Cross-Cultural Comparison of the Participation at Home,at School,and in the Community of Children With Autism Spectrum Disorder in the US and Taiwan

The aim of this study was to explore cross-cultural differences (the US vs. Taiwan) in the participation of children with ASDs ages nine to 12 years in different settings. The statistics on ASDs demonstrate an increasing pattern of prevalence around the world. In a US study, ASD cases among eight-year-old children were shown to increase from 1/150 in 2000–02 to 1/54 in 2016. Data from the national disability registry in Taiwan reveal that cases of ASDs have also increased yearly there. Between 2004–10, the number of children with ASDs grew from 3,995 to 8,072. The US and Taiwan have different cultures that each may influence and cause variance in the participation experiences of children with ASDs. A cultural context is characterized by the customs, beliefs, activity patterns, behavioral standards, and expectations of a group or population, and it affects activity choices. A descriptive and cross-sectional design was used for this study. This study's participants were parents or primary caregivers who met the following criteria: a parent or legal guardian of a child with ASD between nine and 12 years in age in the US or Taiwan. A child with ASD must have received a diagnosis from an American or Taiwanese pediatrician. Participants completed the English and Chinese versions of the Participation and Environment Measure—Children and Youth (PEM-CY). It's an assessment developed to examine the participation levels of children and youth in three contexts: home, school, and the community. Data were collected through convenience sampling and analyzed using the unequal variance t-test (Welch t-test). Of the 24 parents/guardians who completed the PEM-CY, six were from the US, and 18 were from Taiwan. All of the US participants (100%) were a child's mother. Of these participants, one (16.67%) was 40–49 years old, four (66.67%) were 50–59 years old, and one (16.67%) was 60 or above. In Taiwan, six (33.33%) were a child's mother, 10 (55.56%) were a child's father, and two (11.11%) were a child's female guardian. There were statistically significant differences in home environmental resources and home environmental overall supports in the US compared to Taiwan. The environmental resources (M = 86.7) and overall environmental supports (M = 81.9) at home in the US were perceived to be higher than the environmental resources (M = 53.0) and overall environmental supports (M = 63.7) in Taiwan. In addition, there was a statistically significant difference in school environmental resources in the US compared to Taiwan. There were more perceived resources at school for the US parents/guardians (M = 84.0) than the Taiwanese parents/guardians (M = 57.7). Finally, there was a statistically significant difference in overall supports in the community environment in the US compared to Taiwan. More supports were perceived in the community by the US parents/guardians (M = 75.7) than the Taiwanese parents/guardians (M = 57.3). The findings of this study indicated that children with ASDs ages nine to 12 years may experience greater home resources and supports in the US. This may be because they tend to stay at or near the home after school. Children in Taiwan tend to engage in after-school studies. There are also more school resources in the US because of the more comprehensive school policies. The US may have more community resources and supports because participation in the community may not happen as frequently in Taiwan as it does in the US. No previous study has investigated the participation of children with ASDs in relation to the combined effects of the home country. The information gained from this study can aid OTs and other professionals as they work to foster participation among children with different cultural backgrounds.

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