Submit to Brain Sciences Review for Brain Sciences Propose a Special Issue

Journal Menu

Journal Browser

Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs)

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Published Papers

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Developmental Neuroscience".

Deadline for manuscript submissions: closed (25 April 2023) | Viewed by 20405

Share This Special Issue

Special Issue Editor

Prof. Dr. Sayyed Ali Samadi

E-Mail Website
Guest Editor

Department of Life and Health Science, Institute of Nursing and Health Research, Ulster University, Newtownabbey BT37 0QB, UK
Interests: autism spectrum disorders; autism; parental based early intervention; parenting interventions; developmental disabilities; caregiving impacts; intellectual and developmental disabilities
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Globally there is a rising rate of autism spectrum disorder (ASD). However, the increasing global wealth of knowledge on ASD is primarily based on different studies conducted in developed, affluent countries. This situation is partly a result of a lack of epidemiological and service research in the field of mental health in general and ASD in particular in LMICs. The irony is that the demographics of the global human population are tilted so that most (up to 80%) of world children and youth live in LMICs.

A similar shortage of studies reported ASD studies among immigrants and minority groups in high-income countries (HICs). Hence, there is evidence of ethnic and racial differences in ASD prevalence and services access even among the HICs and developed societies. It is also reported that minority and immigrant children who are most displaced from LMICs are less likely to be diagnosed with ASD or overdiagnosed because of the application of the unsuitable cultural scales and standards. Delayed diagnosis is another crucial issue for immigrant children from LMICs to HICs. Within HICs, individuals from high socioeconomic backgrounds are mainly represented in ASD research.

Recently there has been an increase in attention regarding similarities and differences in the manifestations and the impact of the condition in different world regions, among different cultures and minority groups. Hence, evidence remains limited in LMICs and among immigrants and minority groups. The public and policy-makers in LMICs and HICs were not generally persuaded to pay attention to different aspects of ASD research or particular groups of individuals. There are various reasons for this neglect; still, the high cost of researching ASD contributed to this imbalance in LMICs.

More endeavor is needed from different stakeholders in ASD to address the global imbalance in knowledge on ASD in LMICs and among immigrants and minority groups in HICs.

This special issue aims to review the current knowledge about ASD differences, including the complex and multilayered impacts in LMICs and among immigrants and minority groups in high-income countries. It is also aimed to highlight areas in which further research is needed.

Prof. Dr. Sayyed Ali Samadi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Autism Spectrum Disorders (ASD)
Lowe and Middle-Income Countries (LMIC)
High-Income Countries (HIC)
autism research
immigrants
minorities

Published Papers (11 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Editorial

Jump to: Research, Review

4 pages, 212 KiB

Open AccessEditorial

Overview of Services for Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs)

by Sayyed Ali Samadi

Brain Sci. 2022, 12(12), 1682; https://doi.org/10.3390/brainsci12121682 - 08 Dec 2022

Cited by 1 | Viewed by 1278

Abstract

Autism spectrum disorder (ASD) prevalence is rising [...] Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

Research

Jump to: Editorial, Review

15 pages, 2625 KiB

Open AccessArticle

Exploring the Acquisition of Social Communication Skills in Children with Autism: Preliminary Findings from Applied Behavior Analysis (ABA), Parent Training, and Video Modeling

by Daniela Bordini, Ana Cláudia Moya, Graccielle Rodrigues da Cunha Asevedo, Cristiane Silvestre Paula, Décio Brunoni, Helena Brentani, Sheila Cavalcante Caetano, Jair de Jesus Mari and Leila Bagaiolo

Brain Sci. 2024, 14(2), 172; https://doi.org/10.3390/brainsci14020172 - 09 Feb 2024

