at least one parent was an immigrant (Barnevik-Olsson, Gillberg, & Fernell, 2008; Keen, Reid, & Arnone, 2010; Magnussen & Saemundsen, 2001). In addition to the stress of raising a child diagnosed with a disability, it is not uncommon that immigrant families confront culture-related stress or adaptation issues. Additional issues for immigrant children and their families are likely to exist, including language barriers, cultural differences and the lack of reliable and validated measures in the family's primary language. Immigrants referred to health care services may have more limited knowledge about navigating health care systems, further complicating their ability to access appropriate services (Welterlin & LaRue, 2007). While recent immigrant families are on average more likely to live in poverty and to have less educated parents than non-immigrant families, children under the age of six in immigrant families have been reported to use public benefits less often than those of U.S. born parents (Javier, Huffman, Mendoza, & Wise, 2010). The parents' socioeconomic status, language, education, and ethnicity have all been shown to be important factors in how immigrant families with children with special health care needs experienced health care (Javier et al., 2010). Although a substantial amount of research has paid attention to important issues in the early experiences (e.g., diagnosis, services, coping, adaptation) of families who have children with developmental disabilities, these have been predominantly from European American families perspectives (Zhang & Bennett, 2003; Zionts, Zionts, Harrison, & Bellinger, 2003). Cultural linguistic diversity and ethnicity issues have been striving for attention in research. A recent report found not only later diagnosis of ASD for Hispanic American and African American children than Caucasian children, but also significantly later diagnosis for children of mothers born outside the continental United States (Valicenti-McDermott, Shulman, Hottinger, Burrows, Bernstein, & Seijo, 2010). These findings suggest that delay in diagnosis may be more substantial in recent immigrant children or those whose parents have lower English-language proficiency regardless of ethnicity. Children with ASD of minority race and ethnicity, compared with Caucasian children, have been reported to receive limited services and appear to receive these services at a later age (Levy, Mandell, Merher, Ittenback, & Pinto-Martin, 2003; Mandell, Listerud, Levy, & Pinto-Martin, 2002). Most ethnic minority families experience low levels of parent education and are living in nonmetropolitan areas (Thomas, Ellis, McLaurin, Daniels, & Morrissey, 2007). Gender Differences: Perceptions of Mothers and Fathers Several Western studies have examined gender differences between mothers and fathers who have a child diagnosed with ASD. In recent decades investigators have moved into the arena of family systems, examining the needs expressed by both mothers and fathers of children with disabilities (Lamb & Laumann-Billings, 2003). Although there is more research from the mothers' point of view, several studies focus on how fathers and mothers of children with disabilities differ or are similar in functions across several dimensions. …