Access to Diagnosis and Treatment Services Among Latino Children With Autism Spectrum Disorders

Magaña, Sandra; López, Kristina; Aguinaga, Arellys; Morton, Holly

doi:10.1352/1934-9556-51.3.141

Cited by 292 publications

(237 citation statements)

References 28 publications

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“…[79][80][81] However, there is evidence that application of standardized screening can help reduce such disparities and ensure timely diagnosis of children across a diversity of backgrounds. 82 Statement 7: Additional priorities for future research include studies that:…”

Section: Lack Of Office-based Systems For Making Referrals and Monitomentioning

confidence: 99%

Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research

et al. 2015

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This article reviews current evidence for autism spectrum disorder (ASD) screening based on peer-reviewed articles published to December 2013. Screening provides a standardized process to ensure that children are systematically monitored for early signs of ASD to promote earlier diagnosis. The current review indicates that screening in children aged 18 to 24 months can assist in early detection, consistent with current American Academy of Pediatrics' recommendations. We identify ASD-specific and broadband screening tools that have been ev-aluated in large community samples which show particular promise in terms of accurate classification and clinical utility. We also suggest strategies to help overcome challenges to implementing ASD screening in community practice, as well as priorities for future research. Pediatrics 2015;136:S41-S59

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Section: Lack Of Office-based Systems For Making Referrals and Monitomentioning

confidence: 99%

Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research

et al. 2015

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“…The most frequent barriers were "limited access to ASD or developmental specialists," "language differences between providers and patients/families," and "limited access to primary care" (Fig 1). Of PCPs experiencing $1 barrier, the median number experienced was 4 (interquartile range 3 27,28 and less access to ASD-specific information, 15 which could contribute to knowledge deficits about ASDs. Differences in PCP education and anticipatory 36 By choosing to use PFL instead of English proficiency, our study probably minimized differences between the Latino/Spanish group and other groups.…”

Section: Barriers To Asd Identificationmentioning

confidence: 99%

“…5,12,13 Latino families may also have poorer overall healthcare access 14 and less access to information about ASDs. 15 Quality of provider interaction may also mediate ASD identification: Studies show that families of Latino children with ASDs experience poorer health care quality 16 and lower-quality provider communication 17 than white families. However, no studies have assessed specific provider beliefs and behaviors related to ASDs in Latino children.…”

mentioning

confidence: 99%

Pediatrician Identification of Latino Children at Risk for Autism Spectrum Disorder

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Latino children are diagnosed with autism spectrum disorders (ASDs) less often and later than white children. Primary care pediatricians (PCPs) may play an important role in early ASD identification for Latinos. WHAT THIS STUDY ADDS:PCPs find it more difficult to assess for ASDs in Latinos with Spanish primary language, view Latino parents as less knowledgeable about ASDs, and experience frequent barriers to ASD diagnosis in Latino patients. Many PCPs do not offer recommended screenings in Spanish. abstract BACKGROUND AND OBJECTIVES: Latino-white disparities in age at autism spectrum disorder (ASD) diagnosis may be modified by primary care pediatrician (PCP) practices and beliefs. The objectives of this study were to assess ASD and developmental screening practices, attitudes toward ASD identification in Latino children, and barriers to ASD identification for Latino children, in a sample of 267 California PCPs. METHODS:In mail-based PCP survey, we assessed rates of bilingual general developmental and ASD screening, perceptions of parent ASD knowledge in Latino and white families, reports of difficulty assessing for ASDs in Latino and white children, and perceptions of barriers to early ASD identification for Latinos.RESULTS: Although 81% of PCPs offered some form of developmental screening, 29% of PCPs offered Spanish ASD screening per American Academy of Pediatrics guidelines, and only 10% offered both Spanish general developmental and Spanish ASD screening per American Academy of Pediatrics guidelines. Most PCPs thought that Latino (English and Spanish primary family language) parents were less knowledgeable about ASDs than white parents. PCPs had more difficulty assessing ASD risk for Latino children with Spanish primary family language than for white children, even when the PCP conducted recommended ASD screening or had .25% Latino patients. The most frequent barrier to ASD identification in Latinos was access to developmental specialists. CONCLUSIONS:Multiple factors in the primary care setting may contribute to delayed ASD identification for Latinos. Promoting languageappropriate screening, disseminating culturally appropriate ASD materials to Latino families, improving the specialist workforce, and providing PCP support in screening and referral of Latino children may be important ways to reduce racial and ethnic differences in care. Pediatrics 2013;132:445-453 AUTHORS:

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“…8,17,19 However, parents of typically-developing children may also offer important insights into family and community factors affecting ASD diagnostic delay. Usually, a parent is not aware that his/her child has ASD until the child is at least 2-3 years old.…”

Section: Introductionmentioning

confidence: 99%

Conceptualization of Autism in the Latino Community and its Relationship With Early Diagnosis

Zuckerman

Sinche

Cobian

et al. 2014

Journal of Developmental &Amp; Behavioral Pediatrics

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Objective Early identification of autism spectrum disorders (ASD) has been linked to improved long-term developmental outcomes. However, Latino children are diagnosed later than white non-Latino children. We aimed to qualitatively assess the understanding and conceptualization of ASD in the Latino community in order to understand potential community barriers to early diagnosis. Method We conducted 5 focus groups and 4 qualitative interviews with 30 parents of typically-developing Latino children in Oregon. Participants were asked structured questions concerning video vignettes that follow a Latina mother from the time she begins to worry about her 3-year-old son's behaviors to the time he receives an ASD diagnosis. Focus groups and interviews were audio-recorded, transcribed and independently coded. Coded data were analyzed using thematic analysis. Results Many Latino families in the study had not heard of ASD or had little information about it. Families sometimes assumed ASD red flags were normal or could be attributed to family dysfunction. Families also had concerns about provider communication and access to language services. Having a child with a developmental delay was associated with embarrassment, rejection, and family burden, making it difficult for parents to raise developmental concerns with providers. Conclusion Pediatric providers should not assume that Latino parents have heard of ASD or know its symptoms. Providers should be aware that parents may be reluctant to mention concerns due to cultural factors. The health care system needs to improve resources for Latino parents with limited English proficiency. Policies should encourage the use of developmental screening in primary care.

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Access to Diagnosis and Treatment Services Among Latino Children With Autism Spectrum Disorders

Cited by 292 publications

References 28 publications

Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research

Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research

Pediatrician Identification of Latino Children at Risk for Autism Spectrum Disorder

Conceptualization of Autism in the Latino Community and its Relationship With Early Diagnosis

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