Viewed by 2061

Abstract

Social communication skills, especially eye contact and joint attention, are frequently impaired in autism spectrum disorder (ASD) and predict functional outcomes. Applied behavior analysis is one of the most common evidence-based treatments for ASD, but it is not accessible to most families in low- and middle-income countries (LMICs) as it is an expensive and intensive treatment and needs to be delivered by highly specialized professionals. Parental training has emerged as an effective alternative. This is an exploratory study to assess a parental intervention group via video modeling to acquire eye contact and joint attention. Four graded measures of eye contact and joint attention (full physical prompt, partial physical prompt, gestural prompt, and independent) were assessed in 34 children with ASD and intellectual disability (ID). There was a progressive reduction in the level of prompting required over time to acquire eye contact and joint attention, as well as a positive correlation between the time of exposure to the intervention and the acquisition of abilities. This kind of parent training using video modeling to teach eye contact and joint attention skills to children with ASD and ID is a low-cost intervention that can be applied in low-resource settings. Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

► Show Figures

Figure 1

26 pages, 4026 KiB

Open AccessArticle

Who Is Attending? The Role of Child Ethnicity and Maternal Demographics in Research Engagement and Early Identification of Autism

by Ifrah Abdullahi, Nancy Sadka, Melissa Gilbert and Josephine Barbaro

Brain Sci. 2023, 13(6), 903; https://doi.org/10.3390/brainsci13060903 - 02 Jun 2023

Viewed by 2063

Abstract

Inequitable access to early autism developmental surveillance is evident globally. However, there is limited research examining autism diagnosis, ethnicity, and community profiles when engaging in research for the early identification of autism. We aimed to understand the relationships between child ethnicity, maternal demographics, and autism diagnosis, comparing retrospective data from the 2016 census for eight local government areas (LGAs) in Victoria, Australia. Maternal and child health (MCH) nurses monitored 13,511 children under 42 months for the early signs of autism using the Social Attention Communication Surveillance-Revised (SACS-R) and SACS-R Preschool (SACS-PR) tools during well-child checks. Of these, 340 children with a “high likelihood” of autism attended developmental assessments. Participants’ maternal ethnicity (‘European maternal ethnicity’, EME; ‘non-European maternal ethnicity,’ N-EME; ‘mixed maternal ethnicity,’ MME’), socioeconomic factors, and autism prevalence were compared to their LGA community. Results indicated that study participants were representative of their LGA communities, though bi- and multilingualism was higher in our cohort. Differences in current maternal employment, maternal education, annual family income, and autism prevalence were found between the N-EME, EME, and MME groups. Our study found that research engagement was driven by maternal education, maternal employment, and annual family income, and further research is required to understand these relationships. Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

► Show Figures

Figure 1

12 pages, 246 KiB

Open AccessArticle

Organizational Challenges in Healthcare Services Providers for Individuals with Autism Spectrum Disorder (ASD) Considering Personnel Turnover Rate

by Sayyed Ali Samadi, Cemal A. Biçak, Nigar Osman and Barez Abdalla

Brain Sci. 2023, 13(4), 544; https://doi.org/10.3390/brainsci13040544 - 24 Mar 2023

Viewed by 1136

Abstract

The organizational strategy and environment of the healthcare systems influence the turnover rate among healthcare provider personnel. These critical factors have received scant attention in the literature and particularly in the healthcare systems of the Kurdistan Region of Iraq (KRI) as one low-income country with a lack of infrastructural health provision foundations. In this cross-sectional study with qualitative synthesis, the turnover rate of a population consisting of 115 (85 “74%” rehabilitation and training personnel) members of a daycare center for individuals with autism spectrum disorder (ASD) during eight years in the city of Erbil was considered. The aim was to understand the organizational strategy and its impacts on the personnel turnover rate, particularly among healthcare providers. The analysis was conducted utilizing collective data over an eight-year period of service provisions. A qualitative methodological approach was adopted to understand the different aspects of turnover among the staff. The finding indicated a general turnover rate of 87% for the entire personnel and 72% for the rehabilitation and training service providers. This rate imposes considerable costs on the system. Interview analysis also yields supporting evidence for the desire of the staff to change jobs and the lack of understanding of the turnover among system authoritarians resulting in unpredictable changes and staff displacement. Further investigations are needed to understand different contributing factors to imposed or desired turnover rates among healthcare providers in KRI. The turnover over the years has imposed different challenges for the center where the data was collected and imposes unwanted negative impacts on healthcare organizations. Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

