Racial, Ethnic, and Language Disparities in Early Childhood Developmental/Behavioral Evaluations

Zuckerman, Katharine E.; Mattox, Kimber M.; Sinche, Brianna K.; Blaschke, Gregory S.; Bethell, Christina

doi:10.1177/0009922813501378

Cited by 76 publications

(65 citation statements)

References 94 publications

(132 reference statements)

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“…As such, this analysis underscores ongoing calls for reduction in disparities for ASD health care access and quality. 16 As has been found in prior reports 24 ASD health care disparities are widespread and present on a national level. While parent factors may play a role, truly reducing such disparities may require more comprehensive system-level interventions.…”

Section: Discussionmentioning

confidence: 63%

“…Some investigators have hypothesized that differences in ASD health services use may be due to racial/ethnic and socio-economic variation in parent beliefs. 15,16 For instance, if poor or minority parents view ASDs as temporary conditions, they might be less likely to engage in long-term therapy that does not show immediate improvement in child behavior. Likewise, if poor or minority parents believe it is not possible to change a child’s ASD symptoms, they may be less likely to engage mental health professionals in therapy or pharmacological treatments.…”

Section: Introductionmentioning

confidence: 99%

“…Likewise, given that health services utilization is similarly quite variable, understanding which parent beliefs lead to utilization of which services may be important in developing strategies to reducing undesirable ASD health care disparities. 16 Even if the optimum set of beliefs or services use is unclear, if parents’ beliefs prove to be important, interventions might be developed to accommodate these beliefs into existing treatment paradigms or adjust current treatments to better suit family preferences. On the other hand, if parent beliefs play only a minor role in ASD health care disparities, interventions to reduce ASD health care disparities might better focus on provider or health care system factors.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Parent Health Beliefs, Social Determinants of Health, and Child Health Services Utilization Among US School-age Children With Autism

Zuckerman

Lindly

Sinche

et al. 2015

Journal of Developmental &Amp; Behavioral Pediatrics

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Objective Substantial variation exists in ASD care by race, ethnicity, and socioeconomic status; however, the role of parent health beliefs in this variation is poorly understood. Study goals were to (1) examine variation in parent beliefs about ASD prognosis and treatment according to social determinants of health (SDH) and (2) assess whether this variation was associated with variable health services utilization, among 1420 children with special health care needs (CSHCN) having autism spectrum disorder (ASD). Methods We used linked data from the 2011 Survey of Pathways to Diagnosis and Treatment and the 2009/10 National Survey of Children with Special Health Care Needs. Bivariate and multivariate analyses assessed variation in parent beliefs according to race/ethnicity, household income, and parent educational attainment. Further analyses assessed whether variation in beliefs was associated with use of psychotropic medication, traditional therapy, or complementary/alternative therapy for ASD. Results Parents of lower educational attainment or who had lower income were more likely to think that their child’s condition was a mystery. Near-poor families were less likely to feel they had the power to change the child’s condition. Parents of minority children were more likely than white children to view their child’s condition as temporary. However, these differences in beliefs only had modest associations with variation in use of the health services analyzed. Conclusions Some SDH-related variation exists in health beliefs among parents of children with ASD, but these differences may not be the main factors accounting for ASD health care disparities.

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Section: Discussionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Parent Health Beliefs, Social Determinants of Health, and Child Health Services Utilization Among US School-age Children With Autism

Zuckerman

Lindly

Sinche

et al. 2015

Journal of Developmental &Amp; Behavioral Pediatrics

Self Cite

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“…Socio-cultural issues and low literacy may contribute to caregivers not understanding the implications of diagnostic evaluation findings, not perceiving the importance of early childhood services or inability to access recommended therapies. In the United States, Latino and Black children are diagnosed at older ages with more severe symptoms, are more likely to be misdiagnosed with a mental health disorder, and are underrepresented in treatment [46]. Recent research studies have demonstrated the effectiveness of structured educational and behavioral interventions, such as those informed by the learning principles of Applied Behavior Analysis [47].…”

Section: Family Support and Access To Servicesmentioning

confidence: 99%

Early Identification of Young Children with Autism Spectrum Disorder

Nickel

Huang-Storms

2015

Indian J Pediatr

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Early identification and treatment of children with autism and other developmental disorders is an international priority. Currently there is great interest in lowering the age of identification. Attention has been focused on public awareness campaigns and the regular use of developmental screening tests by health care providers, health workers and others. In this article the authors discuss the rationale for the use of autism specific screening tests, review the characteristics of selected tools, and make recommendations for the diagnostic evaluation of young children for autism spectrum disorder in an international context.

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“…Racial/ethnic and socio-economic disparities in screening, identification, and diagnosis of developmental delay are well documented (Zuckerman et al 2014). Further, significant disparities have also been identified for children whose family income is below the federal poverty level (FPL;McManus et al 2009;Roux et al 2012), which is particularly concerning given that research suggests that the prevalence rate of parent-reported developmental delays is higher among individuals whose family income is below the FPL (Boyle et al 2011).…”

Section: Disparities In Screening Identification and Diagnosismentioning

confidence: 99%

Addressing Disparities in Parent Education: Examining the Effects of Learn the Signs/Act Early Parent Education Materials on Parent Outcomes

Graybill

Self-Brown

Lai

et al. 2014

Early Childhood Educ J

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Early intervention is critical for improved prognosis and quality of life for young children with developmental delays and disabilities. Yet, disparities persist among underserved families with young children. These disparities include knowledge of child development, use of medical providers as referral sources, and later diagnosis. The current study employed a mixed method, randomized controlled trial to examine participant outcomes among low-income, underserved families who received child development information. The information included the 42-page Milestone Moments booklet that was developed by the Centers for Disease Control and Prevention's Learn the Signs/Act Early initiative. Participants (n = 108) included parents or legal guardians of children ages birth through 5 years. The participants were predominantly Black/African American (86 %) and female (90 %), and all had incomes below the federal poverty level. Study variables related to the location (home vs. child care center) and context (single session vs. extended visits) for delivering the information did not yield significant differences. Yet, there were clear findings that parents who received the booklet reported increased knowledge about child development, a decrease in concern about their own children's developmental progress, and a positive perception of the booklet. On interview, parents reported learning new information about child development or being reminded of developmental information they had forgotten and the importance of following up with professionals when concerns arose. While not statistically significant, there was a consistent trend toward greater participant outcomes for parents who received materials in the child care setting relative to the home.

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Racial, Ethnic, and Language Disparities in Early Childhood Developmental/Behavioral Evaluations

Cited by 76 publications

References 94 publications

Parent Health Beliefs, Social Determinants of Health, and Child Health Services Utilization Among US School-age Children With Autism

Parent Health Beliefs, Social Determinants of Health, and Child Health Services Utilization Among US School-age Children With Autism

Early Identification of Young Children with Autism Spectrum Disorder

Addressing Disparities in Parent Education: Examining the Effects of Learn the Signs/Act Early Parent Education Materials on Parent Outcomes

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