Cultural and linguistic correlates of autism in Jordan.

Autism is a neurodevelopmental condition characterized by altered social communication and restricted and repetitive behaviors. Social communication is deeply shaped by culture, which also influences what is considered abnormal or disordered behavior. Although nearly 80% of the world's children live in low- and middle-income countries (LMICs), most autism research-including studies on epidemiology, diagnosis, and interventions-originates from Western, high-income countries. Consequently, there is limited knowledge about autism within other cultural and sociodemographic contexts, creating a barrier to developing culturally and linguistically appropriate diagnostic and intervention strategies suitable for various cultural contexts. Using semi-structured interviews, we collected data from Jordanian parents of children 2-5 years of age with autism regarding their children's autism symptoms. We also examined parents' knowledge and attitudes about autism and their responses to the diagnosis, as these factors affect symptom perception and help-seeking behaviors. We found significant differences in Jordanian parents' perception, interpretation and reaction to symptoms compared to those seen in parents from the Western populations that reflect the unique cultural values of the community. These included more concern about social interaction than language development, more tolerance to variance in children's behavior, and a tendency to interpret symptoms in positive terms. Parents were reluctant to accept a diagnostic label as it carried social stigma and sense of loss of potential. We also found unique linguistic features that were used to describe the symptoms that have not been described before, including terms used for the conceptualization of autism as well as symptom descriptions. Our findings provide insights into the unique cultural and linguistic aspects of autism symptoms in this Arabic-speaking, Middle Eastern culture. These findings may inform future autism research and support the development and adaptation of diagnostic tools and interventions for children with autism in Jordan and other culturally similar populations.