Supporting CALD/CARM Communities

In recent years, the neurodiversity movement has been gaining momentum—inviting us to reimagine what it means to support neurodivergent folks with empathy, curiosity, and dignity. But not all communities are being supported equally in this journey and can be a source of inequity. Setting the Scene for this Directory The term Culturally and Linguistically Diverse (CALD) is familiar to many in Australia, yet often this can cast the net too broadly to include many who are racialised as white (e.g. Ukranian, Russian etc). Sometimes when we talk about inclusion of the CALD community, if we were to be true to its definition, we can have CALD representation yet still exclude our most marginalised and in need of cultural support and additional layers of understanding. (A little side note: I don't like the term CALD as technically we are all diverse, and somehow still ends up centering white, Western norms. Similar to the argument of how neurodiverse is actually an all encompassing term for society, and neurodivergent defines those who are significantly different from the norm, but will leave this topic for another day..... )

For the purposes of this article, we will introduce a new term that is growing in familiarity - CARM, standing for Culturally and Racially Marginalised. It includes (but isn’t limited to) Black, Indigenous, and other racialised communities whose cultural identities are not centred or valued in dominant narratives. CARM fits on a personal level for me, having always grown up as a minority - South Indian in a Chinese-dominant culture, then Brown immigrant in Australia. It wasn't so much my diversity that was a challenge, but that it wasn't made space for or as easily understood. CARM acknowledges that people are not simply different, but that their differences are used as a basis for exclusion and discrimination and it is these differences that need to be addressed in building bridges of inclusion. Neurodiversity Affirming and CARM populations

For many CARM families, the concept of being neurodiversity-affirming is still unfamiliar, inaccessible, or even in direct conflict with cultural narratives around disability and difference. We're not 'behind' however, we're different and the way we need to conceptualise support for CARM populations has to be different too.

We risk perpetuating the harm that has been done to our autism and ADHD community when looking at their support through a neurotypical lens when we continue to provide therapy to CARM communities through a Western lens.

So many CARM families are doing the best they can—navigating systems that weren’t built with them in mind. If we truly care about inclusive, neurodiversity affirming practice, we need to dig deeper and recognise intersectional perspectives so we can may them where they're at. Conceptualising CARM Community Support

Let’s break it down:

1. Language and Conceptual Gaps

For many families, especially those with limited English proficiency, the language around neurodiversity is dense, Western-centric, and sometimes untranslatable. Words like “sensory regulation,” “masking,” or “self-advocacy” don’t always have direct equivalents in other languages—or if they do, they carry different cultural connotations. For example, according to Sharen Lui at Sprout Psychology, autism in Mandarin is directly translated to loneliness disorder, without any other ways that clinicians can change it to be more inclusive of its evolution.

This isn’t just a translation issue—it’s a meaning issue.

We need more culturally grounded metaphors and frameworks to explain neurodiversity in ways that resonate. Representation in translated resources matters, but so does cultural relevance.

2. Stigma and Cultural Beliefs

In many cultures, disability (especially invisible disability) is still heavily stigmatised. Families may fear judgment, rejection, or being blamed for their child’s differences. Neurodivergence is often seen through a medicalised or moral lens—something to be corrected or hidden so as to keep the family name in tact.

In such contexts, “affirming” a child’s neurodivergence may feel confusing, unsafe, or even irresponsible. In India and parts of South East Asia, differences may be attributed to 'karma' of wrongdoings in a past life or possession by a 'djinn'. Understanding the lens through which we see these differences is essential to meeting families where they're at. We can support these families using language from their current contexts rather than Western overlays. Some families might find meaning in turning to star charts and numerology to make sense of someone's developmental path. Some cultures may also adopt a different perspective to developmental milestones, being more fluid than Western culture that values reaching certain milestones at certain ages. As such, research has recognised that CARM families may present later for a diagnostic assessment, whilst having more pronounced traits. (Hussain et al, 2023)

We can’t just preach inclusion—we have to create safe, trusted spaces for unlearning internalised stigma, and offer culturally respectful ways to reframe difference that take different perspectives into account.

3. Intergenerational and Bicultural Tensions

In CARM families, there’s often a generational divide. Parents and grandparents may hold traditional values or beliefs about child development that clash with the affirming practices kids are being taught at school or therapy. Furthermore, in some collectivist families, grandparents are the ones who hold power over family decisions and the opinions of the matriarch or patriarch set the tone for the family.

A child may be encouraged to advocate for their needs, but the family values deference and obedience. A therapist might suggest giving the child more autonomy, while the parents feel they're being told to "spoil" them or it doesn't feel right from the traditionally hierarchical family they grew up in.

This isn’t about who’s right—it’s about building bridges of understanding.

