“What is early intervention? I had no idea”: Chinese parents’ experiences of early supports for their autistic children in Australia

<p dir="ltr">Background: Intellectual disability and autism are overlapping heterogeneous neurodevelopmental conditions with early onset. The prevalence of diagnosed autism has increased in recent decades. In addition, children with migrant parents have been shown to have a higher prevalence of autism with intellectual disability. However, there is limited evidence on time trends in the prevalence of intellectual disability and the association between parental migration and intellectual disability. The primary aim of this thesis was to describe the time trends and risks of intellectual disability, with and without autism, overall and in relation to parental migration.</p><p dir="ltr">Methods: In study IV, we described the time trends in the prevalence of intellectual disability diagnosed by age 10, using a cohort that included 1,096,800 children born in Sweden from 2001 to 2011. The other three studies focused on intellectual disability, with and without autism. In study I, a systematic review, and study II, a cohort study including 670,098 children aged 0 to 17 who resided in Stockholm at any time from 2001 to 2011, we described the risks in relation to parental migration status and migration-related factors. Study III explored age at first recorded diagnosis by parental migration status, using a cohort including 1,769,499 children born in Sweden from 2001 to 2017.</p><p dir="ltr">Results: The prevalence of mild, moderate, and other/unspecific intellectual disability diagnoses at age 10 increased in Sweden between 2011 and 2021, particularly in the later years, regardless of co-occurring autism. This trend remained unchanged after adjustment or stratification by birth weight, gestational age, or parental age, migration status, and education.</p><p dir="ltr">Children with two migrant parents had higher risks of intellectual disability, both with and without autism, compared with children with two Swedish-born parents. The association was more pronounced if the parents had migrated from low- and middle-income countries and for reasons other than work or study. Additionally, among children with two migrant parents, being born either before or more than four years after maternal migration was associated with a lower risk of intellectual disability with autism, but not intellectual disability without autism. Furthermore, these children, particularly those with parents from low-income countries, were diagnosed with mild intellectual disability at younger ages compared with those with at least one Swedish-born parent, regardless of co- occurring autism.</p><p dir="ltr">Conclusions: The recorded prevalence of mild and moderate intellectual disability has increased during the last decade in Sweden. This increase does not appear to be explained by concurrent changes in the distribution of sociodemographic or perinatal factors over time, such as an increase in the number of children born preterm, with low birth weight, to migrant parents, or to older mothers, nor by shifts in the levels of parental education. Instead, this increase may reflect changes in diagnostic practices over time.</p><p dir="ltr">Children with migrant parents are more frequently diagnosed with intellectual disability, with and without autism, compared with their peers with Swedish-born parents. Our findings further indicate that the underlying factors linking parental migration to the risk of intellectual disability may vary depending on the co- occurrence of autism and the severity of the condition, at least in part. For intellectual disability overall, factors related to parental origin in low- and middle-income countries appear to play a role. In cases of intellectual disability with autism, environmental factors acting during pregnancy and associated with adverse migration-related circumstances may contribute. For mild intellectual disability, disparities in diagnostic practices between children with migrant parents from low-income countries and those with native-born parents may account for part of the observed associations.</p><h3>List of scientific papers</h3><p dir="ltr">I. <b>Morinaga M,</b> Rai D, Hollander AC, Petros N, Dalman C, Magnusson C. Migration or ethnic minority status and risk of autism spectrum disorders and intellectual disability: systematic review. Eur J Public Health. 2021;31(2):304-12. <a href="https://doi.org/10.1093/eurpub/ckaa108" target="_blank">https://doi.org/10.1093/eurpub/ckaa108</a></p><p dir="ltr">II. <b>Morinaga M,</b> Hollander AC, Heuvelman H, Lundberg M, Dalman C, Rai D, Magnusson C. Migration and risk of intellectual disability with and without autism: A population-based cohort study. Acta Psychiatr Scand. 2021;144(5):487-500. <a href="https://doi.org/10.1111/acps.13350" target="_blank">https://doi.org/10.1111/acps.13350</a></p><p dir="ltr">III. <b>Morinaga M,</b> Magnusson C, Hollander AC, Ahlqvist VH, Lundberg M. Age at diagnosis of autism and intellectual disability in children with migrant parents: a nationwide population-based study. [Manuscript]</p><p dir="ltr">IV. <b>Morinaga M,</b> Ahlqvist VH, Lundberg M, Hollander AC, Rai D, Magnusson C. Changes in the prevalence of intellectual disability among 10-year-old children in Sweden during 2011 through 2021: a total population study. J Neurodev Disord. 2024;16(1):58. <a href="https://doi.org/10.1186/s11689-024-09576-3" rel="noreferrer" target="_blank">https://doi.org/10.1186/s11689-024-09576-3</a></p><p><br></p>

