Challenges to the Development of Culturally Sensitive ASD Interventions for Latino Families

Background:  

Latino families come later than White, non-Latino families to ASD diagnosis and treatment, and disproportionately utilize treatments that are not evidence-based (Mandell & Novak, 2005; Levy, et al., 2003). Disparities exist even after controlling for socio-economic status and availability of local diagnostic providers (Palmer, et al., 2010). This study addresses these differences by describing the characteristics of Latino children who received autism diagnostic services at a publicly funded screening clinic, where approximately 56% of clients identify as Latino. Interviews with parents identified beliefs about the definition and cause of autism that may inform treatment. 

Objectives:  

This study aimed to: (1) describe Latino children who participated in an autism diagnostic screening clinic; (2) examine parents’ beliefs about definition and cause of autism; (3) identify challenging daily activities where culturally sensitive interventions can be implemented. 

Methods:  

Participants were 67 Latino mothers (M age = 33; Education level = 86% less than BA; Main Language: English) and their children (M age = 5 years; 77% male; M IQ = 80) suspected of ASD. Assessors trained in the gold standard ADOS conducted assessments. A subset of 10 parent interviews were analyzed to examine how parents described their beliefs about the definition and cause of autism. Two researchers coded the interviews; mean kappa = .80.

Results:  

Almost half (46%) of the families were referred to our clinic by their school or service provider. Parent reports of child behavior and social skills showed: (a) 25% in the clinical range for behavior problems (CBCL; M = 88.57), (b) 14% exhibited ASD symptomology (SRS; M = 114.40), and (c) 28% exhibited below average social skills (SSIS; M = 43.57). Half of these children received ASD diagnosis (53%). In qualitative interviews, most parents were unclear about the definition of autism (e.g., “I’m not too sure,”) or were partially correct (e.g., “[it’s] a mental disorder where brains function differently.”). When asked about the cause of autism, some parents attributed the cause to vaccinations or genetics (e.g., “they say vaccinations, hereditary, who knows.”) Others attributed the disorder to their religion (e.g., “Christian…God has a reason he makes people the way he does,”). Most challenging for parents were key times during the child’s day that involved transitions (e.g., getting dressed in the morning, bedtime). These specific moments seem to be good places to implement interventions that accommodate the families’ cultural beliefs and routines (Skinner & Weisner, 2007).

Conclusions:  

On the positive side, these families were connected to the service system; they brought their children to the screening clinic; while age 5 is late for initial diagnosis, it is still below the mean age of diagnosis for Latino children. Parents reported behavior problems and social skills challenges consistent with ASD. However, parents’ ideas about the definition and cause of autism do not reflect current science. It is critical that more information be available and disseminated to this group. Understanding autism within a sample of Latino families allows researchers and service providers to adapt interventions to be culturally sensitive for these families.