Written by: Angie Kim
According to the American Academy of Pediatrics, the number of developmental disabilities in children is increasing every year – nearly one in every six to be exact. Some of the most prevalent ones include ADHD (attention-deficit – hyperactivity disorder), autism spectrum disorder, blindness, and stuttering, to name a few. The rising rates of developmental disabilities are not only observed in the United States, but also in various other countries. For example, the United Kingdom has the second-highest prevalence of disabilities. Although children and adults with developmental disabilities are found all around the world, the attitudes across various cultures towards this minority group is found to be different in every part of the world; some are not as welcoming as others. It is important to understand different cultural perspectives not only because the United States is a multicultural society, but also due to the fact that the rates of diagnosed developmental disabilities continue to rise (Jenco, 2000).
Let us first define developmental disabilities. According to the federal Center for Disease Control (CDC), “Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas.”. Some examples of developmental disabilities are ADHD, autism spectrum disorder, cerebral palsy, hearing loss, vision impairment, and intellectual and vision disability. Such conditions typically last throughout one’s lifetime and form during the developmental time period; some begin within the womb and others are caused by external factors such as disease or injury. Other factors that are known to cause developmental disabilities are genetics, birth complications, usage of alcohol during pregnancy, etc. Developmental disabilities are also noted across all racial, ethnic, and socioeconomic backgrounds. It is important to understand that having a developmental disability does not always directly correlate with the healthiness of an individual. However, some cultural groups think otherwise (Facts About Developmental Disabilities | CDC).
Let us now define culture in context for this research. According to the Canadian Pediatric Society, culture is “a pattern of ideas, customs and behaviors shared by a particular people or society.” (Developmental Disabilities Across Cultures). The correlation between culture and each of their approaches to those with developmental disabilities must be talked about as culture influences their understanding of a specific disability, whether to seek help or not, treatment options, and most importantly their relationship with health professionals. For example, some cultures may seek out ‘alternative’ or holistic medicine while others choose a more traditional route. While one culture believes that developmental disabilities are caused by evil spirits, another may believe in a more scientific causation (Allison & Strydom, 2009). Culture is always evolving.
Let us start by looking at my country, the United States of America. A new report from the CDC shows that “Fifteen percent of American children have a developmental disability, including autism and ADHD” (Shute, 2011). Additionally, the National Health Interview Surveys reported a significant increase in the percentage from 1997 (Shute, 2011). This is important to consider as the number may be reflective of the dissolving stigma around autism and in turn, the increased awareness of developmental disability.
In American culture, the subject of autism has given rise to various political arguments and one in particular: the causes of autism. One of the more significant arguments, for example, is on the debate of whether or not vaccinations should be required. To summarize: the causes of developmental disabilities that the American culture believes are largely scientific based and heavily influenced by peer and social media. My reaction to this is mostly positive in regards to the fact that America has changed dramatically in how educated they have become in the topic of developmental disabilities over the years.
I myself have volunteered with individuals with disabilities for over four years and have heard through the caretakers or parents that the attitude or general stigma the American people have is definitely changing. However, I am displeased over the fact that many Americans find themselves encountering “fake news” about individuals with developmental disabilities. In a recent multi-country study conducted by Dalia, Americans encountered the highest amounts of false or misleading content (Research, 2018).
As we discussed in our classroom lecture, groups such as those particularly of the age range between adolescents and young adults are the most vulnerable or influenced heavily by social media content and peer influences. That being said, incorrect information about this subject can potentially lead to mistreatment towards those with developmental disabilities. However, not all of social media produces negative consequences as we talked about during classroom discussions. Because of social media, many are now being more educated about developmental disabilities and as a result, movements and online petitions have called for changes to society and in policy making.
For example, there are now programs that help individuals with disabilities train for and find jobs. I know three of my friends with developmental disabilities who work as grocery baggers at my local Harris Teeters and Target – it warms my heart. This all shows that American culture is largely accepting of individuals with developmental disabilities.
Let us now discuss Chinese culture in regards to a specific belief and their attitude towards developmental disability. In China, traditional Confucian beliefs commonly dominate over a large population of people.
An important characteristic of this belief is that it mainly rotates around the focus of family hierarchy which is based on age, status, and gender. Maintaining the idea of collectivism and appearance overall contributed largely to each of their own status. That being said, those in a family with a developmental disability that involves any part of one’s physical form automatically brought shame to the family hierarchy and thus cannot be disclosed to the outside world. This negative consequence of this the person in the family will most likely avoid seeking supportive services.
Like mentioned before, different cultures have varying understanding of what causes these disabilities. According to traditional Confucian beliefs, it is regarded that any child who is born with such a disability is a punishment for the parents (or their ancestors) as a result for practicing “dishonesty or misconduct”. Because of this, society shows little to no support for the family as they feel the blame lies on them. This makes me extremely sad.
If I were to put myself in their shoes, I would not know how to react if my parents were ashamed of me and forbid the outside world all in the name of keeping the family name in high status. In a way, I am able to see before my very eyes this case. In America, I have seen many with developmental disabilities outside of their homes doing mundane tasks. To clarify, for example, more and more parents are comfortable taking their child with a disability to restaurants, grocery shopping, and even to theme parks.
