Autism, Stigma, and South Asian Immigrant Families in Canada.

Considerable empirical evidence suggests early recognition of autism and access to support result in long-term positive outcomes for children and youth on the spectrum and their families. However, children of racialized families are often diagnosed at later ages, are more likely to be misdiagnosed, and experience many barriers to service access. There is also a paucity of research exploring the experiences of parents from specific immigrant groups caring for their children on the spectrum in Canada, many of whom identify as members of racialized communities. As such, the main aim of the study was to examine how South Asian immigrant parents in Canada are experiencing available care programs and support. Another aim was to examine their perceptions of social stigma associated with autism. We conducted an inductive thematic analysis of qualitative data from nine interviews with South Asian parents living in Ontario, Canada. Findings confirmed barriers to an autism diagnosis and to service access. Additionally, parents reported pronounced autism stigma, which enacted impediments to timely diagnosis, service access, and health-promoting behaviors. Findings also revealed that parents experience considerable caregiver stress and psychological distress. The generated evidence is anticipated to inform equitable policy, programming, and practices that better support the needs of children on the spectrum and their immigrant families.

Piloting a Community-Based, Culturally Adapted Health Promotion Program for Children with Autism Spectrum Disorder and Developmental Disabilities in First-Generation Korean Immigrant Families.

Children with autism spectrum disorder and developmental disabilities (ASD/DD) face barriers to participation in health promotion programs due to the lack of available and/or affordable programs and trained staff at recreation centers. Children with ASD/DD in Korean immigrant families are one of the most underserved minority groups due to language, racial/ethnic discrimination, and stigma and shame within their own ethnic community. However, little research is available on development, implementation, and evaluation of a culturally adapted community health promotion program in this population. The purpose of this study is to assess effectiveness of a pilot program for children with ASD/DD from first-generation Korean immigrant families. The pilot study used a quantitative, quasiexperimental design (one-group design with pre- and posttest) following a seven-week health promotion program. We recruited 15 children with ASD/DD, ages nine through 16, from first-generation Korean immigrant families. The findings of the study suggest that the pilot program was effective in gaining nutrition knowledge and increasing physical involvement among participants. Given the fact that Asian immigrants are a fast-growing population and that nearly 75 percent of them were born abroad, development and evaluation of a community-based, culturally adapted health promotion program is urgently needed.

Different perceptual worlds: Parent and youth perspectives on parenting outcome trajectories from a Latino family-based program.

Discrepancies between parent and youth perceptions of their relationship are a common aspect of generational acculturation gaps influencing immigrant families. Programs designed to strengthen parenting practices among immigrant Latino families commonly address immigration stresses, including differences between parent and youth perceptions, but little is known about discrepancies in their appraisals of program effects on parenting behavior. A randomized trial was conducted examining effects on parent behavior of a program for immigrant families with youth aged 10-14, developed through community-based participatory research principles. Families (346 parents and youth) were recruited by organizations serving Latino families in a Midwestern metropolitan area and randomly assigned to the eight-session psychoeducation and skill-building program or a waitlist control. Parents and youth completed self-report measures at pre-intervention, post-intervention (4 months), and a 6-month follow-up regarding parents' expression of acceptance, efforts to solicit information about the child's experiences, and consistency of discipline, key foci of the program. Based on social cognition theory, the study focused on possible differences in parents' and youths' perceptions of change in parenting behavior. Parents in the treatment group reported pre-post improved acceptance, consistent discipline, and solicitation, whereas youth reported improvement only in parental solicitation, a pattern maintained at follow-up. In the control group, the only change was youth-reported reduction in parental acceptance. Parents' perceptions of improvement are encouraging, but overall lack of improvements from the youth perspective poses a potential problem for impact on parent-child relations. Interventions may need to target both parent and youth cognitions about behavior changes directly.

Recommendations for Working with Culturally and Linguistically Diverse Families: A Report from the Field.

Given the persistent shift in racial and ethnic demographics in the United States, board certified behavior analysts (BCBAs) will increasingly serve culturally and linguistically diverse families. There has been a recent increase in published resources to help behavior analysis practitioners navigate working with diverse populations. The purpose of this article is to add to these resources and demonstrate how these recommendations can be put into action. We outline five recommendations for working with culturally and linguistically diverse families in the context of a small company that has incorporated these practices in their own work focused on serving a large percentage of immigrant families.

The acculturation gap of parent-child relationships in immigrant families: A national study.

