New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 7: Mäori perspectives
Fewer responses were recorded regarding
improved access to professional services. Of
those that were noted, access to child and
adolescent mental health services, Specialist
Education Services (now Ministry of Education,
Special Education (GSE)), and psychologists
received mention.
3. What are some of the barriers for Mäori
accessing assessment and diagnosis
services?
Responses to this question were very similar to
those obtained for question 1. They are grouped
under the following eight categories:
• differential diagnosis/misdiagnosis
• geographic isolation (access difficulties and
isolation)
• funding and resource constraints
• lack of culturally appropriate professionals,
services and contexts
• lack of information available for whänau
• lack of whänau support, the resource
constraints of single parenting, or the needs
of other children
• reluctance to seek treatment or a delay in
treatment seeking
• time to access respite care from initial inquiry
to first response.
Lack of whänau support, and single parenting,
were noted as additional barriers. Problems
with receiving accurate and timely information
and referrals including professional advice on
availability of services were also noted.
4. Are these problems made harder because
the person with ASD is Mäori?
There was a clear demarcation in responses to
this question from hui participants. For those
who agreed that assessment and diagnosis
issues are more difficult because the person with
ASD is Mäori, responses fell into four categories.
These were:
• geographic isolation (access difficulties and
isolation)
• reluctance to seek treatment or a delay in
treatment seeking
• lower socioeconomic status
• not trusting the system.
In contrast, those that disagreed with this
statement believed that ethnicity was not a
significant factor because services should be
the same for Mäori and non-Mäori. It was
also suggested that the main difficulty about
assessment and diagnosis was when an
individual received a diagnosis of ASD and
the need for family members to come to terms
with this.
Part 7
The major focus of the participants was on
cultural issues. Responses recorded included the
need to recognise different cultural definitions
of disability and spirituality, for professionals to
be familiar with Mäori world views, models of
health and protocols, and the value of involving
holistic treatments and tohunga in the provision
of care. The concept of whakamä was also
mentioned as a possible impediment that may
influence delays in treatment seeking by parents
or carers.
An observation was recorded involving the
length of time it takes to receive accurate
professional advice from first observation of
a problem to the need to access respite care.
5. Identify any other Mäori-specific issues or
needs during assessment and diagnosis.
Participants’ responses to this question focused
predominantly, yet broadly, on cultural factors.
A further delineation of responses was therefore
required to distinguish between the main issues
raised. Responses were grouped under the
following three categories:
• cultural protocol
• cultural frameworks
• organisational culture.
Participants of the hui almost unanimously
responded to this question about Mäori specific
needs by identifying the implementation of
New Zealand Autism Spectrum Disorder Guideline 205