12 pages, 289 KiB

Open AccessArticle

Job Burnout and Job Satisfaction among Healthcare Service Providers in a Daycare Center for Individuals with Autism Spectrum Disorders in Low-Resource Settings

by Sayyed Ali Samadi, Cemal A. Biçak, Nigar Osman, Barez Abdalla and Amir Abdullah

Brain Sci. 2023, 13(2), 251; https://doi.org/10.3390/brainsci13020251 - 01 Feb 2023

Cited by 5 | Viewed by 2593

Abstract

Job satisfaction and burnout are components of job morale. In general, and among healthcare provider personnel, these are psychological factors of the job and under the influence of different conditions and the organizational management of the healthcare systems. Both job burnout and job satisfaction among healthcare service providers have received scant attention in the literature, particularly in the healthcare systems of the Kurdistan Region of Iraq (KRI) as one low- or middle-income country (LMIC). The burnout rate and job satisfaction in a daycare center for children with autism spectrum disorders were reviewed and measured using a sample consisting of 34 employees from three different sections. The Maslach Burnout Inventory-Third Edition (MBI-3) and the Job Descriptive Index (JDI) were used. The relationships between the two scales and their consisting factors were examined using Pearson Correlation and Chi-square test to understand the correlation and levels of significant difference between the expected and the observed frequencies. There was a significant negative correlation between job burnout and satisfaction with the job and some significant correlations between the factors of the scales. Lower levels of emotional exhaustion and depersonalization factors of the burnout scale were statistically correlated. It was shown that the personnel were mainly satisfied with their jobs through their choices in the four parts of the job satisfaction scale. Further investigations are needed to understand different contributing factors to job satisfaction and burnout among healthcare providers in KRI. The current study might highlight the importance of understanding the healthcare providers’ perspectives on their careers. Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

12 pages, 279 KiB

Open AccessArticle

Primary Care Clinician and Child Characteristics Impacting Autism Surveillance

by Lashae N. Williams, Andrea Trubanova Wieckowski, Mary F. S. Dieckhaus, Yael G. Dai, Fengqing Zhang, Thyde Dumont-Mathieu, Marianne Barton, Deborah Fein and Diana L. Robins

Brain Sci. 2023, 13(1), 18; https://doi.org/10.3390/brainsci13010018 - 22 Dec 2022

Cited by 1 | Viewed by 1632

Abstract

Early detection of autism provides access to early intervention and subsequently fewer lifelong challenges. However, disparities in screening have been associated with socioeconomic status (SES) and race, and disparities in surveillance have been associated with clinician knowledge and beliefs about autism identification. The present study examines associations between demographic variables and clinician beliefs, and agreement between screening results and clinician surveillance. Surveillance included activities used by the primary care clinicians (PCCs) to assess risk for autism. PCCs reported their beliefs about autism screening and identification, their sex, race, years in practice, and racial distribution of their patient population. Children’s demographic information was also collected. PCCs identified children as having, or not having, an increased likelihood of autism, and parents of children completed an autism screener. Agreement between screening and surveillance results were examined across PCC, practice, and child demographics. Higher confidence in autism knowledge and screening resources, female PCC sex, and majority White practice patient demographics all predicted agreement between screening and surveillance. Female child sex and higher maternal education also predicted agreement between screening and surveillance. These findings highlight the importance of PCC screening beliefs and child and PCC demographics on the autism identification process. Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