Objective: We examined the acculturation processes involving intergenerational consonance and dissonance in parent-child relationships in U.S. immigrant families. Background: This study is important because we lack national studies that examine the association between acculturation processes and intergenerational relationships among diverse racial/ethnic groups in immigrant families. Method: Using national data from Add Health with diverse race/ethnicity, we measured acculturation levels by immigrant generation, age of arrival, and length of time. Intergenerational consonance (the degree to which children and parents share the same values and activities) was measured by family cohesion and sharing meals (specifically dinners) with parents. Intergenerational dissonance (the degree to which parents and children differ in expected norms and parents lose authority over their children) was measured by parent-child conflict and parental control. Ordinary least square, binary logistic, ordered logistic, and Poisson regressions were conducted depending on the nature of the four dependent variables. Results: We found robust evidence that adolescents of the second immigrant generation acculturate more rapidly than those of the first generation and their immigrant parents creating a "gap" in intergenerational relationships. Thus, second-generation adolescents experience lower levels of family cohesion, less frequency of sharing weekly dinners with parents, less parental control of adolescents' activities, and more serious arguments about their behaviors with their parents than their first-generation counterparts. Conclusion: This is the new evidence that is based on national data, across multiple measures of intergenerational relationships, and holds for diverse racial and ethnic groups. Implications: The findings underscore the importance of developing culturally informed interventions supporting healthy parent-child relationships in immigrant families.

Facing a dual threat: Pandemic stress and immigration policy vulnerability on mental health among Latinx immigrant parents.

BACKGROUND: Exclusionary immigration policies rooted in structural racism threaten the wellbeing of Latinx families, increasing stress, anxiety, depression, and distress among immigrant parents. The COVID-19 pandemic has had devastating and disproportionate impacts on communities of color with unique impacts on Latinx immigrant parents in mixed-status families. AIMS: From a syndemic theory lens, we explored the convergence of structural racism and the COVID-19 pandemic to explore if the stress of the COVID-19 pandemic may compound harmful immigration-related policies. METHODS: Our community-based participatory research cross-sectional study administered 145 surveys among Latinx immigrant parents in mixed-status families in Georgia. We examined the relationship of pandemic stress and perceived statewide immigration policy vulnerability to depressive, anxiety, and PTSD symptoms. We conducted multiple linear regression analyses to test these relationships and their interaction. RESULTS: We found that that greater perceived policy immigration vulnerability and reported pandemic stress were associated with higher symptoms of depression. Increased PTSD symptoms were also associated with immigration policy vulnerability, but not pandemic stress. Tests to assess if pandemic stress strengthened the relationship between policy vulnerability on depressive, anxiety, and PTSD symptoms revealed no statistically significant interactions. CONCLUSION: Our findings suggest that stress of the COVID-19 pandemic and longstanding anti-immigrant policies in Georgia were salient for and related to the mental health of these Latinx immigrant parents.

Acculturation/enculturation and internalized model minority myth in Korean immigrant families.

Drawing on Bronfenbrenner's ecological systems theory (1977), this study examined the antecedents and outcomes of internalized model minority myth (MMM) within the microsystem of family and the macrosystem of culture. Among Korean immigrant families, we examined how mothers' internalized MMM (i.e., achievement orientation, unrestricted mobility) and youth's cultural orientations (i.e., acculturation, enculturation) were related to youth's internalized MMM and had direct and indirect relations to youth outcomes (i.e., life satisfaction, depression, antisocial behaviors, and academic performance). In a sample of 334 Korean immigrant mother-youth dyads (155 female youth; 132 foreign-born youth; Mage of youth = 16.37; Mage of mothers = 46.94), we conducted a path analysis by using the maximum likelihood and bootstrapping methods. A path analysis revealed mothers' achievement orientation was indirectly related to youth's academic performance via youth's beliefs in unrestricted mobility. In general, mothers' internalized MMM had harmful relationships to youth's depression and antisocial behaviors versus mixed relationships to academic performance. Importantly, mothers' internalized MMM indicated greater direct and indirect associations with youth outcomes than youth's own internalized MMM. A follow-up analysis of moderated mediation ruled out the possibility that academic performance moderated the relations of youth's internalized MMM and outcomes and thus masked any significant associations. Overall, the current findings highlighted the importance of understanding the internalized MMM within the microsystem of the close-knit Korean immigrant family relations. Implications for research, family intervention, parent education and outreach were discussed.

Perceived Parenting Discrepancy Profiles, Feelings about Language Brokering, and Internalizing Symptoms among Mexican-origin Adolescents in Immigrant Families.

