Autism May Be Overlooked in Young Latino Children08/19/13
MONDAY, Aug. 19 (HealthDay News) -- Latino children typically
are diagnosed with autism more than two years later than white
children, and new research suggests that language-appropriate
screenings and access to autism specialists are two big factors in
"Parents need to know that early identification of autism is important," said study author Dr. Katharine Zuckerman, an assistant professor of pediatrics at Oregon Health and Science University in Portland. "It leads to better outcomes for the child and better family outcomes. It may even save money. All children should be screened."
Yet Zuckerman's study found that only one in 10 pediatricians
administered the general developmental screenings and
autism-specific screenings in Spanish for their Spanish-speaking
Dr. Andrew Adesman, chief of developmental and behavioral
pediatrics at the Steven & Alexandra Cohen Children's Medical
Center in New Hyde Park, N.Y., said there's a screening tool with
yes-or-no answers that a pediatrician can still score and assess
the risk of autism even if they don't speak Spanish.
But, Adesman said, language barriers can definitely pose
problems when trying to assess a child's risk for autism. "To the
extent that a language delay is the core symptom, it becomes more
difficult to assess the language if the clinician doesn't speak the
language," he said. "If the child is living in a bilingual
household, it can be difficult to assess differences in language
"The signs of language issues can be subtle, and they're hard to identify in the first place," Zuckerman said, which makes it even harder if the pediatrician and the child don't speak the same language.
Still, according to the more than 250 pediatricians surveyed for
the study, the biggest barrier to getting a firm autism diagnosis
is access to autism specialists.
Adesman agreed that this is a big problem, especially in certain
parts of the United States. He recommended, however, that any
parent with concerns about their child should request an evaluation
through their state's early intervention service, which typically
is offered through the department of health. He said these services
are free and offered whether or not a child has health insurance.
These screenings also are often available in a child's native
The pediatricians included in the survey were all from
California, and 60 percent were female. Slightly more than half
have been in practice for more than 20 years. About half said more
than 25 percent of their patients are Latino.
Seventy percent of the doctors said they didn't speak Spanish,
or spoke it poorly. Thirty percent said they spoke good or
Eighty-one percent offered some form of developmental screening,
but just 29 percent offered autism screening in Spanish, according
to the American Academy of Pediatrics guidelines. Only 10 percent
offered general developmental and autism screenings in Spanish.
Communication and cultural barriers also were cited as reasons
for the delay in diagnosis. The pediatricians said they felt that
Latino parents don't have as much knowledge about autism as white
"Latino parents may know less about autism, so they bring up fewer concerns," Zuckerman said. She said autism awareness needs to be raised in Latino communities.
"We need to try to increase the information availability. Parents need to know the early signs of autism," she said, noting that a language delay, a lack of eye contact, not pointing to show interest, not wanting to play interactive games such as peekaboo, and playing with toys in an unusual way, such as only spinning the tires of a toy car instead of pretending to make the car drive, are some possible signs of autism.
Pediatricians need to be encouraged to conduct both
developmental and autism screenings, and whenever possible these
screenings should be done in the child's primary language. "Early
identification of autism is super-important," Zuckerman said. "It's
a condition that we know will get better with early therapy. We
need to be assessing kids for this."
"Autism affects all genders and ethnicities," Adesman said. "Any family with a concern about their child should [have their child] screened by their pediatrician or through early-intervention services from their state."
Results of the study were released online Aug. 19 and in the
September print issue of the journal
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