<p dir="ltr">Background: Intellectual disability and autism are overlapping heterogeneous neurodevelopmental conditions with early onset. The prevalence of diagnosed autism has increased in recent decades. In addition, children with migrant parents have been shown to have a higher prevalence of autism with intellectual disability. However, there is limited evidence on time trends in the prevalence of intellectual disability and the association between parental migration and intellectual disability. The primary aim of this thesis was to describe the time trends and risks of intellectual disability, with and without autism, overall and in relation to parental migration.</p><p dir="ltr">Methods: In study IV, we described the time trends in the prevalence of intellectual disability diagnosed by age 10, using a cohort that included 1,096,800 children born in Sweden from 2001 to 2011. The other three studies focused on intellectual disability, with and without autism. In study I, a systematic review, and study II, a cohort study including 670,098 children aged 0 to 17 who resided in Stockholm at any time from 2001 to 2011, we described the risks in relation to parental migration status and migration-related factors. Study III explored age at first recorded diagnosis by parental migration status, using a cohort including 1,769,499 children born in Sweden from 2001 to 2017.</p><p dir="ltr">Results: The prevalence of mild, moderate, and other/unspecific intellectual disability diagnoses at age 10 increased in Sweden between 2011 and 2021, particularly in the later years, regardless of co-occurring autism. This trend remained unchanged after adjustment or stratification by birth weight, gestational age, or parental age, migration status, and education.</p><p dir="ltr">Children with two migrant parents had higher risks of intellectual disability, both with and without autism, compared with children with two Swedish-born parents. The association was more pronounced if the parents had migrated from low- and middle-income countries and for reasons other than work or study. Additionally, among children with two migrant parents, being born either before or more than four years after maternal migration was associated with a lower risk of intellectual disability with autism, but not intellectual disability without autism. Furthermore, these children, particularly those with parents from low-income countries, were diagnosed with mild intellectual disability at younger ages compared with those with at least one Swedish-born parent, regardless of co- occurring autism.</p><p dir="ltr">Conclusions: The recorded prevalence of mild and moderate intellectual disability has increased during the last decade in Sweden. This increase does not appear to be explained by concurrent changes in the distribution of sociodemographic or perinatal factors over time, such as an increase in the number of children born preterm, with low birth weight, to migrant parents, or to older mothers, nor by shifts in the levels of parental education. Instead, this increase may reflect changes in diagnostic practices over time.</p><p dir="ltr">Children with migrant parents are more frequently diagnosed with intellectual disability, with and without autism, compared with their peers with Swedish-born parents. Our findings further indicate that the underlying factors linking parental migration to the risk of intellectual disability may vary depending on the co- occurrence of autism and the severity of the condition, at least in part. For intellectual disability overall, factors related to parental origin in low- and middle-income countries appear to play a role. In cases of intellectual disability with autism, environmental factors acting during pregnancy and associated with adverse migration-related circumstances may contribute. For mild intellectual disability, disparities in diagnostic practices between children with migrant parents from low-income countries and those with native-born parents may account for part of the observed associations.</p><h3>List of scientific papers</h3><p dir="ltr">I. <b>Morinaga M,</b> Rai D, Hollander AC, Petros N, Dalman C, Magnusson C. Migration or ethnic minority status and risk of autism spectrum disorders and intellectual disability: systematic review. Eur J Public Health. 2021;31(2):304-12. <a href="https://doi.org/10.1093/eurpub/ckaa108" target="_blank">https://doi.org/10.1093/eurpub/ckaa108</a></p><p dir="ltr">II. <b>Morinaga M,</b> Hollander AC, Heuvelman H, Lundberg M, Dalman C, Rai D, Magnusson C. Migration and risk of intellectual disability with and without autism: A population-based cohort study. Acta Psychiatr Scand. 2021;144(5):487-500. <a href="https://doi.org/10.1111/acps.13350" target="_blank">https://doi.org/10.1111/acps.13350</a></p><p dir="ltr">III. <b>Morinaga M,</b> Magnusson C, Hollander AC, Ahlqvist VH, Lundberg M. Age at diagnosis of autism and intellectual disability in children with migrant parents: a nationwide population-based study. [Manuscript]</p><p dir="ltr">IV. <b>Morinaga M,</b> Ahlqvist VH, Lundberg M, Hollander AC, Rai D, Magnusson C. Changes in the prevalence of intellectual disability among 10-year-old children in Sweden during 2011 through 2021: a total population study. J Neurodev Disord. 2024;16(1):58. <a href="https://doi.org/10.1186/s11689-024-09576-3" rel="noreferrer" target="_blank">https://doi.org/10.1186/s11689-024-09576-3</a></p><p><br></p>

