Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Pediatrician identification of Latino children at risk for autism spectrum disorder

TitlePediatrician identification of Latino children at risk for autism spectrum disorder
Publication TypeJournal Article
Year of Publication2013
AuthorsZuckerman, KE, Mattox, K, Donelan, K, Batbayar, O, Baghaee, A, Bethell, C
Date PublishedSep
ISBN Number0031-4005
Accession Number23958770
Keywords*Pediatrics, Attitude of Health Personnel, California, Child, Child Development Disorders, Pervasive/*diagnosis/*ethnology/psychology, Communication Barriers, Culture, Developmental Disabilities/diagnosis/ethnology/psychology, early diagnosis, European Continental Ancestry Group/*psychology, Guideline Adherence, Health Literacy, Health Services Accessibility, Health Surveys, Healthcare Disparities, Hispanic Americans/*psychology, Humans, Mass Screening, Multilingualism, Primary Health Care, Risk Factors

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 language-appropriate 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.