1. Late Autism Diagnosis Among Latin@ Children
Clarisa Carina Romero
Collaborative Health & Human Services
Advocacy Report
CHHS 302

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Table of Contents
Table
of
Contents ..................................................................................................................................2
Executive
Summary..................................................................................................................................3
Introduction............................................................................................................................................4
Background ....................................................................................................................................................... 4
Causes .......................................................................................................................................................6
Effects........................................................................................................................................................8
Solutions ..................................................................................................................................................9
Conclusion
and
Recommendation................................................................................................ 10
Reference.............................................................................................................................................. 11

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Executive
Summary
Autism is one disorder from Autism Spectrum Disorder (ASD). It affects the development of the
brain, which helps the ability for the person to socialize, communicate, and

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Introduction
It has been researched that Latin@ children are getting diagnosed with autism two years later
than non-Hispanics would. “Most of the pediatricians reported that they had particular difficulty
identifying autism risk in families who spoke primarily Spanish diagnosis” (Autism Speaks
Listen Know, 2013). Many Latino families do not know what autism is, let alone the symptoms.
If the pediatrician is not able to identify the risk of autism, the family will not be able to identify
them either. Not being able to figure out the risks or symptoms in children is the start of
misdiagnosis or late diagnosis of autism.
Doctors find it more difficult to diagnose Latin@ children because of different barriers. The rate
of Hispanics with autism is one of the lowest and it is all because of how difficult it is to
communicate with the parents and the children (Magaña, Lopez, Aguinaga, & Morton, 2013).
The graph below, the first section shows the total population. Then it splits off by race and by
year, both in numbers and in percentage. The second part shows the Autistic population and is
separated the same way. It shows that in 2006, out of 504 children with autism only 138 of them
are Hispanics.
(Cunniff, Gotschall, Grebe, Kessler, Mancilla, Meaney, Pedersen, Pettygrove; 2012)
Background
Autism is one disorder from Autism
Spectrum
Disorder
(ASD)
(CDC,
2010).
“Autism is one of
a group of serious developmental problems called autism spectrum disorders that appear in early
childhood — usually before age 3. Though symptoms and severity vary, all autism spectrum

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disorders affect a child's ability to communicate and interact with others” (Mayo Clinic, 2013).
Autism affects the development of the brain which helps the ability for the to socialize,
communicating and with their cognitive thinking function (National Autism Association, 2013).
Those with autism have a hard time socializing with others as well as communicating verbally
and non verbally. So they have a tendency to just be on their own. It is often found that those
who suffer from autism also suffer from other medical conditions such as allergies, digestive
disorders, sleeping disorders, feeding disorders, and more (NAA, 2013).
Autism is found more in boys then in girls. Also autism does not affect the life expectancy.
Children may pass earlier because of drowning or small incidents such as that (NAA, 2013).
Detecting autism is very hard since there are no tests that can be done to make sure that a child is
autistic. Pediatricians can detect autism at the 18 months of age or early (CDC, 2010). Late
diagnosis can affect the progress he/she can make by not getting the treatment needed (CDC,
2010).
There are two steps in diagnosing autism. The first step is to be screened for developmental
delays and disabilities during every regular doctor visit starting from 9 months and follow up
after every 9 months and stop once the child has reached 25 or 30 months. Extra screenings may
be needed if the child was born prematurely, underweight or other problems (CDC, 2010). Then
there is to be another screen specifically for ASDs during the age of 18 months and 24 months.
More screenings may be done if the child is at high risk and has a sibling or family member with
autism (CDC, 2010). The second step is for the child to go through a comprehensive diagnostic
evaluation where the child’s vision, hearing, and behavior are evaluated. Also genetic testing,
neurological testing, and other medical testing are done. In some cases the child may be referred
to a specialist (CDC, 2010).
There is no cure for autism but there are treatments that the child can undergo to improve social
skills, communication skills, and good behavioral skill. Early intervention is key for the child
(Wasmer, 2011).

