Zuckerman Katharine E, Lindly Olivia J, Reyes Nuri M, Chavez Alison E, Macias Kristy, Smith Kathryn N, Reynolds Ann
Division of General Pediatrics, Oregon Health and Science University, Doernbecher Children's Hospital, Portland, Oregon;
Oregon Health and Science University-Portland State University School of Public Health, Portland, Oregon.
Pediatrics. 2017 May;139(5). doi: 10.1542/peds.2016-3010.
To compare barriers to autism spectrum disorder (ASD) diagnosis and current ASD-related service use among non-Latino white (NLW) families and Latino families with English proficiency (L-EP) or limited English proficiency (L-LEP).
We conducted a mixed-mode survey of families of children with confirmed ASD seen at specialty clinics in 3 United States cities. Bivariate and multivariate analyses compared barriers to ASD diagnosis, current service use, and unmet therapy need among NLW, L-EP, and L-LEP families.
Overall, barriers to ASD diagnosis were prevalent: families ( = 352) experienced a mean of 8 of 15 barriers to ASD diagnosis. The most prevalent barriers overall were "stress of diagnostic process," "parent knowledge about ASD," and "understanding medical system." Compared with NLW families, L-LEP families were more likely to experience barriers related to knowledge about ASD and trust in providers. Children in L-LEP families also had fewer current therapy hours and more unmet therapy needs than children in NLW families. L-EP families' barriers and treatment services use profile was more similar to NLW than to L-LEP families.
English proficiency was an important marker for barriers to ASD diagnosis and treatment in Latinos. Increasing ASD-related knowledge and provider trust may decrease disparities in the diagnosis and treatment of ASD among US Latinos.
比较非拉丁裔白人（NLW）家庭以及英语熟练（L-EP）或英语水平有限（L-LEP）的拉丁裔家庭在自闭症谱系障碍（ASD）诊断方面的障碍以及当前与ASD相关的服务使用情况。
我们对在美国3个城市的专科诊所确诊患有ASD的儿童家庭进行了混合模式调查。双变量和多变量分析比较了NLW、L-EP和L-LEP家庭在ASD诊断障碍、当前服务使用情况以及未满足的治疗需求方面的差异。
总体而言，ASD诊断障碍普遍存在：352个家庭平均经历了15项ASD诊断障碍中的8项。总体上最普遍的障碍是“诊断过程的压力”“家长对ASD的了解”以及“对医疗系统的理解”。与NLW家庭相比，L-LEP家庭更有可能经历与ASD知识和对医疗服务提供者的信任相关的障碍。L-LEP家庭中的儿童目前接受治疗的时长也比NLW家庭中的儿童少，未满足的治疗需求更多。L-EP家庭的障碍和治疗服务使用情况与NLW家庭更为相似，而与L-LEP家庭不同。
英语水平是拉丁裔在ASD诊断和治疗方面障碍的一个重要指标。增加与ASD相关的知识和对医疗服务提供者的信任可能会减少美国拉丁裔在ASD诊断和治疗方面的差异。
