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These variations in cultural expectations are likely to exist among indigenous professionals as well as parents.The diagnosis of autism varies across different ethnic groups within countries. [14] in a study of over 2,500 eight year-olds in the USA, reported that children from Black, Hispanic and other ethnic or racial groups were less likely than white children to have a documented autism spectrum disorder. [15] found that children of Hispanic and African American origin, foreign-born children, and children born to foreign mothers were more likely to be diagnosed at an older age than those from white American parentage.Using special education data on students with ASD, Coo at al., [20] reported a prevalence of 43.1 per 10,000 among 4–9 years school children in the British Colombia Province of Canada whereas in Quebec it is reported at less than half this, at 21.6 per 10,000 [21].One explanation for differences in the prevalence and identification of ASD across cultures and regions is varying awareness of the criteria associated with a diagnosis of ASD [6].However in London, a more thorough study reported a prevalence rate of 38 9 per 10,000 for autistic disorders and for other ASDs at 77 2 per 10,000; giving a total prevalence for all ASDs of 116 1 per 10,000 [18].A regression analyses of the prevalence studies found that the most significant influence on ASD rates was the diagnostic criteria used, followed by the age of child when identified, the country of origin and urban/rural location of the sample [17].The first stage involves a universal screening of all children and various tools have been developed for use with children at different ages.They consist of a series of items indicative of autism and use parents as the primary informants.

For example, in Western societies the absence of direct eye contact is an early indicator of ASD yet in Chinese and Japanese societies, such eye contact is uncommon as looking directly into someone’s eyes is considered shameful in these parts of East Asia [11].

If this were so, then screening and other assessment tools developed in Western countries may not be sufficiently sensitive to detect early signs of Autism in other societies [3].

This chapter summarises the findings from two studies in Iran that identified the items that best discriminated children who had a diagnosis of autism.

More specifically, it appears that differences may be more likely to arise cross culturally due to various factors such as ‘‘when a symptom is perceived, by whom, and what behaviour is noticed first, as well as whether it is perceived as problematic’’ ([2], p. Moreover cultural attitudes regarding typical behaviours and what is perceived to be normal or abnormal development for that culture would also have an impact on diagnosis of an ASD.

Hence children may be more or less susceptible to a diagnosis of an ASD dependent on the cultural expectations of parents and indigenous professionals.




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