Parental migration, sibling migration, and the educational outcomes of children left behind in rural China

IntroductionGrowth of the Australian South Asian migrant community has surged over the last decade. Yet we have minimal information about migrant South Asian parents’ experiences of raising an autistic child in Australia. This participatory research informs the issue through reporting first-hand accounts of accessing an autism diagnosis and receiving early supports for South Asian parents and their autistic children living in Australia. MethodsParents from India, Pakistan and Sri Lanka (n = 13) were interviewed in their preferred language. During interviews, parents were asked about their experiences of the diagnostic process and navigating early supports for their autistic child. Interviews were analysed using reflexive thematic analysis. ResultsParents described experiencing myriad challenges to accessing early autism supports, including limited knowledge, funding issues, lengthy waiting lists, and poor-quality clinicians. They also reported struggling to accept their child’s diagnoses and facing judgement from within their community. Unlike other migrant Australian communities, this group of parents did not describe obtaining community-specific supports and often navigated their journeys alone. These cumulative challenges impacted parents’ mental health. Yet, parents also described proactively seeking as much support as possible, preferring goal-based, intensive, behavioural early interventions. Discussion and implicationsClinicians should be aware that families from particular migrant/cultural minority groups may be more isolated than others, and consider how best to support a sense of community belonging in other ways. That these parents expressed preference for intensive, behavioural autism supports also highlights the diversity of service-related views and desires in the autistic and autism communities.

The purpose of the researcher was to investigate the opinions of migrant parents and regular classroom teachers toward migrant education. A status survey factorial design was employed. The independent variables investigated were: position (parent and teacher), age (parent and teacher), gender (parent and teacher), amount of formal education (parent and teacher), parent involvement, number of children in school, number of years taught, level taught, and migrant students in class. The dependent variables were scores from the following subscales of the Opinion Toward Migrant Education Questionnaire: Migrant Students, Migrant Parents, Migrant Education, Regular Classroom Teacher, Migrant Classroom Teacher and Total. The sample consisted of 34 migrant parents and 136 regular classroom teachers. Four composite null hypotheses were tested at the .05 level of significance employing three-way analysis of variance (general linear model). A total of 144 comparisons were made plus 19 recurring. Of the 144 comparisons, 60 were for main effects and 84 were for interactions. Of the 60 main effects, 10 were statistically significant at the .05 level. Of the 84 interactions, 13 were statistically significant at the .05 level. Results of the present study appeared to support the following generalizations: 1. classroom teachers view the scale Migrant Parents more positive than migrant parents, 2. classroom teachers view the scale Migrant Education more positive than migrant parents, 3. classroom teachers view the scale Migrant Classroom Teacher more positive than migrant parents, 4. classroom teachers view the scale Total (the entire set of items) more positive than migrant parents, 5. classroom teachers with B.S. Degrees view the scale Migrant Students more positive than classroom teachers with M.S. Degrees or higher , 6. classroom teachers with more than 15 years of experience view the scale Migrant Students more positive than classroom teachers with 7 through 15 years of experience . 7. classroom teachers who had no migrant students in class view the scale Migrant Students more positive than classroom teachers who had migrant students in class, 8. classroom teachers with more than 15 years of experience view the scale Migrant Classroom Teacher more positive than classroom teachers with 7 through 15 years of experience, 9. classroom teachers who had no migrant students in class view the scale Total (the entire set of items) more positive than classroom teachers who have migrant students in class, 10. the age and gender of classroom teachers should be interpreted concurrently for Regular Classroom Teacher, 11. position, age and gender for classroom teachers and parents should be interpreted concurrently for Regular Classroom Teacher, 12. amount of parent formal education and parent involvement should be interpreted concurrently for Migrant Parents, 13. amount of parent formal education and parent involvement should be interpreted concurrently for Migrant Education, 14. amount of parent formal education and parent involvement should be interpreted concurrently for Migrant Teacher, 15. parent involvement and number of children in school should be interpreted concurrently for Migrant Teacher, 16 . amount of parent formal education and parent involvement should be interpreted concurrently for Total (the entire set of items), 17. amount of formal education, number of years taught and level taught should be interpreted concurrently for Migrant Students, 18. amount of formal education and level taught should be interpreted concurrently for Migrant Teacher, 19. number of years taught and level taught should be interpreted concurrently for Migrant Teacher, 20. amount of formal education and number of years should be interpreted concurrently for Migrant Teacher, 21. amount of formal education and migrant students in class should be interpreted concurrently for Migrant Teacher, and 22. amount of formal education and years taught should be interpreted concurrently for Total.

