By: Lena Vo, BA, Graduate Student Clinician at the University of Texas at Dallas
Many current and future speech-language pathologists (SLPs) can trace their interest in the field back to a personal experience. I was exposed to the field of speech-language pathology through my younger cousin Aaliyah, who was diagnosed with autism when she was three years old. Living in a multigenerational Vietnamese home with my mother, grandparents, uncle, aunt, and cousins all present, Aaliyah brought light to our family about the world of neurodiversity. The first time I heard about speech therapy was through a note on the refrigerator labeled, “Aaliyah – 3 p.m. Speech-Language Pathologist.” As a 17-year-old with no idea of what to pursue in college, I searched the term online, and from there, I decided what the next six years of my life would look like. My grandma told me about all the times a “teacher” came to play with Aaliyah and helped her talk while I was attending high school. Although Aaliyah was fortunate to be diagnosed in a timely manner, the hardest part about interpreting diagnoses and accessing early intervention is the cultural stigmas and lack of awareness surrounding autism that continue to exist in immigrant families. In my own family, I continue to see cultural and language barriers that can make navigating healthcare, educational, and intervention systems difficult.
Discussing access to early intervention for autistic children from immigrant families is significant as autistic children from immigrant families face more than twice the risk of lacking a usual source of care. Children from immigrant families may receive a delayed or missed diagnosis, therefore reducing the opportunity to access early intervention services (Schmengler et al., 2021). This article aims to help SLP graduate students and professionals recognize common barriers faced by immigrant families of autistic children and provide practical strategies for culturally responsive care and connections to community resources that can improve access to early intervention services.
Barriers to Accessing Early Intervention
Autistic children from immigrant families may experience delays in receiving early intervention services due to a variety of factors such as cultural stigmas surrounding developmental disabilities, difficulties navigating healthcare and educational systems, financial hardship, and immigration-related stressors related to documentation status. These challenges may affect families’ abilities to recognize developmental concerns, seek services, and access available resources. It is important to note that immigration-related stressors are not limited to undocumented families and, in this context, refer specifically to fears or hesitations about seeking services due to concerns that documentation status may be questioned or disclosed. Immigrant families encompass a range of documentation statuses. Barriers such as systemic navigation, language differences, and cultural adjustment can impact immigrant families regardless of legal status. Furthermore, families may experience assumptions of undocumented status based on racial or ethnic profiling, which can increase their reluctance to engage with healthcare systems and early intervention services.
Cultural stigma surrounding autism and receiving therapy services can significantly delay access to early intervention services for immigrant families. Cultural beliefs about typical child development can influence how parents recognize and report early signs of autism. For example, although children of Latina mothers presented with more severe autism spectrum disorder (ASD) symptoms, their mothers were less likely to report developmental concerns than white mothers of children with suspected ASD (Schmengler et al., 2021). The cultural context of a child’s family background is significant to early identification, as some Asian cultures consider imitating adult gestures and maintaining eye contact as disrespectful. Therefore, Asian and/or Pacific Islander families are less likely to identify and agree that their child’s behavior is part of a disorder. Understanding the origin of autism also varies across families, with some interpretations being parental responsibility, destiny, or past life experiences. There is consistent research that demonstrates how Latino, Native American, and Asian families often believe they are responsible for their children’s disabilities. Negative perceptions of healthcare systems, fear of labeling a child, and concerns about community judgment can further discourage families from pursuing evaluations and services.
Immigrant families additionally reported limited social support in navigating the healthcare and education system. When discussing concerns of their child’s development with extended family, many parents reported that they were advised to disregard the ASD diagnosis, as it was believed the child would eventually “grow out of it” (Schmengler et al., 2021). Parents additionally feared negative reactions from members of their community regarding their child’s behaviors, leading some to avoid discussing their child’s diagnosis and delay accessing intervention services. Challenges faced within the healthcare and educational systems include language barriers, limited understanding of medical terminology, excessive paperwork, lack of awareness of available services, and reduced empowerment from healthcare providers (Sritharan et al., 2018). Khanlou et al. (2017, as cited in Sritharan et al., 2018) found that immigrant mothers expressed uncertainty about receiving adequate services when needed, reporting dissatisfaction with coordination among healthcare, social service, and school systems. A parent reported, “We need more respectful translators with knowledge about disability” (Khanlou et al., 2017, as cited in Sritharan et al., 2018). As a result, these experiences can leave families without the necessary support to navigate and access therapeutic services.
