A Mixed Methods Investigation of Korean Americans’ Autism Awareness and Attitudes

Background: Korea’s ASD prevalence is a staggering 1 in 38, but two-thirds of children with ASD in Korea have never received special education services (Kim et al., 2011). Korean parents avoid registering their children as disabled due to stigma (Kim & Kang, 2003), and view ASD as a hereditary disorder that threatens marriage prospects for relatives (Grinker et al., 2012).

As 76% of Korean Americans are Korean-born immigrants (U.S. Census Bureau, 2004), it is likely that many Korean Americans still hold Korean values and cannot access ASD information in English due to language barriers.

Misconceptions and stigma may discourage Korean American families of children with ASD from obtaining services. ASD knowledge and attitudes in the Korean American community need to be assessed.

Objectives: The goal of this study was to examine the relationships between age at immigration and 1) ASD knowledge and 2) attitudes in the Korean American community.

Methods: A survey was administered to 159 Korean adults at Korean community organizations in Los Angeles, CA. The survey consisted of adapted versions of the Autism Knowledge Survey (Tipton & Blacher, 2014) and open-ended questions assessing autism attitudes (Grinker et al., 2015). The survey was translated into Korean.

Participants’ responses on the Autism Knowledge Survey, containing 14 statements about ASD, were scored based on correctness. Open-ended questions included: 1) What words or phrases do you think of when you think of autism? 2) What causes autism? The causes listed by participants were coded into categories. Interrater reliability calculated using Cohen’s Kappa, was high (range=.72-.93).

Results: A multiple regression was conducted to investigate the relationship between age at immigration and autism knowledge, controlling for having a family member with ASD, gender, age, education level, and income (see Table1). Earlier age of immigration, having a family member with ASD, and being a female were associated with higher levels of ASD knowledge. The model explained 23.9% of the variance (R²=.24, F(6, 122)=6.40, p<.001), with age at immigration by itself explaining 13.7%.

Four themes were identified through inductive coding of participants’ perceived causes of autism: 1) biological, 2) parenting, 3) postnatal (includes parenting), and 4) unsure. A logistic regression was performed to examine the relationship between age at immigration and the likelihood of listing parenting as a cause, controlling for demographic variables (see Table2). The model was statistically significant (χ²(6)=16.92, p=.010). It explained 25.3% of the variance and correctly classified 84.7% of cases. Individuals who immigrated to the U.S. at an older age were more likely to list parenting as a cause (odds ratio=1.08, p=.017). Examples from the qualitative responses included “parents’ drug addiction”, “parents’ lack of love”, and “reckless behaviors”.

Conclusions: Koreans who immigrated later in life tend to have lower levels of ASD knowledge and incorrectly believe that parenting causes ASD. More resources in Korean are needed to raise Korean Americans’ ASD awareness. Mass media and educational seminars may be effective ways of disseminating ASD information. Awareness campaigns should consider individuals’ acculturation levels and incorporate cultural adaptations in the design and implementation.