ABSTRACTScholarship has examined how immigrant parents in North America and Europe acculturate their children to the education system in their receiving societies, with a focus on overcoming language barriers and coping with cultural differences in education between home and host societies. However, relatively less attention has been paid to the efforts of migrant parents in circumventing structural obstacles to the education access of their migrant children. To address that gap, this study draws on the qualitative data obtained from 23 rural-urban migrants in South China to investigate how these parents help their migrant children access urban education resources in a social context where structural obstacles outweigh cultural/racial differences. This study defines migrant parents as active agents who use strategies and actions to adapt to, manoeuvre within or circumvent the structural constraints to augment urban education resources for their migrant children. The migrant parents’ agency includes persistent efforts in obtaining urban hukou for their children; applying strategies to increase their children’s qualification for public schools that use a point system; exploring guanxi and using tiger parenting to get their children into public schools; exchanging economic resources for education opportunities in elite private schools; purchasing extracurricular education services; and actively maintaining parent-teacher partnerships to support their children’s schooling. While valuing the migrants’ agency, this study also indicates that the efficacy of their actions and strategies is affected by disparities in their socioeconomic resources.

ABSTRACTThis article examines the collective actions undertaken by two groups of Chinese female migrants in Paris: sex workers who opposed a new law on prostitution, and manicurists who joined trade unions and went on strike. These women share similar geographical origins and migration projects; many came to France alone, and thus have much weaker social capital than other Chinese migrants in Paris, which pushed them to choose professional sectors viewed as marginal or even stigmatized. Despite their precarious situation, their marginal position has created conditions for collective action, enabling them to develop strong sense of collective belonging and receive support from organizations outside the community. These findings show how a marginal position in an ethnic community can be a triggering factor for migrants’ inclusion and political engagement in the host society.

Background Parental involvement in children’s education is widely recognised as positively associated with students’ academic achievement. However, migrant parents often face specific barriers to engaging with their children’s education, including language and cultural obstacles. This paper examines the participation of migrant parents in schools in Ireland, drawing on data from a multi-country research project, IMMERSE Horizon 2020. Purpose The research aimed to explore the extent and nature of migrant parents’ involvement in their children’s education in Ireland and to identify key barriers to their participation compared to non-migrant parents. Specific objectives were: 1) to investigate the availability of channels for parental involvement in schools; 2) to explore parental involvement in school activities; and 3) to examine the influence of parental migrant status. Methods Quantitative data was collected through surveys administered to parents and school principals in Ireland. The data examined parental involvement in both school-based and home-based activities, including attendance at parent-teacher meetings, involvement in homework support, volunteering, and participation in school decision-making. The study also investigated whether schools adapted their communication and involvement strategies to meet the language and cultural needs of migrant parents. Findings The findings reveal a high level of parental involvement overall, with most parents attending parent-teacher meetings. However, fewer migrant parents reported taking part in parent-teacher meetings and information sessions compared to those parents born in Ireland. Language barriers emerged as a potential factor limiting parental involvement. Migrant parents had significantly lower odds of attending information sessions, and significantly higher odds of experiencing barriers due to language difficulties. Parental educational attainment was also a significant factor influencing the level of involvement. Conclusion The research highlights persistent inequalities in parental involvement among migrant families in Ireland. It underscores the importance of schools adopting more inclusive and culturally responsive strategies to facilitate the active participation of all parents, particularly those from migrant backgrounds.

