Pediatrician Identification of Latino Children at Risk for Autism Spectrum Disorder

Zuckerman, Katharine E.; Mattox, Kimber; Donelan, Karen; Batbayar, Oyundari; Baghaee, Anita; Bethell, Christina

doi:10.1542/peds.2013-0383

Cited by 231Autism Spectrum Disorder ResearchChild and Adolescent HealthChild Nutrition and Feeding Issues

Pediatrician Identification of Latino Children at Risk for Autism Spectrum Disorder

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Zuckerman, Katharine E., Mattox, Kimber, Donelan, Karen, Batbayar, Oyundari, Baghaee, Anita, Bethell, Christina·2013·Pediatrics

DOI 10.1542/peds.2013-0383PMC PMC3876760

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Abstract

BACKGROUND AND OBJECTIVES: 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.

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Patients from minority groups in the United States are screened less often for autism.
“Additionally, patients from minority groups in the United States are screened less often (Carbone et al., 2020; Guthrie et al., 2019; Zuckerman et al., 2013)”
From Navigating the Challenges: A Commentary on Barriers to Autism Screening in Childcare Centers (2026) · cites this paper as Zuckerman et al., 2013
For the Hispanic population, studies have identified lack of awareness of ASD, stigma associated with disability, lack of access to health care services due to noncitizenship or low income, and language barriers as factors that might reduce identification of ASD among Hispanic children.
“For the Hispanic population, studies have identified lack of awareness of ASD, stigma associated with disability, lack of access to health care services due to noncitizenship or low income, and language barriers as factors that might reduce the identification of ASD among Hispanic children (31–35).”
From Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012 (2016) · cites this paper as [33]

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Authors: Zuckerman, K. E., Mattox, K., Donelan, K., Batbayar, O., Baghaee, A., & Bethell, C.
Affiliations: Oregon Health & Science University (US)
Massachusetts General Hospital (US)
Child and Adolescent Health Measurement Initiative, and
ORCID: Zuckerman, Katharine E.
Donelan, Karen
Bethell, Christina
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2013-09-01
Volume: 132
Issue: 3
Pages: 445-453
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2013-0383
PMC: PMC3876760
OpenAlex: W2155931520
Cited by: 231
References: 34
Citations by year: 2026: 10 · 2025: 9 · 2024: 15 · 2023: 12 · 2022: 34 · 2021: 13 · 2020: 17 · 2019: 32 · 2018: 18 · 2017: 27 · 2016: 21 · 2015: 12 · 2014: 10 · 2013: 1
FWCI: 8.04
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: PEDIATRICS (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Centers for Disease Control and Prevention
National Institute of Mental Health (K23MH095828)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords: autism spectrum disorder, Latino children, primary care pediatricians, developmental screening, autism screening, racial and ethnic disparities, early detection
MeSH terms: Attitude of Health Personnel, California, Child, Developmental Disabilities, Child Development Disorders, Pervasive, Communication Barriers, Culture, Health Services Accessibility, Health Surveys, Hispanic or Latino, Humans, Mass Screening, Pediatrics, Primary Health Care, Risk Factors, Multilingualism, Guideline Adherence, Early Diagnosis, White People, Healthcare Disparities, Health Literacy

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Pediatrician Identification of Latino Children at Risk for Autism Spectrum Disorder

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