AbstractThis paper examines the effect of cultural influences in South Korea on autism diagnosis and treatment. The lack of information, statistics, and awareness of autism in South Korea is reflected in not only the under-diagnosis of autism but also in the limited treatment resources available. This study calls attention upon what problems parents are most affected by what they feel needs to change. It also looks at the current sentiment and understanding of autism and its perceived causes.
The results of this study indicate that there is a lack of awareness and understanding of autism by the general population. Parents choose to intentionally avoid diagnosing their children or refuse to accept the result after the diagnosis due to the intense stigma of autism from the general population. Thus, many children affected by autism do not participate in special education programs at schools and are hindered from receiving appropriate care. The lack of appropriate treatment oftentimes aggravates both nonverbal and verbal communications.
Traditional values that lead parents to feelings of shame and guilt still perpetuate in South Korea society, preventing the spread of awareness and understanding of autism in both families with autistic children and the general population. These findings suggest that there is a need for standardization in the diagnostic process and a new special education curriculum that has been adapted to fit Vietnamese culture.
In 2011, Young-Shin Kim MD, MS, MPH, PhD conducted a first comprehensive study of autism spectrum disorder (ASD) prevalence in South Korea and concluded that prevalence of ASD in South Korea to be 2.64%. The research was done on all children from ages 7-12, including those enrolled in special education school and general education schools. Of the 2.64%, three-quarters of the children have not previously been diagnosed with autism; the previous estimate of autism prevalence in South Korea was 1%. The statistics from the study does not mean that there is a sudden surge in autism; autistic children have been there all along but were not diagnosed, recognized, or treated previously. Cultural factors such as Confucianism, collectivism, and the tradition of extended families may have an impact on autism diagnoses and prevalence estimates.
WHAT IS AUTISM SPECTRUM DISORDER?
Autism is one of five complex, neurological disorders, collectively called autism spectrum disorder that impairs not only outward behaviors but also social and communication skills; “spectrum” refers to the fact that the symptoms, skills, and disabilities of each affected individual vary greatly in range. The challenging behaviors presented by people with ASD include “repetitive motor behaviors (hand flapping, body rocking), insistence on sameness, resistance to change and, in some cases, aggression or self-injury.” Many people with ASDs also have unusual ways of learning, paying attention, and reacting to different sensations. Signs of autism can begin at a very young age, even before the age of 3, and lasts throughout a person's life.
CAUSES OF AUTISM
According to National Institutes of Health, no specific cause of autism has been ident\nified, although many point to abnormalities in the brain function and structure as the main cause. For example, based on MRI images, children with autism have certain areas in the cerebellum, specifically vermul lobules VI and VII that are underdeveloped. Additionally, there are studies that suggest that individuals with autism have extra synapses in the brain, excess caused by slowdown of “pruning” process during development. While there is likely genetic link to autism, there are also environmental components \nto autism. Researchers are still looking for clues as to specifically which genes contribute to genetic predisposition for autism and how autism stems from disruption in early brain development in the mother’s womb. While these theories are intriguing, further studies are required.
There is no definitive medical test to diagnose autism. Diagnosis for autism usually i\nnvolves two stages: general developmental screening during early childhood (between 18 and 24 months of age) with a pediatrician and a detailed evaluation by a team of doctors and special professionals. Different types of screening instruments include Checklist of Autism in Toddlers (CHAT), Modified Checklist for Autism in Toddlers (M-CHAT), and Screening Tool for Autism in Two-year-olds (STAT). When the pediatrician suggests for a further evaluation, a team of a psychologist, a neurologist, a psychiatrist, and a speech therapist will work together on the assessment. [National Institute of Health]
SELECTION OF EMPIRICAL RESEARCH
Basic information about autism in different cultures was gathered through reviewing on\nline articles, published journals, and related books. I analyzed selected articles to review the different cultural perspectives on autism between Korea and the US. Among the articles found, I chose studies that were focused on cultural perspectives on autism as well as peer reviewed, databased, and empirical for this review.
While American values are focused on individualism, and personal responsibility, Korea\n, whose culture is based on Confucianism, emphasizes “the importance of hierarchy, group orientation, and vertical lines of authority.” The differences in social ideologies between Western and Asian cultures influence how individuals interpret and judge others’ social and communicative behaviors. Thus, the social implications of autism, the effects these implications have for family members, and the way in which the family responds to the general population’s cultural beliefs abo\nut autism vary among cultures.
According to National Institutes of Health, no specific cause of autism has been identified, although many point to abnormalities in the brain function and structure as the main cause. For example, based on MRI images, children with autism have certain areas in the cerebellum, specifically vermul lobules VI and VII that are underdeveloped. Additionally, there are studies that suggest that individuals with autism have extra synapses in the brain, excess caused by slowdown of “pruning” process during development. While there is likely genetic link to autism, there are also environmental components to autism. Researchers are still looking for clues as to specifically which genes contribute to genetic predisposition for autism and how autism stems from disruption in early brain development in the mother’s womb. While these theories are intriguing, further studies are required.
Although research has shown that diagnosis done at age 2 can be most valid, reliable, and stable, most children around the world are not diagnosed until the age of 4. Specifically in South Korea, the age remains close to 5 years. Lack of awareness may account for the primary cause of late diagnosis in many children.
PARENT'S PERSPECTIVE ON AUTISM
Due to a stigma attached to the word autism, many parents feel a degree of shame if th\neir child is labeled “autistic.” Thus, oftentimes, parents are motivated not to medically diagnose their child regardless of the child showing certain symptoms of autism. Even after the child is diagnosed after a teacher’s recommendation, the parents are reluctant to accept the fact. Some parents are shocked and devastated when they learn about the child having autism.
Because parents in Korean society have a strict definition of “normal,” there is very little toleration for individuality or differences. There is no special class for the “talented” because everyone is expected to be equally good at academics, sports, music, etc; thus, all students are considered as “same.”
SCHOOL'S PERSPECTIVE ON AUTISM
Oftentimes, children diagnosed with autism attend public schools without receiving any special education or psychological treatments.
Heavily influenced by collectivist culture, students of South Korea must conform to society’s norms and contribute to the society as a whole. Thus, autistic children are oftentimes left out due to their behaviors that seem to stand out and distract other students in the classroom. Most schools do not have disability services and separate curriculums for autistic students, who are forced to learn the same material at same pace with others in the classroom.
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