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Many pediatricians don't offer Spanish autism tests

By Andrew M. Seaman

NEW YORK (Reuters Health) - Only one in 10 pediatricians offers screening for general developmental and autism spectrum disorders in Spanish, according to a new study.

Researchers who surveyed 267 California pediatricians found only a handful offered Spanish developmental and autism spectrum disorder (ASD) screenings that are recommended by the American Academy of Pediatrics (AAP).

"It may be that the pediatricians don't think that the screening tools are reliable for children who speak Spanish," Dr. Katharine Zuckerman, the study's lead author from Oregon Health and Science University's Department of Pediatrics in Portland, told Reuters Health.

Although the reason is unknown, previous research has found Latino children with an ASD are typically diagnosed about two and a half years later than white children with autism, the researchers write in the journal Pediatrics.

"We know that early identification is good for kids and if we can identify them early, we can connect them with the appropriate resources and they do better," Zuckerman said.

Currently, an estimated one in every 88 children has an ASD. The AAP recommends all children be screened for developmental delays at 9, 18 and 24 or 30 months and for autism at 18 and 24 months.

For the new study, Zuckerman and her colleagues mailed surveys to 500 California pediatricians between August 2011 and March 2012.

Of the 267 responders, 81 percent said they offered some kind of developmental screening. Only 29 percent said they offered autism screening in Spanish and one in 10 offered both ASD and developmental screenings in Spanish.

What's more, most pediatricians - even those with a patient population that was over one-quarter Latino - said they had a difficult time recognizing ASD symptoms in Spanish-speaking children.

Respondents also raised concerns about access to specialists and communication and cultural barriers and felt Latino parents were less knowledgeable about autism than white parents.

Zuckerman said there's a need for better understanding of what different parents do know about ASDs.

She said some of the gaps in access, pediatrician concerns and other barriers may be partly responsible for Latino children being diagnosed with ASDs later than white children.

"Obviously we didn't follow kids to see. This is a survey of pediatricians' opinions. So we can't say these things lead to late diagnoses, but it (could) definitely be the case," Zuckerman said.

"What we can say is that pediatricians think these are problems," she added.

Zuckerman said there are some Spanish screening tools available to pediatricians for free, but the problem is more complicated than just giving doctors the tools.

"It's a whole office process," she said, adding that doctors need to figure out who is going to administer the screening, who is going to collect the results and what will happen when there are abnormal results.

"I think it's a basic health equality issue that we should be offering (Latino patients) the same care as everyone regardless of the languages they speak," she said.

SOURCE: http://bit.ly/1akQFK6 Pediatrics, online August 19, 2013.

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