As part of SAMHIN’s mission to encourage open conversations about mental health in the South Asian community, we invited Dr. Bhumika Shah, a passionate advocate for mental health awareness, to share her perspective on how autism is understood and experienced within the community.
A few years ago, a family asked me a question that left me surprised. “Does Riya have autism because I did something wrong? Is it because I don’t know how to parent her? Why is she so different from Aditya?”
I noticed her shaky voice and hands gripping the edge of the table. This moment kept me wondering about misconceptions that the South Asian community could have about autism, the stigma that leads to the guilt, and fear carried by these families and the impact on the child’s life. I hear questions like this frequently in my practice, reflecting deep cultural stigma. This stuck with me because small actions and understanding made a big impact in the family’s well-being. This question reflects a broader challenge I often see in families grappling with misconceptions about autism and the weight of cultural expectations.
Autism is a neurodevelopmental disorder (conditions affecting brain growth) that affects social communication and some behaviors. It is a spectrum and affects each person differently. Some children may communicate in ways other than speech and need support with daily routines like bathing or eating. In milder cases, children may prefer to be alone, have strong routines, be sensitive to sounds or textures, or focus intensely on specific interests. Research suggests autism arises from differences in genes and how they interact with environmental factors. It is not caused by poor parenting.
In many South Asian communities, success is often measured by social and academic milestones, making developmental differences harder to accept. In South Asian families, some of the behaviors associated with autism may be seen as being disrespectful, fussy, shy, or as a phase. For example, a child may avoid eye contact or not greet relatives, which could be interpreted as disrespectful or shy. They may want the same plate or cup for every meal or get distressed with small changes in their routine, which can be viewed as fussy.
Families may have high expectations of their children for milestones, academic or social skills. When the child’s development does not match the parents’ expectation, parents may feel confusion, anger, guilt, and shame. These feelings, though difficult, often come from love and the desire to help their child succeed. When unaddressed, they can affect the child, leading to poor self-confidence and self-worth, and potentially increasing the risk for anxiety and depression later in life.
From my experience with many families, practical steps can help reduce stress and support a child’s growth. Observing behaviors or patterns is the first step. Common signs to watch out for include not responding to their name, delayed speech, or difficulty with transitions (shift focus, activities or environments). Seeking a pediatric or developmental evaluation does not mean labeling, it is a way to understand and support the child. Collaborating with the school can also help. This can be done by sharing observations with teachers, scheduling meetings to discuss screenings or accommodations, or exploring available resources.
Most importantly, focus on the child’s strength. For example, a child’s strong memory, love for routines, or a love for numbers can be used to teach new skills or encourage independence. Autistic children also often have remarkable abilities for visual learning, attention to detail, or persistence that are worth recognizing and nurturing. A diagnosis does not change who the child is, it helps families respond with compassion, celebrate their unique abilities, and reduce stress for everyone. By noticing strengths, building on abilities, and seeing the whole child, parents can create an environment where their child thrives and the family feels supported. Autism does not define a child’s potential. It opens doors to unique strengths that, when nurtured, help them thrive. Small steps make a big difference, just as small actions helped Riya’s family.
By Bhimika Shah, M.B.B.S., M.D.
Child and Adolescent Psychiatry Fellow, Duke University
Dedicated SAMHIN volunteer
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Dr Shah – Thank you for the article. I think it is also very important to really highlight as well that many highly intelligent and professionally and financially successful adults get late diagnosis of autism as adults. They work in a number of fields that we deem as prestigious and have degrees from elite colleges. They are married and have kids. Of course this has variability as well. South Asians lack awareness of this as well. If a therapist suspects an adult of falling on the Autism Spectrum being referred to a neuropsychologist for evaluation can be helpful.
Thank you for your comment. You’re absolutely right that many successful adults could receive late autism diagnoses. It’s crucial to raise awareness, especially in communities like South Asians, where this might be less recognized. If you highly suspect someone to be autistic, referring them to a neuropsychologist for evaluation would be appropriate.