Disparities in Diagnosis and Treatment of Autism in Latino and Non-Latino White Families

Pediatrics. 2017 May;139(5):e20163010. doi: 10.1542/peds.2016-3010.

Abstract

Objectives: To compare barriers to autism spectrum disorder (ASD) diagnosis and current ASD-related service use among non-Latino white (NLW) families and Latino families with English proficiency (L-EP) or limited English proficiency (L-LEP).

Methods: We conducted a mixed-mode survey of families of children with confirmed ASD seen at specialty clinics in 3 United States cities. Bivariate and multivariate analyses compared barriers to ASD diagnosis, current service use, and unmet therapy need among NLW, L-EP, and L-LEP families.

Results: Overall, barriers to ASD diagnosis were prevalent: families (n = 352) experienced a mean of 8 of 15 barriers to ASD diagnosis. The most prevalent barriers overall were "stress of diagnostic process," "parent knowledge about ASD," and "understanding medical system." Compared with NLW families, L-LEP families were more likely to experience barriers related to knowledge about ASD and trust in providers. Children in L-LEP families also had fewer current therapy hours and more unmet therapy needs than children in NLW families. L-EP families' barriers and treatment services use profile was more similar to NLW than to L-LEP families.

Conclusions: English proficiency was an important marker for barriers to ASD diagnosis and treatment in Latinos. Increasing ASD-related knowledge and provider trust may decrease disparities in the diagnosis and treatment of ASD among US Latinos.

MeSH terms

  • Autism Spectrum Disorder / diagnosis*
  • Child
  • Child, Preschool
  • Communication Barriers*
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Health Surveys
  • Healthcare Disparities / statistics & numerical data*
  • Hispanic or Latino
  • Humans
  • Language
  • Male
  • United States