PONE-D-22-26125Service access experiences of immigrant and refugee caregivers of autistic children in Canada: A scoping reviewPLOS ONE

Dear Dr. Casale,

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Adetayo Olorunlana, Ph.D.

Academic Editor

PLOS ONE

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2. We noticed that the database search of your scoping review was performed in early 2021. Please ensure that your search is up to date and any relevant studies published since early 2021 are included in your review.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This review collects findings from a curated collection of papers investigating the experience of newcomers to Canada pertaining to ASD-specific services, interventions, and related personal experience. The review details selection criteria for the inclusion and exclusion of papers, provides description of features of those included, and distills a set of themes cutting across the papers.

This review’s selection criteria are clear and easy to follow, and overall the manuscript is clear and readable. While the scope is limited to Canada, most of the considerations will be thought-provoking to audiences in other countries. Given the attention to issues of representation in research and clinical service, the demonstrative value of this review has value beyond its specific scope.

I would generally recommend this review for publication, though I include a few minor suggestions for possible improvement:

1. An inherent feature of scientific literature is the influence of prior publications onto others. When identifying general themes, as this review does, the lack of independence of the underlying papers can cause certain themes to rise up due upstream ideas percolating down into later work.

With this in mind, I would recommend the authors consider inspect the papers in some sort of chronological graph indicating linkages and themes (essentially a labeled flow-chart). This need not be a supplemental figure, but could be if it is productively illustrative.

With these connections in hand, I would hope the authors could review their themes and perhaps observe whether some that have appeared in multiple papers did so independently - a mark of general importance above and beyond a mere “sticky” idea from an early paper, or if a less widely-cited theme has only recently cropped up (a possible mark of emerging importance). This seems like a useful means of triaging the themes in the review above and beyond a mere citation count.

2. The review summarizes demographic information from the cited papers (e.g. Figure 2), but could, in theory relate this information to broad immigrant / refugee demographics across Canada from other sources across the highlighted time frame. Given that the emerging consensus is that ASD prevalence (if not diagnosis) is uniform across ethnicities / countries of origin, a comparison of the published studies to broader demographics might highlight gaps in the space of the literature reviewed here.

For a while in the United States there existed a lower rate of ASD in the latinx population, generally thought to be driven by a reduced rate of recognition/diagnosis. Without this first step of identification, these populations would be underrepresented in a review such as this.

A comparison of general population demographics to those of the cited papers might cast light upon those populations currently overlooked in the literature.

3. I was left wondering about the demographic statistics of refugee families. My unfortunate suspicion is that a significant percentage of refugee families entering Canada are incomplete (e.g. missing a father). This seems like a potential for interaction with the larger theme of paternal involvement in caregiving with refugee status. This might be an informative point for discussion toward the particularities of the refugee experience and useful for future investigators.

I don't consider the above suggestions mandatory for acceptance, but if they are fruitful without sacrificing the overall clarity and readability, their inclusion might be of value.

Reviewer #2: Thank you for the privilege of reviewing your scoping review on immigrant and refugee caregivers of autistic children in Canada. I have some concerns about the search reporting. Please follow PRISMA for searching http://www.prisma-statement.org/Extensions/Searching.

1) please include the vendor name for all databases.

2) in the appendix please include the search strategies for all databases, copied and pasted exactly as run.

3) please use the most recent PRISMA flow diagram (2020). In the first box, please provide a breakdown of number of results per database.

4) as there were so few results, I would suggest that in your search, the phenomenon concept was unnecessarily focused and might result in missing relevant citations. I would omit that section of the search and screen for those concepts manually. A search for a scoping review should be broad to capture all available research.

5) For population concepts 1 and 2 you have done a good job of using both subject headings and keywords. However, you did not do this in the other sections of your search. For population concepts 3a and b, please supplement the keywords with the appropriate subject headings. For example, exp Indians, North American/

Inuit/ exp "Emigrants and Immigrants"/ Refugees/ "Transients and Migrants"/ . Similarly for population concept 4, there is a subject heading for Canada: exp Canada/

6) For the dates searched, please provide day and month of searches, as database results vary sometimes daily. Searches should be less than a year old. Your searches are a couple of years old. Please update your searches.

7) For screening of titles/abstracts, how many screeners did you have? There should be two independent reviewers. Similarly for data extraction, this should be done by two independent extractors.

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Reviewer #1: No

Reviewer #2: Yes: Ani Orchanian-Cheff

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Service access experiences of immigrant and refugee caregivers of autistic children in Canada: A scoping review

PONE-D-22-26125R1

Dear Dr. Casale,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Adetayo Olorunlana, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: I Don't Know

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: Thank you for the revisions. I am satisfied with the changes. The searches were rerun according to my comments.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: Yes: Ani Orchanian-Cheff

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