Latino parents' perspectives on barriers to autism diagnosis.
OBJECTIVE
Latino children are diagnosed with autism spectrum disorders (ASDs) at older ages and at the point of more severe symptoms. We sought to qualitatively describe community, family, and health care system barriers to ASD diagnosis in Latino children.


METHODS
Five focus groups and 4 qualitative interviews were conducted with 33 parents of Latino children previously diagnosed with an ASD. Participants described Latino community perceptions of autism and barriers they experienced during the diagnostic process. Sessions were audiorecorded and transcribed. Transcripts were coded by 2 researchers, and data were analyzed using thematic analysis.


RESULTS
Parents reported low levels of ASD information and high levels of mental health and disability stigma in the Latino community. Parents had poor access to care as a result of poverty, limited English proficiency, and lack of empowerment to take advantage of services. Providers sometimes dismissed parents' concerns. The ASD diagnostic process itself was slow, inconvenient, confusing, and uncomfortable for the child. These factors led many parents to normalize their child's early behaviors, deny that a problem existed, and lose trust in the medical system.


CONCLUSIONS
Additional educational outreach to Latino families, destigmatization of ASD, streamlining the ASD diagnostic process, and providing additional support to Latino parents of at-risk children may decrease delays in ASD diagnosis among Latino children.
Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, Ore; Division of General Pediatrics, Oregon Health & Science University, Portland, Ore. Electronic address: zuckerma@ohsu.edu.
Katharine E
KE
Zuckerman
Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, Ore.
Brianna
B
Sinche
Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, Ore; Department of Sociology, Syracuse University, Syracuse, NY.
Angie
A
Mejia
Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, Ore; Department of Psychology, Pacific University, Hillsboro, Ore.
Martiza
M
Cobian
Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Ore.
Thomas
T
Becker
Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Ore; Department of Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, Ore; School of Social Work, Portland State University, Portland, Ore.
Christina
C
Nicolaidis
D000328:Adult; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis*; D002675:Child, Preschool; D057210:Delayed Diagnosis; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006630:Hispanic or Latino; D006801:Humans; D007182:Income; D008297:Male; D010290:Parents; D010817:Physician-Patient Relations; D036301:Qualitative Research; D057545:Social Stigma; D055815:Young Adult
Hispanic Americans; autism spectrum disorder; delayed diagnosis; health services accessibility; qualitative research