► Show Figures

Graphical abstract

17 pages, 321 KiB

Open AccessArticle

Profile of Service Use and Barriers to Access to Care among Brazilian Children and Adolescents with Autism Spectrum Disorders

by Beatriz Araripe, Cecilia Montiel-Nava, Daniela Bordini, Graccielle R. Cunha, Gabriela Garrido, Sebastián Cukier, Ricardo Garcia, Analia Rosoli, Daniel Valdez, Sheila C. Caetano, Alexia Rattazzi and Cristiane S. Paula

Brain Sci. 2022, 12(10), 1421; https://doi.org/10.3390/brainsci12101421 - 21 Oct 2022

Cited by 1 | Viewed by 1471

Abstract

Delayed diagnosis and a lack of adequate care for people with autism spectrum disorder (ASD) are related to worse outcomes and quality of life. This study aimed to identify the profile of service use, barriers to access care, and factors related to those barriers in Brazilian families with children with ASD. A total of 927 families with children with ASD (3–17 years) from five Brazilian regions completed an online version of the Caregivers Needs Survey. Results showed that the most used services were behavioral interventions and pharmacotherapy, while the most used professionals were neurologists, nutritionists, speech therapists, psychiatrists, psychologists, and pediatricians. The main barriers included waiting lists, costs, and the absence of services or treatment. Service use varied according to age, the region of residence, type of health care system used, and the parents/caregivers’ education. Access to behavioral interventions was more frequent among users of the private system/health insurance and families whose caregivers had higher education. The absence of specialized services/treatments was less frequent among residents of state capitals and families whose caregivers had higher levels of education. This study highlights how families with children/adolescents with ASD in Brazil face significant barriers to access care related to sociodemographic factors. Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

13 pages, 281 KiB

Open AccessArticle

Support Needs and Parent Outcomes in Arab Families of Children with Autism Living in the United Kingdom

by Barah Alallawi, Richard Hastings and Nura Aabe

Brain Sci. 2022, 12(8), 1114; https://doi.org/10.3390/brainsci12081114 - 22 Aug 2022

Cited by 2 | Viewed by 2100

Abstract

Research on the experiences of Arab families of children with autism living in non-Arab countries is scarce. A survey investigated the support needs, psychological distress, and parental relationships of Arab parents (n = 100) of children with autism living in the United Kingdom (UK). The survey consisted of five main questionnaires: a demographic questionnaire, the GO4KIDDS Brief Adaptive Scale, the Family Needs Survey, the Strengths and Difficulties Questionnaire, and the Hospital Anxiety and Depression Scale. Descriptive analysis indicated that the most frequently identified support needs were information, community services, and explaining to others. Parents reported high levels of psychological distress, a high level of parental relationship satisfaction with their spouse, and few parental disagreements about their child with autism. Regression analyses showed that increased child behavior problems predicted more total family needs. Higher levels of child prosocial behavior, the better health status of parents, and a larger number of children in the family were associated with lower levels of parental psychological distress. A longer time living in the UK was associated with more parental disagreement over issues related to the child with ASD. Reducing child behavior problems and increasing child prosocial behavior may be important targets for support and intervention to improve outcomes for Arab parents of autistic children. Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

Review

Jump to: Editorial, Research

13 pages, 288 KiB

Open AccessReview

Nurturing the Positive Mental Health of Autistic Children, Adolescents and Adults alongside That of Their Family Care-Givers: A Review of Reviews

by Roy McConkey

Brain Sci. 2023, 13(12), 1645; https://doi.org/10.3390/brainsci13121645 - 27 Nov 2023

Viewed by 1151

Abstract

The rising prevalence of autism internationally has been accompanied by an increased appreciation of the poorer mental health experienced by people with this condition and also of their family care-givers. In particular, higher incidences of anxiety and depression are reported in high-income nations and these conditions are likely to be under-recognised and under-reported in lower-resourced regions or countries. Mainstream mental health services seem to be ill-equipped to respond adequately to the needs of autistic persons and their care-givers. This literature review of 29 recently published reviews covering nearly 1000 journal articles summarises the insights and strategies that have been shown to promote the mental health and emotional wellbeing of autistic persons. In particular, a focus on family-centred, community-based supports is recommended that aim to enhance social communication, extend social connections and promote an individual’s self-esteem, self-determination and social motivation. These low-cost interventions are especially pertinent in low-resourced settings, but they can be used internationally to prevent mental illness and assist in the treatment of anxiety and depression in autistic persons and their family carers. The priority is to focus on primary-care responses with cross-sectoral working rather than investing in high-cost psychiatric provision. Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

