Researchers asked clinicians in the U.S. and in four other countries—Greece, Italy, Japan, and Poland—to screen for autism spectrum disorder (ASD) in children ages 17 to 37 months using a parent survey designed to assess three classes of autism features: social behavior and nonverbal communication; repetitive behaviors and restricted interests; and language.
The researchers then analyzed the responses for the 250 kids who ended up being diagnosed with ASD, and found that children in the U.S. scored the highest (most severe), while children from Greece scored the lowest (least severe) based on their parents' assesmments.
And the differences didn't end there. The parents in Poland were most likely to report that their children had restricted interests. U.S. parents more often identified their children's repetitive movements. Parents in Greece were most likely to say their children had unusual routines and rituals. And while less than 25 percent of U.S. parents said their child differed from his peers in intellectual ability, that number jumped to almost 70 percent of parents in Japan.
Why? The researchers postulate that either the parents in Japan believe autism features reflect intellectual disability, or that a relatively high number of kids screened for autism in Japan turned out to have intellectual disability as well. Of course, the range of responses regarding the different ASD behaviors could also be at least partially explained by cultural differences.
"Screens for autism largely rely upon caregiver report of symptoms, which are likely to be influenced by a number of cultural factors, such as beliefs about appropriate development and behavior," Maya Matheis, a graduate student who worked on the study at Louisiana State University, explained to Spectrum News. "Culture may play a larger role in influencing the degree to which restricted, repetitive behaviors are perceived as problematic compared to other symptoms related to autism."
Makes sense. Which is why the researchers say the findings underscore the importance of identifying behaviors reported as problematic across all cultures, as well as the ones in which there is cultural variation, in order to help develop more universally effective screening measures.