Challenges in Diagnosis of Autism Spectrum Disorder in Vietnam

Background:  

For individuals with ASD, diagnosis enables early intervention, which leads to improved life of these individuals. Nevertheless the diagnostic process for ASD is a confusing process and socially and culturally constructed. The diagnostic label of ASD has recently recognised in Vietnam since 2000 and the number of children who have been given the diagnosis has increased dramatically. However, there is limited understanding on the condition and diagnostic process of ASD in Vietnam. This paper is a part of a larger qualitative study being undertaken in Hanoi, Vietnam from June 2011 to May 2012 that seeks to understand the social construction of ASD in Vietnam.

Objectives:  

To describe practices of providing a diagnosis on ASD and the negotiation between parents and professionals on the diagnostic label in Hanoi, Vietnam.

Methods:  

Data for this paper came from in-depth interviews and case studies with parents and service providers, as well as observations at health clinics and centers that provide diagnosis and intervention services for children with ASD. Approximately 25 parents of children with ASD, and 15 key informants have participated in this study with written consent.

Results:

There has been some improvement in diagnosis for Tu ky (a Vietnamese word for Autism) in Vietnam; however, parents and professionals still struggle with a number of concerns on the diagnosis of this condition. First, there is no governmental standard guideline on diagnosis of ASD as well as no organization responsible for monitoring the quality of diagnosis. Second, while clinics use different procedures and Western-developed tools for assessment, social and cultural influences may lead to misinterpretation of child’s behavior and capacity, and misdiagnosis. For example,   Vietnamese children are expected to obey adult’s instruction and if they do not they may be “culturally” labeled as a problem behavior. This study also reveals that the limited communication between parents and professionals, the judgment attitude and the unclear on diagnostic process contribute to the parents’ confusion and unsatisfaction on diagnosis. In addition, although ASD has became hot topic in media recently, lack of understanding of the normal development of children and limited knowledge on this condition, amongst both parents and professionals result in panic among parents and the pressure to give this diagnostic label.

Conclusions:  

It is very important to recognize influences of social structure and cultural norms to the diagnosis of autism in Vietnam and other cross-cultural settings. In addition to public education on ASD, attention needs to be paid to capacity building for professionals and monitoring the quality of diagnosis.