While different patterns of perceived parenting discrepancy among mother-adolescent dyads have been shown to be associated with adolescent internalizing symptoms, little is known about the pathway underlying such associations, particularly among immigrant families. The current study considered one culturally salient form of mother-adolescent communication, language brokering (i.e., adolescents translating and interpreting between host and heritage languages for mothers), in order to investigate its mediating role based on two waves of longitudinal data on Mexican-origin immigrant families. Wave 1 included 604 adolescents (54% female; Mage = 12.92, SD = 0.92) and 595 mothers (Mage = 38.89, SD = 5.74); Wave 2 was collected one year later with data from 483 adolescents. Perceived parenting discrepancy patterns at Wave 1 were captured by three profiles based on the levels of both mothers' and adolescents' perceived positive parenting (i.e., Mother High, Adolescent High, and Both High). Compared to the other two profiles, adolescents who reported much lower positive parenting than mothers at Wave 1 (i.e., Mother High) experienced more negative feelings about brokering at Wave 2, relating to more anxiety. Being in the Mother High (vs. Both High) group was also directly related to more depressive symptoms one year later. This study highlights the importance of considering culturally salient forms of communication, such as language brokering, when designing family-level interventions to reduce adolescents' internalizing symptoms by building agreement on high positive parenting among mother-adolescent dyads from immigrant families.

Parental perceptions of bilingualism and home language vocabulary: Young bilingual children from low-income immigrant Mexican American and Chinese American families.

Dual language learners (DLLs), especially those from immigrant families in the United States, risk losing their home language as they gradually shift to speaking English as they grow up. Given the potential benefits of bilingualism on children's cognitive, linguistic, and social-emotional development, it is crucial to maintain children's home language to foster bilingual development. The current literature suggests that parental beliefs toward bilingualism and the language and literacy environment are linked to children's language development. With the growing number of DLLs living in the United States, little is known about what parental beliefs about bilingualism of their children are integrated into these bilingual households and parents' role in home language maintenance. The present study addresses the gap in the literature by investigating low-income immigrant families, specifically Chinese American and Mexican American families, and exploring the parental perceptions of children's bilingual language learning. Further, the present study examines the relations among parental perceptions of bilingualism, home language and literacy practices, and home language oral proficiency. Data were collected from a total of 41 Mexican American and 91 Chinese American low-income immigrant families with DLLs ages 50-88 months who had been recruited from Head Start programs and state-funded preschools in Northern California when the children were 3-4 years old. Information about shared reading frequency, home language exposure and usage, and parental perceptions of bilingualism was collected through parental interviews, and DLLs' home language oral proficiency was individually assessed. No significant difference in home language oral proficiency was observed between the two groups. Principal Components Analysis on the parental perceptions of bilingualism measure revealed two components, "Importance of Being Bilingual" and "English over Bilingualism." Stepwise regression analysis results show that "Importance of Being Bilingual" was associated with children's home language oral proficiency after controlling for culture, child age, the frequency of home language shared book reading, and child home language exposure and use. The results show that parents' positive beliefs toward bilingualism are related to the children's use of that language and their children's language outcomes. Implications and suggestions for home language and literacy support for DLLs are discussed.

Economic Pressure and Parent Acculturative Stress: Effects on Rural Midwestern Low-Income Latinx Child Behaviors.

Contrary to the visible Latinx population growth in rural America, rural Latinx households have experienced far greater economic disparities compared to Whites. Family economic stress predicts parents' emotional distress, lower family functioning, and places children at high risk for behavior problems. However, few studies have examined the combined effects of economic and acculturative stress on rural Latinx child behaviors, nor the family stress process among rural Latinx immigrant families in the Midwest, a new settlement area for Latinx and other immigrants (Kandel & Cromartie, 2004). Guided by the family stress model (FSM), we examined the relationships among economic pressure, parent acculturative stress, maternal depressive symptoms, parenting competence and child internalizing and externalizing behaviors using a sample of 148 rural low-income Latinx immigrant mothers in a Midwestern state. Structural equation modeling was performed to test these relationships. Results revealed that higher levels of economic pressure and parent acculturative stress were related to higher levels of maternal depressive symptoms, which in turn were associated with lower parenting competence and eventually linking to higher levels of child externalizing behaviors. Maternal depressive symptoms were positively associated with child internalizing behaviors. Parent acculturative stress was also found to be directly linked to child internalizing and externalizing behaviors. Intervention programs that aim to promote health and well-being among rural Latinx immigrant mothers and their children may find it beneficial to incorporate information and strategies that lessen parent acculturative stress and depression, promote parenting competence, and connect families to resources to help reduce economic pressure.

