Looking back at my experiences during the last few decades I realize that my views on autism have gradually become more complex. As I have traveled all over the world as an ambassador for the International Consortium of Autism Institutes, I have often looked forwards to being hosted by local special education schools, to exchange experiences with health care providers, and to talk with many autistic individuals as well as their parents. It is undeniable that there are markedly contrasting viewpoints on autism among different countries. Whether autism is regarded as a medical condition, the best means for diagnosing it, and what are “the” useful interventions, it all depends on the shared beliefs, traditions and knowledge of the particular country. Indeed, the beliefs that people adopt from their culture mold the way that they think and behave, as well as the solutions they offer to problems. This cultural influence appears to be the more significant as the problems become more challenging or as they require greater resources as in the case of autism.
Taking our ideas regarding autism from the US or the UK does not offer a perspective applicable to the rest of the world. Indeed, the worldview on autism by Western cultures, is quite unique. Although Western cultures emphasize individuality they also accept a medical model that is heavily scripted as to how people ought to behave. Westernized cultures readily affix labels to any deviant behavior and place a greater pressure on families to conform to established medical guidelines.
Despite marked differences in geography, non-Westernized countries see autism as a social responsibility rather than a medical condition. These countries offer a collectivist perspective that downplays individuality and prioritizes maintaining relationships within a given group of people. In this regard, I have often marveled as to how vastly different countries, like Colombia and the more desolate regions of Eastern Russia (Siberia), share similar perspectives regarding autism. Indeed, due to a lack of resources, interventions in these countries are usually parent-mediated and heavily influenced by cultural norms. Lack of personnel trained in behavioral analysis has been supplanted by art and music instruction. Classes are provided in group settings where outperforming other members is not seen as conductive to the overall benefit of the group. Members are encouraged to adopt the norms of the group while teachers emphasize cooperation and nurturing. Students arrive early to school to participate in team building exercises.
I have often marveled at the achievements of troupes of autistic children performing autochthonous musicals and their accompanying choreography. Adopting the norms of the group have served them far better than any Westernized behavioral intervention. Participants in these groups seem genuinely happy; in part, given the sense of achievement at contributing to a piece of artistic expression. In addition, the structured activities in such groups offer norms that minimize uncertainty. Participants feel a sense of security in a group that fast becomes their extended family.
Autism is a medical condition but, without a cause that we can target, treatment options have remained symptomatic. This is one of the reasons for looking at other countries and learning what has worked for them. Indeed, I believe that we can gain from adopting the cultural perspective of other countries to benefit our own children. Whether it is an improvisation on an autism chair, electroacupuncture, or using a zen bowl, spending time with your children and group socialization, in my experience, have provided the most favorable outcomes.
For those interested I have written previous blogs about cultural differences regarding autism in Colombia, China and Russia.
Casanova MF. Autism Updated: Symptoms, Treatments and Controversies. Amazon Publishing, Co, 2019
Thank you for this article; I concur that cultural environments influence outcomes for autism spectrum disorder. Consistently, have you also considered cultural environments as a causal factor?
I assume that the radically increasing rate of autism in the US (documented by the CDC as steady at 1:2500 until 1980 and now at 1:54) implies an environmental “pathogen.” I also assume that the radically different rate of autism between cultures (poorly documented at from 1:3333 in Poland to 1:27 in Hong Kong) implies that the environmental “pathogen” for autism is cultural.
Shouldn’t the radical change in learning environments that I have witnessed over my lifetime be considered as a causal factor for autism?
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Manuel que bueno leerte, un placer como siempre, gracias por introducir esta perspectiva cultural en relación al TEA, no es un camino difundido, pero es un recurso en extremo necesario para neuro diversificar los enfoques y abordajes, en Latinoamérica tenemos mas recursos adecuados que devienen de los modos culturales propios de cada región que los que podemos “importar” como los más “exitosos y efectivos”. El camino a la inclusión plena solo depende del desarrollo cultural de una sociedad, caminamos globalmente en tal sentido aunque de manera lenta, algunas sociedades con pasos más largos otras con pasos más determinantes y otras tambaleantes…
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Muchas gracias por el comentario. Buenos puntos a considerar.