title: Pediatrician identification of Latino children at risk for autism spectrum disorder.
abstract: OBJECTIVE
  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.
authors: Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, OR, USA. zuckerma@ohsu.edu
authors: Katharine E
authors: KE
authors: Zuckerman
authors: Kimber
authors: K
authors: Mattox
authors: Karen
authors: K
authors: Donelan
authors: Oyundari
authors: O
authors: Batbayar
authors: Anita
authors: A
authors: Baghaee
authors: Christina
authors: C
authors: Bethell
mesh_terms: D001291:Attitude of Health Personnel; D002140:California; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D003144:Communication Barriers; D003469:Culture; D002658:Developmental Disabilities / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology; D042241:Early Diagnosis; D019983:Guideline Adherence; D057220:Health Literacy; D006297:Health Services Accessibility; D006306:Health Surveys; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008403:Mass Screening; D019303:Multilingualism; D010372:Pediatrics; D011320:Primary Health Care; D012307:Risk Factors; D044465:White People / Q000523:psychology*
keywords: Hispanic Americans; autism spectrum disorder; child development; developmental disabilities; developmental screening; health care disparities; pediatrics
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