"Do the Best You Can with Resources You Have to Offer": Community stakeholder views on supporting immigrant families.

First and second-generation immigrant families of young children in the United States face potential challenges that may be mitigated with stakeholder support in their communities. We examined self-reported views and behaviors among professionals (n = 76) working with families in a mid-Atlantic urban community, and whether these views correlated with demographic factors. Over half of respondents were not able/willing to report the number of immigrant families served and over half believed immigrant parents are less likely to advocate for themselves or their child. Participants were fairly split in seeking advice from others and comfort in talking with immigrant families about their culture/needs. It is essential to assess stakeholders' views on perceived roles, roadblocks, and desired supports. This analysis informs efforts to work more collaboratively with community partners to improve outreach to immigrant families during those formative years in a child's development. Implications for research, practice, and policy are discussed.

Longitudinal relations between self-regulatory skills and mathematics achievement in early elementary school children from Chinese American immigrant families.

Drawing from two waves (∼1.5-2.5 years apart) of longitudinal data, the current study investigated the bidirectional associations between self-regulatory skills and mathematics achievement among a socioeconomically diverse sample of school-age Chinese American children from immigrant families (N = 258; 48.1% girls; ages 5.8-9.1 years; first to third grades at Wave 1). Children's self-regulatory skills were assessed with task-based measures of attention focusing, inhibitory control, behavioral persistence, and comprehensive executive function as well as parent- and teacher-reported effortful control. Multiple regressions showed that behavioral persistence and parent-reported effortful control positively predicted math achievement over time. Math achievement positively predicted comprehensive executive function over time. These effects were found when controlling for child age, sex, generation status, family socioeconomic status, parents' cultural orientations, and prior levels of math achievement or self-regulation. The prospective relation of math achievement predicting comprehensive executive function remained significant after a false discovery rate correction.

Mother-Adolescent Perceived Parenting Profiles and Mexican-origin Adolescents' Academic Performance.

Mothers and adolescents often perceive parenting differently, but it is unclear how different profiles of mother-adolescent perceived parenting and developmental transitions of such profiles would influence adolescent academic performance longitudinally. The current study adopted a three-wave dataset of 604 Mexican-origin adolescents (54% female; Mwave1.age = 12.92 years) and 595 mothers. Adolescents who agreed on high levels of positive parenting with their mothers in early adolescence (i.e., the Both High group) and stayed in the Both High group demonstrated the best academic performance in late adolescence. However, adolescents who changed from the Both High group in early adolescence and ended with discrepancies in perceived parenting or an agreement on low positive parenting with mothers in late adolescence had the worst academic performance. The findings suggest the plasticity of mother-adolescent relationships during adolescence, which can be an intervention target to improve Mexican-origin adolescent academic performance.

Changes in Economic Hardships Arising During the COVID-19 Pandemic: Differences by Nativity and Race.

Hardships in early childhood impact health. Few longitudinal studies have examined pandemic-related hardships among families with young children by race/ethnicity or nativity. We used prospective longitudinal data from 1,165 caregivers of children < 4 years surveyed in English and Spanish face-to-face in 5 urban hospitals 1/2018 to 3/2020 (pre-pandemic) and again by telephone 9/2020 to 3/2021 (during pandemic). Caregivers reported hardships (household food insecurity [HFI], child food insecurity [CFI]), behind on rent [BOR]) and maternal race/ethnicity and nativity. During the pandemic vs pre-pandemic, families with immigrant mothers had greater increases in HFI [aOR = 2.15 (CI 1.49-3.09)] than families with US-born mothers [aOR = 1.44 (CI 1.09-1.90)] and greater increases in BOR [families with immigrant mothers aOR = 4.09 (CI 2.78-6.01) vs. families with US-born mothers aOR = 2.19 (CI 1.68-2.85)]. CFI increases for all groups did not vary by nativity nor race/ethnicity. HFI and BOR increases during COVID were significantly greater in families with Latina mothers and those with immigrant mothers than other groups.

Parent Emotion Talk with Preschoolers from Low-Income Mexican American and Chinese American Families: Links to Sociocultural Factors.