What makes me the most joyous, as mentioned before, is the increased amount of jobs available for those with disabilities. However, I see the opposite in other countries. I am Korean and thus, like to travel to Korea as often as I can. Every single time I go to Korea, I do not recall a single time I saw those with obvious developmental disabilities outside of their homes. Upon talking to Korean families and caretakers, within the organization I volunteer with, with children (or adults) who have disabilities, I have found that they were too embarrassed to do so. This broke my heart. Although Korean culture is not like the Chinese culture mentioned in the beginning of this paragraph, the same code of family honor is buried underneath Korea. Treatment of developmental disabilities include CAM, or complementary and alternative medicine, which focuses on traditional Chinese medicine and acupuncture.
A second perspective that arises from China is through another religious belief: karma. It is no doubt that Buddhism has a strong influence in China and in their people’s understanding of disabilities as well. Similarly to Confucious beliefs, a disability is widely believed to be a punishment of one’s past life sins – karma. According to the blog author, two are two terms of disability in Chinese: “Chanji” (meaning serious disease that will never been recovered from) and “Chanfei” (worthless to family and society). The two words bring hopelessness and negativity to children with disabilities and it is no surprise that they later transition into adulthood with harmful coping strategies and reduced social abilities. Again, to me this is heartbreaking. To even have a term, or should I say slang, like Chanfei used to say the word ‘disability angers me. But then again, America has negative phrases or slang for individuals with autism spectrum disorder (ASD) such as “retard” or “on the spectrum”. This made me realize that people all over the world need to be educated not just on the politically correct terms to describe those with developmental disabilities, but also be educated on human rights and morality (Chinese Cultural Perspectives and Interventions on Disabilities, 2017).
There are South Asian cultures, such as Pakistan, where communities believe an individual with a disability is possessed by a djinn (spirit). Due to this, treatment approaches for these individuals include calling a shaman, who is a spiritual and health provider, who practices healing and prevention rituals. This is widely different to American culture as our treatment involves therapy sessions and traditional scientific physician care. It is important to understand that the belief of possession creates a dangerous stigma around those with developmental disabilities and as a result, the families are found to be isolated within their own community. This is because of their belief that their boys are to grow up to be like their fathers and girls, their mothers; a disability breaks that natural order. As a result, families from this culture, and those that are similar. worry that the disabled child will affect future husband/wife prospects in context to their tradition of arranged marriage. As for their understanding of what causes developmental disabilities, or in their case, possession of a spirit, South Asian cultures believe they are caused by the wrongdoings made by the ancestor – like China (Developmental Disabilities Across Cultures).
There are also many other cultures who similarly believe in superstition fueled understanding of developmental disabilities. Besides ancestral punishment or karma, according to Canada, there are also the wills of God or Allah, black magic, or evil spirits, to name a few. The culture that seems the closest to America, in regards to the belief that the cause was biomedical in nature, is India where the possibilities range from pregnancy illness to lack of environmental stimulation during infancy (LeeAnne Hidde, et al. 2013).
Another example of a socio cultural belief is found in Botswana culture where the cause of the disability is inherently God’s will (LeeAnne Hidde, et al. 2013). Unlike other cultures, they typically did not seek treatment for their child as they believed it was a gift [from God] (Developmental Disabilities Across Cultures). The culture I found most interesting in regards to their perspective on developmental disabilities is Native American and Native Hawaiian perspectives.
According to LeeAnne, “The cause of the illness or disability is placed on the family and the natural cycle of life…the individual with a disability is not considered to have any “special needs” (LeeAnne Hidde, et al. 2013). In other words, the children are not labeled as disabled and are accepted and valued. Upon reading this, I was taken back and thought to myself: was there really a place like that? A place where there was no label to be put on others and where individuals with disabilities were treated like normal human beings in their community – this was definitely a stark contrast to South-Asia’s culture. I remember reading articles about how America should remove labels such as “special needs” or “autistic” but I have only witnessed, through my volunteer experience, a small group of people actually doing that. Usually those people were associated in some way or another with the ASD community and such. But for a whole (or majority) culture to be pushing for the same goal of basic human rights about this topic seems like an amazing feat to me.
As rates of diagnosed developmental disabilities rise, it is absolutely crucial for society to become educated, not only on the subject but on different sociocultural perspectives. When comparing culture in America, something we are all familiar with, to other cultures, one may see various differences in regards to the causes of a disability and treatment. For example, while American culture sees medical factors as a cause, South Asia sees karma at work. As the United States continues to stay multicultural, it is especially important for healthcare workers to do this research as well in order to appropriately intervene and treat minority children in a culturally sensitive manner (Nehring, 2007). As a pre-med student, this was one of the biggest reasons I had to choose this topic. I truly believe that understanding other cultures builds bridges. Therefore, I can say that it is our responsibility to learn from other perspectives on their views on disabilities, both the good and the bad, so that we may not only be educated on the matter but develop empathy.
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