13 pages, 270 KiB

Open AccessReview

Responding to Autism in Low and Middle Income Countries (Lmic): What to Do and What Not to Do

by Roy McConkey

Brain Sci. 2022, 12(11), 1475; https://doi.org/10.3390/brainsci12111475 - 30 Oct 2022

Cited by 8 | Viewed by 1655

Abstract

Autism is a spectrum disorder that occurs globally with increasing numbers of children and adults being identified with this condition. Although rates are higher in more affluent nations, the bulk of people with autism reside in Low and Middle Income Countries (LMICs). However, most do not have access to timely and appropriate support. The types of services delivered in high income countries are often ill-suited to the needs and resources of LMICs. Rather alternative forms of provision need to be devised. In common with other public health initiatives, these should be family-focused and community based, with suitably qualified and experienced leaders who in turn train and supervise a cadre of knowledgeable support workers drawn from local communities and cultures. As well as providing personalized, home-based guidance to people with autism and to their primary carers, regular group-based advocacy and training activities are undertaken in partnership with available mainstream services such as schools and social services. The principles and operations of these new forms of services are described in this paper albeit with an acknowledgment of their limitations. In recent decades, the cost-effectiveness of these approaches have been demonstrated with other chronic illnesses and disabling conditions in LMICs but their extension to autism has barely begun. More affluent countries are being forced to adopt similar strategies in response to the increased numbers of people identified with autism. A transformation in research strategies is essential to building better international support for persons with autism. Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

13 pages, 564 KiB

Open AccessReview

The Challenges of Establishing Healthcare Services in Low- and Middle-Income Countries: The Case of Autism Spectrum Disorders (ASD) in the Kurdistan Region of Iraq—Report from the Field

by Sayyed Ali Samadi

Brain Sci. 2022, 12(11), 1433; https://doi.org/10.3390/brainsci12111433 - 25 Oct 2022

Cited by 5 | Viewed by 1534

Abstract

The present report from the field tries to present challenges associated with establishing healthcare services for individuals with autism spectrum disorders (ASD) in a low- and middle-income area. The given case that has been highlighted is establishing daycare services focusing on rehabilitation and training services for individuals with ASD, and their caregivers and family members, in the Kurdistan Region of Iraq (KRI). Based on my experience, the associated challenges are divided into three primary levels: personal, professional, and organizational. The report highlights the importance of understanding the challenges associated with establishing healthcare services with the desire to put them under control. Plus, understanding the cultural aspects of the healthcare services for individuals with ASD experiences to address the issues at each level shared. It is concluded in the final part of the report that the key to establishing healthcare quality is to understand attitudes toward healthcare at the personal, professional, and organizational levels. This attitude determines the expectation from the services and defines assistance-seeking behaviors. Results offer insight for stakeholders in the healthcare field, allowing for a better understanding and improvement of availability and access to quality-driven healthcare services. A pre- and in-service training approach is practiced to address the associated challenges of establishing healthcare services at the personal level in KRI. A similar policy might be applicable in other LMICs, where there is a lack of professional and skillful healthcare service providers. Full article

(This article belongs to the Special Issue Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs))

► Show Figures

Journal Menu

Journal Browser

Autism Spectrum Disorders (ASD) in Low- and Middle-Income Countries (LMICs) and among Immigrants and Minority Groups in High-Income Countries (HICs)

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Published Papers (11 papers)

Editorial

Research

Review

Further Information

Guidelines

MDPI Initiatives

Follow MDPI