Emotion talk (ET), an emotion socialization practice theorized to promote children's emotion understanding and emotion regulation, has been linked to better socioemotional adjustment in diverse samples. Immigrant children face developmentally unique challenges and opportunities related to their multi-lingual and multi-cultural experiences. The present study aimed to identify sociocultural correlates of parent ET in two groups of low-income immigrant families with preschool-age children: Mexican American (MA) and Chinese American (CA) families. In 90 parent-child dyads (child age = 38 to 70 months, 59% girls; 46 Mexican American and 44 Chinese American) recruited from Head Start programs, parents' (mostly mothers') ET quality and quantity (i.e., use of emotion words, emotion questions and explanations, and overall elaborateness of ET) were coded from verbal transcripts of a shared picture book reading task. First, we found similarities and differences in ET across the two groups. Both MA and CA parents used emotion words, emotion questions, and emotion reasoning, whereas linking the story to personal emotion experience was infrequent. MA parents used more negative emotion words, emotion reasoning, and engaged in more elaborate ET than CA parents. Second, we examined the unique relations of multiple socio-cultural factors (SES, cultural orientations, parent and child demographics) to parent ET. Parent education and child age were associated positively with emotion questions, income was associated positively with emotion reasoning, and parents' heritage culture orientation was associated positively with the elaborateness of ET. The findings highlight the need to consider socio-cultural variations in emotion socialization practices when adapting and disseminating socioemotional learning interventions.

Immigrant family legal clinic: A case of integrated student supports in a community school context.

Research is growing on the ways K-12 schools can address immigration policy and assist in mediating its impact on students and families. Community schools are poised to address these issues through integrated student supports by taking an asset-based perspective that views community members and organizations as powerful constituents in the struggle for educational equity. We report the findings of a qualitative case study of the implementation of a school-based legal clinic for immigrant families in a high-poverty urban neighborhood. We applied an equity-minded school change framework to examin the range of services offered by the clinic, the process of integrating the clinic's work into the life of the school, and the perspectives of teachers regarding the intersection between immigration and education.

Collateral Damage: Increasing Risks to Children in a Hostile Immigration Policy Environment.

Purpose of Review: To identify how recent immigration policies have affected the health of children in immigrant families (CIF). Recent Findings: As the number of children and families arriving to the US border has increased, so too have immigration policies directly targeting them. Summary: Anti-immigrant policies increase the dangers experienced by children migrating to the USA, while also limiting access to needed resources and medical care for CIF inside the country, including many who are US citizens. The resultant deprivation and toxic stress are associated with adverse consequences for children's physical and mental health.

Mental health disparities in Latinx immigrant communities residing in the United States during COVID-19: Implications for policy and practice.

Objectives: Studies have demonstrated that Latinx populations face significant health disparities in access to mental health care. The objective of this study was to describe the impact of the COVID-19 pandemic on the mental health needs of Latinx families, from the perspectives of direct service providers working with Latinx communities. Methods: Twenty-one semi-structured interviews were conducted virtually with direct service providers to the Latinx community from August to October 2020. Interviews were transcribed verbatim and analyzed using thematic analysis. Results: Two-thirds of providers were female, with a median age of 33 years, and provided direct services to Latinx clients and had extensive experience working with immigrant families, particularly in Massachusetts. Key themes identified describing the impact of COVID-19 on the mental health needs of Latinx families included: (1) exacerbation of mental health symptoms, (2) financial stressors, (3) preoccupation regarding transnational lives, (4) secondary needs becoming more salient, and (5) immigration status as a main driver of inequality. Conclusions: Our findings highlight the importance of focusing on the mental health needs of Latinx immigrants and ensuring their access to mental health services. Telehealth seems to be a potential tool that promotes mental health access among Latinx clients. Future research needs to continue investigating the role of telehealth in decreasing mental health access disparities.

Religion and Spirituality: Why and How to Address It in Clinical Practice.

Religion and spirituality (R/S) have been influential in societies' history, daily life, and identity in the past and in today's society. From a sociological perspective, R/S contributes to family development and organization, influences culture, and often contributes to forming opinions, beliefs, and concepts about oneself, family, society, and the world. In addition, R/S help shape individuals, families, and communities' ethical and moral understanding, thus influencing their behavior. This review article aims to provide the clinician with tools to understand, assess, and provide interventions that consider the patients' and their families' R/S. A recent review of the topic focused on general aspects of the R/S but we are unaware of reviews that integrate attachment, moral foundation theory, and forgiveness. This review will integrate these additional features into our understanding of the role of R/S in the delivery of mental health.