Abstract of Master’s Dissertation
No.1

CourseThesis
Title

Master of Public Health

Name

Machi MAEJI (KAKIMOTO)

Social, perinatal, and symptomatic characteristics among the native and immigrantchildren with autism spectrum disorders in Mie, Japan: A Comparative Case Series
at a single center

Abstract of Master’s Dissertation
Background: Autism Spectrum Disorder (ASD) is one of the neurodevelopmental disorders,characterized by impairments in social communication and restricted interests.

Early

diagnosis and interventions are essential because it affects patients and their families
throughout their lives. On the other hand, the number of immigrant children is increasing inJapan and their developmental problems sometimes highlight their social/culturalmaladaptation. However, studies about immigrant children with ASD are profoundly lackingin Japan.
Objectives: This study aimed to clarify social, perinatal, and symptomatic differences
between native and immigrant children with ASD through analysis of clinical cases in Mie,
Japan.
Methods: A retrospective case-series study with a quantitative method was conducted at achildren’s psychiatric hospital, Mie prefectural Medical Center for Child Growth andDevelopment (MMCCD). Participants were all previous patients who had their first
consultation between January 2016 and December 2020, and were diagnosed with an autism
spectrum disorder (ASD). They were divided into two groups, the Immigrant and the Native
group. The data of socio-demographic features, perinatal complications, and standardized
cognitive tests were collected through existing records in MMCCD, then analyzed with Chisquare analyses for binary and ordinal nominal variables, and Student’s t-test for continuousones.

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Abstract of Master’s Dissertation
No.2

CourseMaster of Public HealthNameMachi MAEJI (KAKIMOTO)

Results:
Social, perinatal, and symptomatic characteristics of the 1884 Native and 45 Immigrantchildren with ASD were compared at the time of the first visit to MMCCD. Of the total
immigrant children, half of them were offspring of Brazilian parents, and 82% were born andraised in Japan.
The mean age of the first visit was 6.39 years old (95% CI: 5.50-7.27) in the Immigrantchildren, younger than 7.83 years old (95% CI: 7.67-7.98) in the Native children (P<0.005).
Immigrant children were more often referred by a welfare institution (P<0.005). As a total
for both groups, rates of single-mother households and family history of psychiatric diseases
were higher than that of the overall population, at 11.8 % and 31.4 %, respectively.
Even though antenatal complications were almost the same, the Immigrant group showed
44.4% of Caesarean sections, much higher than 18.9% in the Native group (P<0.005).
In comparing a cognitive test, Developmental Quotient (DQ) in the Kyoto Scale ofPsychological Development 2001, the mean of DQs was 52.4 (95% CI: 45.1-59.6) in theImmigrant group, which was significantly lower than 68.5 (95% CI: 67.0-70.0) in the Native
group (P<0.005).
The difference in symptoms between the Native and the Immigrant participant groups hardly
existed, except for insomnia, probably due to random sampling error.
Conclusion:
The Immigrant children with ASD visited a psychiatric hospital at a younger age,accompanied by multifaceted problems such as lower cognitive levels and familial
vulnerabilities (single-mother households and psychiatric family history). These are deeply
associated with socio-economic, cultural, and language barriers in immigrant children andfamilies. Multi-professional collaboration including a welfare institution, a proper
assessment of their complex problems, and the promotion of parental empowerment arerecommended to tackle these challenges.
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