At least 25% of autistic children worldwide have the potential to grow up in a bilingual environment. However, many autistic children are being denied opportunities to access additional languages and the cultural, familial and community connections that come with this. There is little evidence identifying the barriers to language learning and access, and no research addressing the perspectives of speech and language therapists (SLTs), who are crucial in supporting parents to make informed choices about bilingualism with their child. The aim of this research was to understand the experiences of SLTs working with autistic bilingual children, to understand the main considerations when working with families, and the opportunities and barriers for training, including the sources of information that current practice is based on. Twelve SLTs from across the United Kingdom were recruited for this study. All participants were experienced in working with autistic bilingual children and their families (M = 7 years, range 4-23 years). Semi-structured interviews were conducted and focused on the experiences of SLTs regarding familial bilingual experiences, the effect of sociocultural factors of practice, and the extent to which practice is based on current research. Data were analysed using reflexive thematic analysis. Three central themes were identified from the interviews: (1) participants discussed parental uncertainties as to whether they were doing the right thing for their child, (2) while participants were in support of bilingualism, they were not always confident that they were providing the right advice and found it difficult to in keep up to date with relevant, evidence-based research, and (3) participants highlighted a need to shift towards a more inclusive and culturally diverse practice. This is the first qualitative study to understand the perspectives of SLTs working with autistic bilingual children. We identify several key difficulties in supporting access to language learning, and these findings have immediate and longer-term implications for supporting SLTs, and in turn, the children and families they support. What is already known on the subject Research suggests that autistic children currently have fewer opportunities to maintain bilingualism compared to neurotypical peers. Despite the lack of evidence, many families remain concerned that bilingualism will have a negative impact on their child's development. To date, little is known about the perspectives of speech and language therapists (SLTs) who play a significant role in supporting the development of autistic bilingual children. This is the first study to provide an in-depth qualitative analysis of the experiences of SLTs working with autistic bilingual children and their families in the United Kingdom. What this study adds The results highlight a number of reoccurring barriers in providing optimal support: first, frequently cited concerns about bilingualism from parents that link to a lack of understanding about autism and the role of SLTs more generally. Second, SLTs do not have confidence in the assessments and tools available and described a lack of emphasis on cultural factors in practice. Many SLTs were concerned about the limited options for resources and interventions available in other languages, which could be challenging for parents who were less proficient or confident communicating in English. Third, SLTs reported having limited opportunities to keep up to date with relevant research to support their decision-making processes. What are the clinical implications of this work? These results have several important implications for practice-they highlight the need for more inclusive practices where possible, a need for more diversity within the profession and further opportunities to be provided with evidence-based advice around good practice. The results also suggest a benefit of providing accessible, evidence-based resources for parents about autism and bilingualism, to ensure that research key findings are reaching families.

Drawing on semi-structured interviews with six Chinese migrant families with children aged 12–15 years old, this qualitative study uses a Bourdieusian lens to probe how the historically lived and migration experiences of Chinese internal migrant parents construct their paradoxical beliefs in children’s English learning and informs their family language practice. The discursive process of constructing family language policy (FLP) reveals how migrant parents negotiate between changing habitus and the newly acquired capital during migration to Shanghai. Findings indicate that the migrant parents acknowledge the value of English in the linguistic market and hold high expectations and aspirations of their children’s English education. However, their historically constructed language ideologies constrain their engagement in children’s English learning and hinder their FLP decision-making. The urban field’s prevailing social and educational norms of promoting children’s learning English as a foreign language to enhance cross-cultural communication and attain academic success has its transformative power, which enables migrant parents to adjust their understanding of English learning and encourages them to facilitate the same for their children at home. The present study proposes a theoretical model to conceptualise the FLP construction in internal migrant families. Implications of the findings for different stakeholders have been discussed.

