Autism and Autism Services with Indigenous Families and Children in the Settler-Colonial Context of Canada: A Critical Scoping Review

Abstract

In Canada, Indigenous families and children experience structurally-rooted marginalization due to longstanding and ongoing histories of colonization and discrimination. Indigenous children with autism spectrum disorder (ASD) are currently underrepresented in literature and databases on ASD in Canada, raising concerns about their equitable access to related services and optimal health outcomes. This critical scoping review maps out existing and emerging themes in literature pertaining to ASD and the provision of ASD services with Indigenous children and families in Canada. No previous reviews of literature have focused exclusively on ASD among Indigenous children in Canada. A literature search conducted across eight databases between 2011 and 2021 resulted in 362 potentially relevant publications, of which 19 met our inclusion criteria. Findings point to a clear lack of data on ASD and unmet health, social, and educational service needs among Indigenous children with ASD in Canada. ASD is also frequently discussed through a Western, deficit and medical discourse. The main contributors to the lack of data and unmet service needs relate to the historical positioning of colonial oppression, stigma, an overrepresentation of fetal alcohol spectrum disorder (FASD), lack of funding, and concerns about standardized diagnostic and assessment tools, and social determinants of health. Recommendations for policy, practice and research concerning Indigenous children with ASD are proposed.