It's also about what feels personally meaningful for the family, and taking how they form identity into context. Affirming practice should consider important people to the individual, and find ways to honour culture and neurodivergence at the same time. It's up to each family to decide and sieve through the parts of their heritage that they'd like to hold true that serve them, and the parts of culture that we've fused with trauma and no longer serve us.

4. Systemic Barriers to Accessing Affirming Services

CARM families often face racism, discrimination, and bias in healthcare and education. They may not trust professionals or feel heard when they express concerns. Additionally, some interventions may not match with what their beliefs are. For example, being your authentic self and 'unmasking' can be seen as a Western, individualistic concept that ignores collectivist values and familial/group obligations. This can lead to a distrust of health professionals and the system at large to being able to support them. The CARM community are more likely to experience late or missed diagnoses, and less likely to be offered strengths-based, affirming interventions. Even when services are available, they’re rarely offered in community languages or tailored to diverse worldviews.

We need more therapists and safe spaces to help build bridges of understanding between culture and newer understandings of neurodivergence in order to support information uptake in CARM community. (Ps. We're releasing The Brain Forest in Spanish soon, and are thrilled to be part of making waves here)

5. Different Societal Standards
   

Behaviours that are seen as 'quirky' in white children may be conceptualised as dangerous or life threatening for Black and Brown Children. There are truths that CARM families know - in the bones of their soul - that behaviourist approaches might be the way to go for their child, because unmasking in public is a luxury that society does not accord them. The privilege of being understood is not one that is given. We only need to look at the number of deaths in the United States to give us a picture of how Black and Brown children are viewed differently and where power inequities lie. Closer to home ground in Australia, the overrepresentation of Aboriginal and Torres Strait Islander people in the prison population presents a significant cause of concern, representing approximately 2% of the adult population but account for 28% of the full-time adult prison population. (Human Rights Watch, 2018) Stories of mistreatment simply... don't make it to media. We need to be introducing nuance into the conversations around what neurodiversity-affirming practice is in order to be inclusive of marginalisation and everyday realities for CARM populations.

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Grounding ourselves in cultural humility for the way forward is essential. Developing inner reflection on what Western therapy and supports look like is crucial. Continuing to listen to a variety of voices in the CARM community will support us in gaining a deeper understanding of what CARM communities are like, the nuances, the complexities, the strengths that we have that can become a beautiful celebration of culture in your room. Resources to listen to the CARM community further:

Podcasts

Chinese Culture with Sharen Lui on the Neurodivergent Woman Podcast The Immigrant Experience with Sandhya Menon on the Neurodivergent Woman Podcast The Black Autistic Experience with Khadija Gbla Culturally Responsive Care with Native Clients with Joshuaa-Allison Burbank

Social Media Resources

Bad Indian Therapist Chinese Autism UK AutiAnthology - Chinese/Candian writer AutisticAsFxxk - Singapore Chinese creator Onwards and Upwards Psychology (me!) - Singaporean/Indian immigrant Project Lily - Autistics in Malaysia Blog Posts Talking to Children about Autism - Mandarin by Reframing Autism Explaining Autism (Mandarin) Growing up Mexican

Translated Documents

Positive Partnerships - multiple languages

Explaining Neurodivergent Affirming Practice in Mandarin

Autism myths and Facts - English and Indonesian translation (1).pdf

Download PDF • 120KB

Community Spaces

Online - themiddlebridgeproject

Online - Australian Asian Autism/ADHD Group

Supportive Spaces [Note: Therapists backgrounds are noted in order to support potential clients finding an appropriate fit; however, many of these therapists are versed in culturally affirming practice and likely to extend this to other different cultural backgrounds. Sandhya has no personal affiliation with the companies below nor receives any commission for the recommendations. Each individual is encouraged to explore the services to decide if they are a right fit for you] VIC - Pola Practice [African/Indian]

VIC - InSession Counselling  [South Asian/Sri-Lankan] VIC - Unhypen Psychology VIC - Umeed Psychology [South Asian/Muslim] VIC - Ascension Psychology [SE Asian men's mental health]

VIC - Sprout Psychology [Chinese families]

VIC - Little Birds Allied Health [Chinese families] If you've got a resource that you'd like us to add to the list, this is very much welcome and part of community care. This is a document that is designed to serve the community and spread awareness. Do email us at info@onwardsandupwardspsychology.com.au if you've got a resource that might fit well in our lists. References Human Rights Watch (2018) Australia: Prisoners with Disabilities Neglected, Abused. As retrieved from https://www.hrw.org/news/2018/02/06/australia-prisoners-disabilities-neglected-abused? Hussain A, John JR, Dissanayake C, Frost G, Girdler S, Karlov L, Masi A, Alach T, Eapen V. (2023) Sociocultural factors associated with detection of autism among culturally and linguistically diverse communities in Australia. BMC Pediatrics . 23(1):415. doi: 10.1186/s12887-023-04236-2. PMID: 37612588; PMCID: PMC10463473.