Latino kids and autism: diagnosed later and less often

Latino children are less likely to be diagnosed with autism than white children—and when they are diagnosed, they are significantly older, according to a study in the September 2013 issue of Pediatrics.

Lead study author Katharine Zuckerman, MD, and colleagues looked at the screening and referral patterns of pediatric offices throughout California. More than half of children in the state are identified as Latino. During the study, researchers found widespread issues with screening that results in fewer Latino children being referred for autism diagnosis.

The biggest problem was the lack of routine screenings at pediatrician offices. Overall, researchers found that only 15.2 percent of pediatrician offices in the targeted study area followed the American Academy of Pediatrics recommended screening guidelines for both general development and autism spectrum disorders (ASD). The rates were even lower for Spanish-speaking screenings: only 10.3 percent of offices screened their children.

Pediatricians viewed Latino parents as less knowledgeable about autism and health issues in general.

“Most providers do not offer guideline-based developmental and autism spectrum disorder screening,” the study found. “Rates were particularly low for Spanish-language screening, which disproportionately affects ASD identification in Latinos.”

But low screening rates and a language barrier didn’t entirely explain the problem, according to study authors. Researchers found that pediatricians viewed Latino parents as less knowledgeable about autism and health issues in general.

Finally, even after a positive screen for autism, researchers identified barriers to a successful diagnosis. Although autism screening is done in the pediatrician’s office, the actual diagnosis is typically performed by a specialist or team of specialists.  Researchers found there weren’t enough developmental specialists to complete the evaluation, especially specialists who spoke Spanish.

Taken together, the study painted a troubling picture of autism screening and diagnosis in the growing population of Latino children. According to the Centers for Disease Control and Prevention, 1 in 88 children in the United States has autism, and research has consistently shown that diagnosing and treating autistic kids earlier has a profound benefits.

“These findings have important policy implications,” the study authors wrote. “First, rates of Spanish-language developmental and ASD screenings need targeted improvement… Primary care physicians may also need information about bilingualism and language development, accurate interpretation of screening results in less-acculturated Latinos, or strategies for discussing this difficult topic with parents from a different culture.”

Reviewed by Dr. Sara Connolly, February 2019