Financial hardship can limit opportunities for parents to spend quality time with their child. Many families may prioritize financial stability and will work to meet basic needs, requiring some parents to work long hours or multiple jobs. Due to financial difficulties, families may not have time during the day to provide transportation for their children, actively engage in therapy sessions, and consistently implement intervention strategies at home. Fathers are particularly more likely to take on the traditional breadwinner role, reporting that they feel like a “shadow” in the diagnostic and therapy process for their child (Imanpour et al., 2025). Immigrant fathers are often assumed to be less physically and emotionally involved in raising children with autism due to their role to financially support the family. These challenges reflect work-related demands and can create additional barriers to accessing early intervention as it limits the ability to attend appointments, participate in services, and carry over strategies at home.
More immigrant families are disengaging from services as immigration-related stressors related to documentation status continue to increase (Lopez, 2019). As tension and law enforcement regarding documentation status continue to rise in the United States, many families from immigrant backgrounds demonstrate hesitancy in interacting with the healthcare system due to these concerns. This is one of the major reasons why the number of children without health insurance has increased through the years. For example, Ana is a mother from Central Texas and has a 9-year-old daughter with autism. Although both of her children have been covered by Medicaid for years, she decided to no longer pursue additional government-funded therapy services as she feared it would negatively impact her pending application for permanent residency (Lopez, 2019). Immigration-related fears can cause families to forego services as they prioritize maintaining their family’s safety and stability.
Community Supports
Due to the various barriers discussed, some immigrant families seek support through community-based organizations that include and are not limited to Catholic charities and nonprofits that serve Spanish-speaking families. The Catholic Diocese of Dallas provides sensory-friendly masses, along with the availability of Spanish-language services (Catholic Diocese of Dallas, n.d.). Faith-based centers can offer immigrant families not only a familiar and highly trusted environment but also opportunities to connect with other families in the community who have shared experiences navigating autism services, support systems, and available community resources. Families may feel more comfortable, less isolated, and connected to their community through involvement in faith-based centers.
Nonprofit organizations such as VELA in Austin, Texas, specialize in educating and supporting Spanish-speaking families whose children have disabilities (VELA, n.d.). Services include assistance with accessing Medicaid plans, monthly support groups, and case management offering one-on-one support with a social worker to navigate access to therapy and interpretation of special education plans. Additionally, they offer in-person and virtual courses related to autism, caregiver wellness, transitions into adulthood, and special education. VELA requires no health insurance and provides services at no cost to families. These services bridge gaps in early intervention access for families who may otherwise face linguistic, cultural, and systemic barriers.
The South Asian Autism Awareness Centre (SAAAC) works to reduce stigma through education, open dialogue, and culturally responsive support (Sritharan & Koola, 2018). Although SAAAC is intended for the South Asian community, its program model can be applied to other immigrant groups. This program targets awareness, education, and education to families about autism. SAAAC creates dialogue through media (e.g., newspapers, brochures) and hosts booths at local community gatherings about ASD and early identification signs. Addressing cultural barriers through community-based models like SAAAC is essential to increasing autism awareness, mitigating stigmas, and promoting earlier access to intervention services.
Clinical Strategies To Engage Immigrant Families (Alanís, 2025)
- Use culturally familiar and relevant visuals. In therapy, SLPs can incorporate visuals that are personal to the child’s family and cultural background. For example, utilizing family albums, food labels, objects, and signs found in the child’s community can help children generalize skills by connecting their learning to realistic contexts. By encouraging families to contribute meaningful materials from their home and community, caregivers have the opportunity to share more about their culture and background. This can foster trust by recognizing and valuing families’ personal perspectives and lived experiences. An example from Alanís (2025) includes a child bringing photographs of their family picking pumpkins. The educator cut the pictures into puzzle pieces and allowed students to work together to reassemble them. This group activity encourages conversation about the images while providing the child with the opportunity to share personal stories about their families. Children can discuss pictures in their preferred language, allowing them to express themselves authentically while supporting bilingual language development. Clinicians can incorporate local signs in the child’s community, such as neighborhood markets, restaurants, and other local businesses that display Spanish, Vietnamese, and other home languages. Pairing these signs with blocks and encouraging the child to build a representation of their community provides opportunities to practice vocabulary and storytelling in meaningful contexts.
