Centre for Creative Initiatives in Health and Population, Hanoi, Vietnam.
School of Social Sciences, Monash University, Melbourne, Australia.
Disabil Rehabil. 2023 Feb;45(4):684-695. doi: 10.1080/09638288.2022.2040613. Epub 2022 Mar 2.
The aim is to understand what therapies and interventions families in a low and middle income (LMIC) country, such as Vietnam resort to in their attempts to seek care for their children with ASD and why they choose these therapies.
We undertook semi-structured qualitative interviews with 27 parents of children with autism and an online survey of 112 parents as part of a broader ethnographic study over one year augmented with recent interactional observations and a review of social media.
There is limited access to formal interventions for families with children with ASD in Vietnam. Rather, families resort to syncretic care using an average of 6.8 different interventions per child. These included: speech therapy; physical therapy; prescribed medicines; and ABA as well as geomancy, special dietary regimes, biochemical testing, stem cell therapies and religious and cultural practices. Despite having low incomes, the families surveyed spent an average USD 345 per month on interventions, many of which are not evidence-based. Desire to care and potentially "cure" their children within a context of stigma associated with ASD drives parents to seek all possible interventions for their children.
There remains a large gap in access to appropriate evidence-based interventions or trained therapists for families. Further information for parents, culturally appropriate guidelines for effective interventions, more trained rehabilitation professionals and regulation is required.IMPLICATIONS FOR REHABILITATIONWithin low and middle income countries (LMIC), such as Vietnam there is a lack of intervention services, difficulties in accessing appropriate specialists, poor quality care and the costs of care.Families seek a range of formal interventions and costly informal therapies as well as culturally specific practices to care for their child/ren and require information on effective therapies.In LMIC training programs to build capacity for allied health professionals need to be implemented on the latest evidence-based therapies.It is important to develop culturally appropriate Vietnamese guidelines to support interventions for children with ASD.
旨在了解低收入和中等收入国家（如越南）的家庭为其自闭症儿童寻求治疗时会采用哪些疗法和干预措施，以及他们为何选择这些疗法。
我们对 27 名自闭症儿童的家长进行了半结构化的定性访谈，并对 112 名家长进行了在线调查，这是一项为期一年的更广泛民族志研究的一部分，研究中还增加了最近的互动观察和社交媒体评论。
越南的自闭症儿童家庭获得正规干预的机会有限。相反，家庭会采用融合式的治疗方法，每个孩子平均使用 6.8 种不同的干预措施。这些措施包括：言语治疗、物理治疗、规定的药物治疗、应用行为分析以及风水、特殊饮食疗法、生化测试、干细胞疗法和宗教文化实践。尽管家庭收入较低，但接受调查的家庭每月平均在干预措施上花费 345 美元，其中许多干预措施都没有经过验证。在与自闭症相关的污名化背景下，父母渴望照顾和潜在地“治愈”他们的孩子，这促使他们为孩子寻求一切可能的干预措施。
对于家庭来说，获得适当的基于证据的干预措施或训练有素的治疗师的机会仍然存在很大差距。需要为家长提供更多信息、为有效干预措施制定文化适宜的准则、增加更多经过培训的康复专业人员和进行监管。
在像越南这样的低收入和中等收入国家（LMIC），缺乏干预服务，难以获得合适的专家，护理质量差，护理费用高。家庭会寻求一系列正规的干预措施和昂贵的非正规治疗方法，以及特定文化的实践，以照顾他们的孩子，并需要有关有效治疗方法的信息。在 LMIC 中，需要实施培训计划，为从事相关健康职业的人员提供最新的基于证据的治疗方法方面的培训。制定适合文化的越南指南以支持自闭症儿童的干预措施非常重要。
