Introduction
Immigration is a key component of government policy in Canada, making the nation a popular choice for many foreign employees. More than one in five Canadians are foreign-born, reflecting the country’s growing immigrant population. However, equal access to autism services for all populations remains suboptimal. The increased ethnic diversity in local communities affects both the host society and the immigrants, with consequences for fair access to and delivery of social and health services. Autism spectrum disease affects roughly one in 66 children and adolescents (Shanmugarajah, Rosenbaum, & Di Rezze, 2022). Based on literature evaluations, there is growing evidence that immigrant children are more likely to experience neurodevelopmental abnormalities, including autism spectrum disorder. Immigrant children may experience delays in diagnosis and more challenges in accessing quality medical care.
Immigrant families with children with ASD face unique social, cultural, and language challenges. These challenges are compounded by obstacles to accessing health care and educational resources. The social determinants of health are more apparent in the immigrant population than in native-born citizens, thus exacerbating the inequality in healthcare. Autism spectrum disorder is perceived differently in the setting of immigrant families, primarily from Asia and Africa, residing in Canada.
The research objective is to review the literature on the social and health services accessible to autistic immigrant children in Canada, focusing on the hurdles to accessing health care. The study focuses on health care utilization and access hurdles in Canada to highlight service gaps for immigrant families with autistic children. The research emphasizes how immigrant families perceive ASD and the main obstacles to effective treatment to understand the needs of immigrant families better.
Literature Review
The subject of this study regards the availability and use of health and social services by immigrant families in Canada with children with ASD. The research is based on critically examining relevant literature and key research findings. The research is multidisciplinary as it incorporates references from the literature in the social and behavioral sciences and publications from the medical community. The inclusion criteria for the study entail research literature and scientific studies published in English within the last five years. In addition, the research focused on two main immigrant communities, Asian and African immigrants, and their families living in Canada with an ASD child. The articles’ selection was achieved in different steps, primarily by prioritizing those focusing on immigration and barriers to access to health and social services. The major themes regarding inequality in healthcare access among the immigrant population entailed language barrier, lack of specialized education support, long wait times for access, limited health literacy, and inadequate financial support.
Language Barrier
The immigrant families limited English proficiencies prevented them from fully engaging in conversations with their providers. Medical providers spend relatively limited time communicating with them and considering their opinions. Another form of language barrier challenge is the absence of translated materials, such as application forms for services. Sritharan and Koola (2019), the lack of access to interpretation services leads to lower physician-patient interaction satisfaction. Language obstacles result from both the cultural connotations of words and concepts and variances in the spoken languages. There are concerns regarding healthcare providers’ poor and limited awareness of the linguistic obstacles they face while interacting with the immigrant population (Millau, Rivard, & Mello, 2018). Language limitations may lead immigrant families to make uninformed medical treatment decisions as the medical terminology used during health checkups is difficult for parents to understand (Khanlou et al., 2017). The language barrier can lead immigrants’ parents to withhold information as they lack proficiency in determining the relevancy of such information to physicians.
Limited Education Services
Inequality regarding the lack of procedures or staff training in school settings for supporting students with behavioral challenges highlights challenges in accessing education services. Throughout a school week, immigrant parents get multiple calls asking them to pick up their kids from school. The system does not adequately address the requirements of their children, which are highlighted by the inaccurate learning development assessments (Millau, Rivard, & Mello, 2018). Children with ASD symptoms are not taught alongside neurotypical peers and lack the assistance of teachers who are inattentive to the students’ development.
Effective individual education planning (IEP) communication is difficult since demands for special education teachers are routinely ignored. Cultural differences become apparent as parents and instructors argue about what to teach the autistic child. Due to their lower levels of English proficiency, immigrant children with ASD are less likely to include social skills and communication goals on their IEPs (Millau, Rivard, & Mello, 2019). Immigrant families struggle to teach their children these skills since they lack personal technological knowledge. The families frequently need to speak with the child’s teacher numerous times to get their concerns addressed.
Long Wait Times
Parents of immigrants frequently face long wait times, especially for publicly supported diagnostic procedures. There could be a two-year wait before receiving publicly paid diagnostic services. Some parents pay out of pocket for private diagnostic services despite the exorbitant cost. While seeking diagnostic and intervention treatments, the immigrant family members may get stressed due to the lengthy and painful wait times. It can be challenging for families to access health programs designed for children with ASD because the application procedure is time-consuming and frequently requires waiting lists (Lim et al., 2021). Most immigrant families express anger at the long wait times to receive services and, more significantly, at not knowing when their child will be contacted.
Additionally, sometimes the potential benefits of the medical treatments are lost by the time they are finally accessed, as is the situation with speech therapy, where children access services at an older age. Families of immigrants who miss the chance to accept the given therapy must re-register in the system, which requires them to join interminable waiting lists. Khanlou et al. (2017), lengthy application forms and other complex regulatory requirements frequently deter immigrant parents from seeking medical care for their children with ASD. Furthermore, the burdensome paperwork is a significant obstacle to getting medical assistance.