- Design shared spaces that acknowledge and celebrate multilingualism. Consider the perspective of families when they first enter the classroom or shared spaces. Simple gestures, such as placing banners or signs that say “Welcome” in a variety of languages, allow children and families to feel acknowledged and supported to use their home language. Affirm a variety of languages in common areas such as the main lobby, hallways, stairways, bathrooms, etc. The therapy room or classroom where the child spends their time learning should reflect and affirm their linguistic and cultural background. In early intervention services that occur in the family’s home, SLPs can similarly incorporate multilingualism by involving books, songs, and everyday familiar routines in the child’s home language. Collaborating with the family to identify meaningful words, phrases, and routines that are part of the child’s daily life ensures culturally responsive practices.
- Integrate culturally relevant socio-dramatic play themes. Alanís (2025) shares an example of asking children what they did over the weekend. A child discussed with the class about going to the local bakery with their grandma (e.g., Yo estuve con mi abuelita y fui a la panaderia). As a result, the teacher created a socio-dramatic play area where the children worked at a panaderia and talked about their favorite baked goods. These same activities that are culturally relevant to children’s backgrounds can be implemented in therapy sessions. Engage the child and their family by asking about what they like to do in their free time, their interests, favorite music, restaurants, etc. This allows the clinician to not only personalize therapy for each child but also create meaningful opportunities for children to use their cultural knowledge and real-life experiences to support their communication and language development.
- Acknowledge fears and anxieties. Because of known hesitancies toward the healthcare, educational, or political systems, accessing early intervention for autistic children from immigrant families is not always straightforward. As a clinician, being aware of the current social and political climate, as well as how it may influence families’ willingness to engage in services, is crucial. Simply asking families how they are doing, what resources or support systems they currently have, and if there is anything else that you can do for them can go a long way. Recognizing the fears and anxieties that families may experience strengthens the therapeutic relationship, creating a safe and supportive environment where families feel heard and respected.
- Build a local “resource map.” An additional way to support families through their early intervention experience is to develop a local resource map that highlights community organizations, support groups, cultural centers, parent networks, interpreters, healthcare providers, and others that may be useful. Providing families with a centralized list of trusted resources can make services feel accessible and reduce burdens of navigating unfamiliar systems. The resource map may also serve as a practical tool for SLPs, as it offers quick access to established community partners and referral options.
Conclusion
Early intervention plays an influential role in supporting the developmental progress of children with autism. Immigrant families often face additional barriers that can delay or limit access to these critical services. Current and future SLP clinicians should intentionally incorporate culturally relevant visuals and play activities, create environments that celebrate multilingualism, address caregiver experiences and uncertainties, and connect families with community resources to help foster trust and engagement in services. By recognizing the cultural, linguistic, and systemic challenges that immigrant families may encounter, SLPs can provide more culturally responsive care and help reduce disparities in access to early intervention. Through ongoing advocacy, clinicians can contribute to improving and ensuring that autistic children and their families receive the support necessary to thrive.
References
Alanís, I. (2025). Engaging immigrant families: Strategies and tools for early childhood educators [Video]. YouTube. https://youtu.be/mljRmPXyhGI
Catholic Diocese of Dallas. (n.d.). Disabilities and Deaf Ministries. https://dallascatholic.org/disabilities/
Imanpour, S., McGehee, A., & McMaughan, D. J. (2025). “As immigrants we are all lost in our autism journey”: Experiences of raising children with autism, barriers to equal access, and facilitators to accessing autism services among immigrant fathers. Research in Autism, 124, 202588. https://doi.org/10.1016/j.reia.2025.202588
Lopez, A. (2019, February 1). Immigration fears force family to forego autism services for citizen child. The Transmitter. https://www.thetransmitter.org/spectrum/immigration-fears-force-family-forego-autism-services-citizen-child/
Schmengler, H., Cohen, D., Tordjman, S., & Melchior, M. (2021). Autism spectrum and other neurodevelopmental disorders in children of immigrants: A brief review of current evidence and implications for clinical practice. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.566368
Sritharan, B., & Koola, M. M. (2018). Barriers faced by immigrant families of children with autism: A program to address the challenges. Asian Journal of Psychiatry, 39, 53–57. https://doi.org/10.1016/j.ajp.2018.11.017
VELA. (n.d.). VELA Families. https://www.velafamilies.org/