In my own experience as a person with disabilities and working for Chinese immigrant with disabilities, I have found that Chinese understand disability issues very differently from the mainstream in the U.S. I think it’s important for clinicians who work with Chinese to gain an understanding of Chinese cultural perspectives and traditional interventions on disabilities, reduce the bias toward Chinese immigrants which caused by cultural differences, and find better ways to engage with and empower this population.
Traditional Chinese Belief on Disability
Cultural beliefs can have a strong influence on people’s understanding of disabilities. In Chinese culture, the Buddhist belief of karma provides an explanation for the cause of disability (Wang, et al, 2007). A disability is believed to be a punishment for the disabled person’s parents or past life sins. Chinese mothers often blame themselves for violating the cultural taboo during pregnancy, such as seeing something ominous or eating the wrong kind of food (Chiang & Hadadian, 2007). In Chinese, there are two terms of disability, one is “Chanji,” which means a serious disease that will never get recovered. Another is “Chanfei”, which means someone is worthless toward the family and society. These words bring the negative sense that people with disabilities are helplessness and hopelessness, and the child’s disabilities are disruptions to natural order in family tradition and the whole society. Parents felt they could not give and receive the cultural expectation of moral debts and credits throughout family life. Thus, parent experience great shame and obligation toward the child (Chiang & Hadadian, 2007).
The negative perspectives on disabilities give social stigmas to families with children with disabilities (Chiang, 2014), which predispose the adoption of harmful coping strategies and reduced quality of social networks, such as withdrawal or restricting social contact. Moreover, secrecy or concealing the treatment history of family members with disabilities is predominantly endorsed by Chinese groups (Yang, et al, 2014). Actually, in general, there is high prevalence of delayed or forgone pediatric care among Chinese immigrant families with various SES and educational levels (Huang, et al, 2009), which negatively influences the development of children with disabilities for whom the early diagnosis and intervention is very critical. For example, the reported average age of Chinese parental concern of autism is 3.1 years old, which is much later than the 19 months in non-immigrant American populations (Qian, et al, 2012). It’s important for clinicians to come up with culturally appropriate strategies to destigmatize disability, empower parents with children with disabilities and support them to reach out to early intervention resources.
Traditional Chinese Intervention on Disability
According to traditional Chinese medical theory, disability is an imbalance in energy, and should be treated with the same method for other diseases to reduce phlegm. For this, herbal and nutritional remedies and acupuncture are used. Whereas herbs and nutrition are intended to treat phlegm, acupuncture is intended to reconnect neural circuits that have been disrupted and disconnect vital areas of the brain (Parette, Chuang &Huer, 2004). In Chiang’s study (2007), a mother even took her son with autism back to China at least once a year just for acupuncture. The problem of these traditional cultural interventions is that currently there is no scientific research that shows that they can effectively treat the symptoms of disabilities.
Parette (2004) found that Chinese parents had difficulties in managing the behavioral problems of their children with disabilities. One study shows that in general Chinese and Chinese-American parents report greater use of physical punishment, verbal admonishment and yelling than European-American parents (Fung & Lau, 2009). Because of the cultural value of promoting family unit and filial piety, Chinese parents sometimes punish their children’s misbehavior by arousing their fear of personal taunt and family shame. Primary forms of discipline used by Chinese parents are name-calling, teasing, and verbal reprimands. Physical punishment is usually considered acceptable. Children are reminded that their misbehaviors result not only in their “loss of face” but also disgrace and embarrassment for their family (Wang et al, 2007). These disciplines are actually associated with increased aggression, delinquent and antisocial behavior and low self-esteem in children (Fung & Lau, 2009).
While the cultural perspectives bring a lot of shame and stigma to families with children with disabilities, and the Chinese parent’s help-seeking behaviors and interventions impede the children’s development, I think it’s important for us to understand how cultural values influence the Chinese parents’ choices, gaining empathy towards them and build rapport with them.