Cultural Differences in Socialization Therapy for Autism

Introduction

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction across multiple contexts. There are deficits seen in social reciprocity, emotional expressions, and skills in developing and maintaining relationships. Therefore, many children and adults with ASD require specific socialization skills in order to engage and interact with people around them such as family, friends and in general, the society. These children and adults require systematic teaching on how to socialize and form relationships. 

Social component of ASD

There are two main presentations of the social component of autism. In the first, these individuals do not want and avoid social contact, become anxious and agitated in social situations and will frequently tantrum when social demands are placed on them, or on the contrary will exhibit a complete lack of interest and disconnect from their surroundings. In the second, these individuals want social contact, want friends and to socialize, want to belong and to integrate into society but do not know how to achieve doing so. They have great difficulty with social reciprocity, in understanding and responding to social cues and will frequently misunderstand social situations.

Socialization therapy

Socialization therapy is an umbrella term and consists of various techniques and exercises that help in developing the social skills in individuals with ASD and helping them understand the social context. Various techniques include social skills training, exposure therapy, cognitive-behavioral therapy, play therapy and role-playing exercises. In socialization therapy, the skills that are developed and worked on include: initiating and maintaining eye contact, initiating conversations, social interaction, understanding the emotions and facial expressions, appropriate behaviour in social settings and so on. Socialization therapy includes various evidence-based programs designed to foster socialization. Son-Rise program, Peer mediated instructions, and PEERS (UCLA program) are some of the examples of the programs included in socialization therapy. Various professionals such as teachers, school psychologists, therapists, behaviour analysts and autism support professionals, can implement these intervention techniques. 

Cultural differences in symptomatology of ASD

ASD has strong biological roots and occurs with similar core features; however, the manifestations of the symptoms may vary depending on the culture. Western cultures tend to have independent social orientation, emphasising self-direction, autonomy, and self-expression whereas Eastern cultures have interdependent social orientation, emphasising harmony, relatedness, and connection. 

Often, the early detection of symptoms of ASD in a child is endorsed by the parents. One of the key cultural differences that can be seen, during early detection, is the influence of general knowledge or norms regarding the developmental milestones of the children in various cultures. For example, in Western communities, lack of eye-contact and lack of pointing at an object may be considered as a distinctive feature of deficit in socio-communicative gesture. However, in certain Eastern communities such as Chinese and Indian communities, direct eye-contact and pointing in certain situations are regarded as impolite. Example, prior it was culturally important to look down while speaking to elders in Indian society.  This results in cultural differences in the expectations of the parents for the children to perform certain behaviours at a certain age. Studies have indicated that the detection of the problem in a child’s behaviour in India usually takes place 6-10 months later than parents in the U.S. Parental styles and child-rearing styles in different cultures are often found to influence the detection of the symptoms of ASD. Differences on a range of constructs have been observed between Western and Eastern populations. For example, Indian children with ASD may appear to accept spontaneity more than children with ASD in the UK. 

Conclusion

Socialization Therapy is used to develop and maintain the social skills of children and adults with ASD. Culture plays a vital role in the implementation of Socialization Therapy as recognition of symptoms or problematic behaviour also varies across cultures. The norms of a particular culture impacts what is considered appropriate at what age. Certain lack of behaviours or skills that may be considered as problematic in one culture, may not be considered problematic in another. Hence, Socialization Therapy will focus on the lack of behaviours or skills that may be considered as problematic in a particular culture. Therefore, culture impacts early detection, diagnosis and treatment of ASD in children and adults. 

Nehal Shah

Psychologist (Consultant)

Neuro Revolution International

References