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Katharine Zuckerman, MD, MPH, on delayed diagnosis of autism in Latino children

Katharine Zuckerman, MD, MPH, on delayed diagnosis of autism in Latino children

Bundoo Expert

Katharine Zuckerman, MD, MPH
Assistant Professor of Pediatrics, Doernbecher Children’s Hospital, Oregon Health & Science University

This fall, Dr. Zuckerman was the lead investigator of a study that made waves across the country. According to her research, Latino children are diagnosed with autism significantly later than their white peers. The result is a delay in critical services.

The study painted a surprising and alarming picture of autism screening in Latino children:

  • Barely 10 percent of pediatricians surveyed conducted the recommended screening tests in Spanish.
  • Most pediatricians in the study said it was more difficult to diagnose autism in Latino children for a variety of reasons, including cultural barriers, language barriers, and a lack of access to specialists.
  • Doctors in the survey reported that the parents of Latino children were generally less knowledgeable about autism and health issues than white parents.

The study appeared in the September 2013 issue of Pediatrics. Here, Dr. Zuckerman discusses her group’s findings.

It’s fair to say your study was big news—it was covered throughout the national media. Were you surprised by the reaction to it?

I really was. You never know what people will respond to. I think the research community is just beginning to focus on disparities in autism diagnosis and treatment, and the public is coming along. I think it’s a really important issue.

You went into the study assuming that language would be the main barrier, but that really wasn’t what you found, was it?

It’s more complicated than that. Pediatricians in general found it more difficult to identify autism spectrum disorders in Spanish-speaking children. But it wasn’t because of language alone. The vast majority of pediatricians had access to Spanish speakers. Autism is hard enough to identify in a primary care setting. Early signs of autism are variants of normal. When you throw in another language and another culture, it’s even harder.

One of the big surprises was the low rate of screening, in English and Spanish.

Yeah, we found out that pediatricians weren’t doing the screening, which is a problem. Screening can happen in a number of settings, including the pediatrician’s office, but it can also happen through early intervention services in your state, an educational facility like Head Start, whatever. In many states, autism screening is publicly available, so there’s no economic barrier to it. Every parent has access to early screening. But a lot of Latino kids aren’t getting screened.

What do you think are the ramifications of this?

It’s a problem. We know that if we diagnose a kid earlier, they’ll have better outcomes. And Latino kids are a growing population. In California, they are the majority. If a lot of kids are getting diagnosed later, they aren’t getting as much therapy. The lifetime cost of caring for a person with autism is over $1 million, and that’s a cost we all have to bear.

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  1. I was not aware there was a difference in diagnosis timeframes… interesting article.