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Causes
“Primary Care Pediatricians (PCPs) experienced difficulty recognizing signs and symptoms of
ASDs in Latino/Spanish PFL children, even if they performed recommended ASD screening or
had >25% Latinos in their practice due to language barriers” (Baghaee, Batbayar, Bethell,
Donelan, Mattox, Zuckerman; 2013). Language barrier is one of the causes that many Latin@
children are being diagnosed late with autism (Autism Speaks Listen Know, 2013). About 3 in 4
patients are Spanish speakers that have doctors that only speak English. Many children have
Spanish as their first language and do not learn English once they have entered Pre School or
Kindergarten. So the English language is so foreign to them and do not understand at all.
Doctors are not able to communicate with the patients and families, therefore making it hard or
even impossible to diagnose a child with autism (Autism Speaks Listen Know, 2013).
Researchers have shown that even though the screening tests had been run the same as nonHispanic children to Latin@ children, it was still difficult to detect if the child had autism
because of the language barrier (Baghaee, Batbayar, Bethell, Donelan, Mattox, Zuckerman;
2013).
Pediatricians also had a harder time diagnosing Latin@ children because parents did not have
much knowledge about autism (Baghaee, Batbayar, Bethell, Donelan, Mattox, Zuckerman;
2013). The lack of awareness is also a key as to why there are kids not being diagnosed with
autism until the age of 4 or 5. Most of the Latin@ community are unaware of what autism is and
the seriousness of what it can do to the child. Most of the flyers or pamphlets about autism are in
English so the Spanish speakers do not even bother trying to read because it is in a language that
they cannot understand (Autism Speaks Listen Know, 2013). Also Pediatricians realized that
there is a lack of development and autism specialists that can help spread the awareness. Only 1
in 10 California pediatricians’ screenings were found in Spanish (Baghaee, Batbayar, Bethell,
Donelan, Mattox, Zuckerman; 2013).
In the Latin@ culture it is believed that the symptoms of autism will just pass and that it is just a
phase. So there is no need to go to the doctor to see if there is anything wrong with the child.
“The child will grow out of the awkward stage. Every child goes through it” is what the Latin@
culture believes in. According to studies, it shows that Latin@ families had cultural barriers,
such as trust or pride, that were hard to detect even for the pediatrician to help out the Latin@
families with their disparities because they did not speak up and show that they had barriers and
did not understand (Baghaee, Batbayar, Bethell, Donelan, Mattox, Zuckerman; 2013).

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Here, above, is a graph that show statistics of all the barriers that prevent early autism diagnosis
among Latin@ children.

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Effects
Because the family has not enough knowledge about autism there is a lack of proper care. The
child will not be getting the proper attention that he/she needs to grow. According to the CDC,
when a child is diagnosed with autism he or she will be provided with services to help the child
learn how to grow and improve social skills and other skills to get on with life (CDC, 2013).
Children need to be able to grow and have friends so that they can have a childhood that is
healthy for them to prosper in the future. If the child is going on in life as if it is a child that is
not autistic, the he or she will have a hard time living. Family or friends may neglect him or her
because he or she may be “weird” and not someone that maybe wanted around. According to
research a child with autism also suffers from other medical conditions (NAA, 2013). If the
autism is not being treated then the other medical conditions are not being treated as well. This
could affect the health and well being of the autistic Latin@ child.
Another effect when children are diagnosed late is that there are no social skills or develop late
social skills. By the time the child gets diagnosed with autism, he/she will already be at least 3-4
and will not have any social skills to make friends a school or to interact with any family
members including children. (Autism Speaks, 2013). A child has time to improve all the social,
communication, and listening skills if treated early. As the child gets older it will just be tougher
for the family and the child because the older the child is the harder it will be to make progress.

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Solutions
There
is
time
to
fix
the
problem
of
Latin@
child
being
diagnosed
with
autism
late.
Researchers
are
doing
their
best
to
make
resources
accessible
to
Spanish
speakers
so
that
Latin@
children
can
have
early
diagnosis
(Autism
Speaks
Listen
Know,
2013).
There
is
a
program
that
is
called
Autism
speaks
early
access
to
Care
to
translate
all
resources
into
Spanish
so
that
the
Latin@
population
can
be
involved
in
the
Autism
Speaks
campaign.
This
can
help
the
screenings
as
well.
It
is
a
perfect
way
to
reach
out
to
the
minorities.
There needs to be more awareness in the hospitals and clinics by mentioning autism and
symptoms by Spanish-speaking pediatricians so parents can get familiar with autism and the
symptoms. “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.” (Baghaee, Batbayar, Bethell, Donelan, Mattox, Zuckerman;
2013). Having Spanish-speaking pediatricians see the patients that only speak Spanish so that the
language barrier between pediatricians and patients and their families can be cleared. Language
should not be an excuse for Latin@ children to have late diagnosis.
Not just telling them about the screenings but also telling them what autism is. Explain the
definition of autism, how a child can get autism, the symptoms, and treatments that a child can
undergo if diagnosed. Latin@ families have no knowledge what autism is, let alone that it even
exist (Baghaee, Batbayar, Bethell, Donelan, Mattox, Zuckerman; 2013). What clinics need to do
is explain different disorders that a child is at risk at, or the fastest growing disorder so that the
family can get familiarized and be on the look for. That way when the child is born and has its
regular visits, autism can be easier to detect and screenings can be done to figure out if the child
is autistic or not.