This study shows how conducting a narrative inquiry with migrant parents not only serves as a means of collecting their experiences of kindergarten services but also opens up a communicative space that allows for engagement with stories different from one’s own, and thus allows for the re-experiencing of the services provided. The presented re-experiences were ultimately found to be necessary for the participating parents to understand the values and knowledge underpinning kindergarten practices and routines, and thus to engage meaningfully and authentically with kindergartens. In the material presented, re-experiencing comprises the process of relating to the retold narrative’s temporality and sociality, which are oriented toward facilitating engagement with other people’s stories, as well as with one’s own and others from the past. The conclusion drawn was that the communicative spaces created through narrative inquiry have the potential to support kindergarten’s work in enhancing authentic partnerships with (particularly migrant) parents and addressing the democratic deficit in the involvement of (migrant) parents. Diverse ways of using narrative inquiry as facilitating parental engagement in the synergy between academia and the early childhood education sector are also reviewed.

Where should Chinese internal migrant parents locate their school-aged children: migrate with them or leave them behind? And should they invest in private education of their children? Empirical evidence based on the 2009 wave of the Rural-Urban Migration Survey in China (RUMiC) data is inconclusive. We use an overlapping generations model to find a theoretical optimum that maximizes parents’ utility which includes the children’s educational performance. Depending on the educational investment parents make and the relocation cost of children, we provide necessary and sufficient conditions for migrant parents to take their children to migrate and whether they should provide their children with private education. As the choices of migrant parents affect not only their children’s human capital accumulation, but also on the economic potential of their descendants, we present both short- and long-term consequences of the parents decision.

This study explores Chinese immigrant parents’ decision-making processes regarding childcare arrangements in Spain based on migration status and the availability of kinship networks. Drawing on 33 semi-structured interviews with Chinese parents who have preschool-aged children during the early stages of parenthood, this study reveals that Chinese immigrants’ childcare management is largely based on informal childcare provided by extended family members in both the host society and home country due to its high quality and flexibility, and because it transfers cultural values to the second generation. Moreover, migrant parents’ childcare needs are constantly negotiated within extended families due to the roles of grandparents’ care in other family members’ wellbeing. By exploring Chinese families’ collaborations, negotiations, and even conflicts in the childrearing decision-making process following families’ migration to a receiving country, our research contributes to a better understanding of the complexity of migration and the role of kinship networks in ethnic minority groups’ childcare choices.

This study examines the uses and derived gratifications of mobile phones among migrant parents in communicating with children they left behind. Data were gathered from a sample of 378 migrant parents who worked in factories in southern China. The results show that migrant workers who used mobile phones to assist in distance parenting were motivated by a desire for instantaneous communication (e.g., immediate access and reassurance), online transactions, affection, mobility, relaxation, and information. The demographic results show that the migrant workers tended to communicate with their older male children via calls and text messaging with their female children via audiovisual interaction. When migrant parents called, texted, or interacted with their children via audiovisual functions, they were motivated by the need for affection and relaxation. In predicting the quality of migrant workers’ involvement in parenting, the current study found that significant motives for the use of mobile phones included their ability to care for the children they left behind through communicating instantaneously, expressing affection, and conducting online transactions. The current paper discusses the theoretical and practical implications of the results of this study.

This article explores the narratives of Chinese migrant older parents and addresses how the interplay between familism and neoliberalism, as structural forces behind older parents migrating to reside with their adult children, influences their perceptions of intergenerational relationships in the context of internal migration in China. Adopting the intergenerational ambivalence perspective, this study thus analyzes the connections between participants’ lived experiences and the structural forces and processes. The empirical data are drawn from 16 semi-structured interviews with 10 migrant older parents in Shenzhen. Through narrative and thematic analyzes, three main areas of intergenerational ambivalence are identified, which were expressed through how they talk about: (1) their adult children; (2) the childcare work they provided; (3) their expectation about filial care. These narratives highlight a strong focus on the younger generation’s socioeconomic success, with older parents inscribing themselves the role of supporting them to achieve this goal. This entails a change in the norms that regulate intergenerational relationships in contrast to the traditional direction of obligation around filial piety. Furthermore, the analysis demonstrates that the intergenerational ambivalences experienced by migrant older parents are created by their unfavourable positions across two incompatible systems: the neoliberal state-capitalist economy and unchanged family-based welfare/care regime.