Limited Health Literacy
Immigrant families’ limited health literacy hinders their ability to locate all the available resources and thus cannot acquire information about how to access assistance. Due to the families’ inability to obtain the programs, there is an additional delay in providing care to immigrant children (Lim et al.,2021). The use of jargon terminology by educators and medical experts is another barrier to parents’ understanding of the services offered. It takes longer for parents of children with ASD to access and get services as the immigrant families do not grasp terms like respite care (Khanlou et al., 2021). Finding a family doctor who can treat ASD in children can be challenging for immigrant families, which frequently causes delays in receiving specialized care.
Families may be unaware of how to receive primary care services or disregard the importance of family physicians as crucial players in facilitating access to the healthcare system. Immigrant families have little access to information about services specifically designed for them; thus, there is a problem with the service systems that contributes to low health literacy (Sritharan & Koola, 2019). Another crucial point is that immigrants may still be learning about the social and health care organizations accessible in Canada and how to get services informally.
Lack of Financial Support
Immigrant families frequently experience financial and social hardship, which may ultimately prevent them from obtaining the medical and social care their ASD children require. Parents struggle for tests and treatments not provided by the Canadian government necessary for their children’s accurate diagnosis and treatment. Most families cannot afford the variety of services required for their kids, especially in the early phases of treatment. Khanlou et al. (2021) obtaining government funding for programs and initiatives presents difficulties due to the lengthy waiting lists. Immigrant families who do not receive funding struggle with balancing the needs of their family and their child’s specific needs and interests. These challenges include locating cheap housing that meets the needs of both the family and the child.
Conclusion
The research objective is to review the literature on the social and health services accessible to autistic immigrant children in Canada, focusing on the hurdles to accessing health care. The major themes regarding inequality in healthcare access among the immigrant population entailed language barrier, lack of specialized education support, long wait times for access, limited health literacy, and inadequate financial support. Immigrant parents cannot express their concerns about treatments or request alternate medical treatments due to the language barrier. Communication challenges result from the language used and the various cultural connotations linked to terminology. Translators are crucial in helping immigrant families make better decisions regarding their children’s treatment. A translator for languages such as Hindi, Spanish, and Mandarin can ensure proper interpretation of words and phrases, thus improving patient-physician relationships.
Limited educational services and long wait times to access health care are challenges Canada’s bureaucratic policies created. There is limited educational support for immigrant children as the system does not adequately address the requirements of their children, highlighted by the inaccurate learning development assessments. It is challenging for immigrant families in Canada to access health programs designed for children with ASD because the application procedure is time-consuming and frequently requires waiting lists. Immigrant families’ limited health literacy hinders their ability to locate all the available resources and thus are unable to acquire information about how to access assistance.
In addition, the lack of financial resources may delay access and utilization of the services needed. Social and health care providers and members of the immigrant community must work more closely together to enable parents of ASD children to access and use state and local level programs, such as obtaining necessary information and logistical support. Regardless of their legal or financial situation, immigrant families raising autistic children in Canada can access free services and funding. Health care providers should help immigrant families by centralizing healthcare information to ensure children with ASD have adequate healthcare and educational materials to manage the condition effectively.
References
Khanlou, N., Haque, N., Mustafa, N., Vazquez, L. M., Mantini, A., & Weiss, J. (2017). Access barriers to services by immigrant mothers of children with autism in Canada. International Journal of Mental Health and Addiction, 15(2), 239–259. Web.
Lim, N., O’Reilly, M., Sigafoos, J., Lancioni, G. E., & Sanchez, N. J. (2021). A review of barriers experienced by immigrant parents of children with autism when accessing services. Review-Journal of Autism and Developmental Disorders, 8(3), 366-372. Web.
Millau, M., Rivard, M., & Mello, C. (2018). Immigrant families’ perception of the causes, first manifestations, and treatment of autism spectrum disorder. Journal of Child and Family Studies, 27(11), 3468-3481. Web.
Millau, M., Rivard, M., & Mello, C. (2019). Quality of Life in immigrant parents of children with autism spectrum disorder: a comparison with parents from the host culture. Journal of Child and Family Studies, 28(6), 1512-1523. Web.
Rivard, M., Millau, M., Magnan, C., Mello, C., & Boulé, M. (2019). Snakes and ladders: barriers and facilitators experienced by immigrant families when accessing an autism spectrum disorder diagnosis. Journal of Developmental and Physical Disabilities, 31(4), 519-539. Web.
Shanmugarajah, K., Rosenbaum, P., & Di Rezze, B. (2022). Exploring autism, culture, and immigrant experiences: lessons from Sri Lankan Tamil mothers. Canadian Journal of Occupational Therapy, 89(2), 170–179. Web.
Sritharan, B., & Koola, M. M. (2019). Barriers faced by immigrant families of children with autism: A program to address the challenges. Asian Journal of Psychiatry, 39, 53-57. Web.