Table 4.

How Asian ethnicity and language information may be clinically relevant.

Missing Demographic Information	Description
Primary information
Ethnicity	Gathering ethnic identities of a family can serve two purposes. First, it can support a culturally responsive discussion of the family’s understanding of autism, disability, and health-related behaviors (e.g., treatment choices) that may be influenced by ethnically specific cultural beliefs. Second, it can provide critical data for institutional- and population-level health equity research and policies.
Preferred Language(s)	Collectivism is integral in many Asian families, and extended family members often play a critical role in healthcare decisions for the child. Acknowledging the multigenerational component within family dynamics may require attending to an extended family composition that is multiracial, multiethnic, and multilingual. Identifying the preferred spoken and written language of the parents as well as other caretakers the parents identify as important (e.g., maternal grandmother, paternal uncle) can facilitate continuity of care when different family members are involved in the child’s care.
Secondary Information
Families’ Perceptions of Autism and Related Developmental Concerns	Treatment decisions can be strongly associated with perceptions of autism. Knowing the family’s cultural perceptions of autism may facilitate effective family-professional communication and collaborative healthcare decision-making. Cultural perceptions of autism, stigma, and beliefs about cause can impact parental emotional wellbeing positively and/or negatively23. Incorporating traditional healing methods is also common in Asian cultures24. Cultural perceptions of skill attainment (e.g., higher education, speaking multiple home languages, living independently with family members) can play a critical role in how a family makes sense of the diagnosis and follows through with recommendations and referrals. Co-occurring conditions (e.g., ADHD, language disorders, intellectual disability, epilepsy, anxiety) may not be immediately understood as part of the clinical complexity and need for multiple interventions. It is important to note that this discussion may happen in more than one session and warrant an ongoing check-in with the families.
Families’ Understanding and Perceptions of their consumers’ rights in seeking different services and treatments	Ongoing discussions with the family regarding their knowledge of the U.S. autism care system can foster self-empowerment in families within the Asian diaspora. The intersectional experience of how the U.S. Asian diaspora is racialized (MMS) and the collectivistic cultural values (e.g., respect for authority of the healthcare professionals, stigma of disability) may combine to create barriers to care. For example, if a provider assumes Asian families are well educated and acculturated, and the family’s silence or deference is misconstrued as agreement or understanding, the family may not have the information they need for their child. Health information in multiple languages can help ensure parents fully understand the healthcare information. Providers can foster the family’s sense of self-empowerment by sharing with them their rights as patients in the healthcare system, and their rights across different service settings (e.g., schools, state-level social service programs). Specifically, providers can do so by explaining the information in a culturally and language responsive way (sometimes referred to as being a health knowledge broker). Relatedly, providers may consider acting as an advocate directly, by offering to consult with other relevant providers in the child’s care system to explain test results, diagnoses, and treatment/service recommendations.