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Conclusion and Recommendation
The numbers of children with autism is rising more now than before but the numbers of Latin@
children who have autism is still low (Baghaee, Batbayar, Bethell, Donelan, Mattox, Zuckerman;
2013). The numbers are low because of different barriers such as language and knowledge about
autism. When children get diagnosed after the age of three, it is considered late diagnosis (NAA,
2013). Late diagnosis of autism can affect the health of a child and their development such as
living skills that a child learns around the age of 3 will not be developed yet until proper care is
given. Many services provided are often in English where it is difficult for Latin@ families to
understand. The late diagnosis of autism among Latin@ children needs to stop and something
needs to happen.
There are many things that can be done to prevent late diagnosis in the Latin@ community. If
knowledge about autism is advocated to the Latin@ families, it could be the first step to stop the
late diagnosis. After more Spanish speaking pediatricians can be located in the Latin@
communities to help with doctor visits and someone who better understands the culture to
improve services such as screenings and provided references for the families to seek the
treatment and care that is needed (Baghaee, Batbayar, Bethell, Donelan, Mattox, Zuckerman;
2013).
Recommendations:
• More
Spanish-­‐speaking
pediatricians
• Resources
provided
in
Spanish
for
families
• Spread
awareness
of
what
autism
is
in
the
Latin@
communities,
especially
in
clinics
and
hospitals.

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Reference
Wasmer,
M.
(2011).
What
is
Autism?.
Training,
121(450),
7576.
Retrieved
from:
http://www.autismdeservesinsurance.com/uploads/1/7/3/5/17359259/overv
iew_of_autism_and_intensive_early_intervention.pdf
Autism
Speaks
Listen
Know:
Facts
About
Autism.
(2013).
Retrieved
from:
http://www.autismspeaks.org/what-­‐autism/facts-­‐about-­‐autism
Autism
Speaks
Listen
Know:
Study
Assesses
Pediatricians’
Role
in
Delayed
Autism
Diagnosis
among
Latinos.
(2013).
Retrieved
from:
http://www.autismspeaks.org/science/science-­‐news/study-­‐assesses-­‐
pediatricians%E2%80%99-­‐role-­‐delayed-­‐autism-­‐diagnosis-­‐among-­‐latinos
Baghaee, A; Batbayar, O; Bethell, C; Donelan, K; Mattox, K; Zuckerman, K. (2013). Pediatrician
Identification of Latino Children at Risk for Autism Spectrum Disorder. Pediatrics 2013; 132:3
445-453; published ahead of print August 19, 2013, doi: 10.1542/peds.2013-0383. Retrieved
from: http://pediatrics.aappublications.org/content/132/3/445
Centers for Disease Control And Prevention (CDC): Autism Spectrum Disorders (ASDs). (2013).
Retrieved from: http://www.cdc.gov/ncbddd/autism/data.html
Magaña, S., Lopez, K., Aguinaga, A., & Morton, H. (2013). Access to Diagnosis and Treatment
Services Among Latino Children With Autism Spectrum Disorders. Intellectual &
Developmental Disabilities, 51(3), 141-153. Doi: 10.1352/1934-9556-51.3.141.
Retrieved from:
http://web.ebscohost.com.library2.csumb.edu:2048/ehost/detail?vid=3&sid=a3b874426c6c-4ac6-bd61478ce8d05361%40sessionmgr12&hid=18&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3
d#db=aph&AN=89366567
MayoClnic: Autism. (2013). Retrieved from:
http://www.mayoclinic.com/health/autism/DS00348.
National Autism Association. (2013). Retrieved from:
http://nationalautismassociation.org/resources/autism-fact-sheet/
Pedersen, A; Pettygrove, S; Meaney, J; Mancilla, K; Gotschall, K; Kessler; D.B; Grebe, T.A and
Cunniff; C. (2012). PEDIATRICS official journal of the American Academy of
Pediatrics: Prevalence of Autism Spectrum Disorders in Hispanic and Non-Hispanic
White Children. DOI: 10.1542/peds.2011-1145. Retrieved from:
http://pediatrics.aappublications.org/content/early/2012/02/15/peds.2011-1145.full.pdf
(Cunniff, Gotschall, Grebe, Kessler, Mancilla, Meaney, Pedersen, Pettygrove; 2012)