Abstract
Recent statistics indicate children of Latino background are diagnosed with autism spectrum disorder (ASD) at a much later age than their non-Latino White counterparts. Once a diagnosis is made, it is critically important that families get access to evidence-based interventions, including applied behavior analysis (ABA) services. However, disadvantaging factors such as a lack of awareness of available services, poor health care access and health literacy, and language barriers may impact these families’ ability to access and maintain ABA services. The purpose of this pilot study was to obtain preliminary information on the experiences of accessing and maintaining ABA services for a sample of Latino American families living in Massachusetts. We conducted structured interviews with 28 families that had a child with ASD aged 8 years or younger. Questions in the interview were related to the background and diagnostic experiences of the child; difficulties in accessing ABA services; and for those children receiving ABA services, parents’ perceptions of the services. Results of the interviews are summarized, and implications for future research and service delivery are discussed.
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Notes
The authors appreciate the importance of the term “Latinx” as a nonbinary version of Latino/a. Spanish is a gendered language, and the term “Latinx” is not widely known or adopted in all of the communities it serves to represent. For this reason, we elected to use the term “Latino” throughout the article.
References
An Act Relative to Insurance Coverage for Autism. (2010). https://malegislature.gov/Laws/SessionLaws/Acts/2010/Chapter207.
Angell, A. M., Frank, G., & Solomon, O. (2016). Latino families’ experiences with autism services: Disparities, capabilities, and occupational justice. OTJR : Occupation, Participation and Health, 36(4), 195–203. https://doi.org/10.1177/1539449216666062.
Autism Omnibus Bill. (2014). https://malegislature.gov/Laws/SessionLaws/Acts/2014/Chapter226.
Behavior Analyst Certification Board. (2021). U.S. employment demand for behavior analysts: 2010–2020. https://www.bacb.com/wp-content/uploads/2021/01/BurningGlass2021_210126.pdf.
Bishop-Fitzpatrick, L., & Kind, A. (2017). A scoping review of health disparities in autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(11), 3380–3391. https://doi.org/10.1007/s10803-017-3251-9.
Broder-Fingert, S., Shui, A., Pulcini, C. D., Kurowski, D., & Perrin, J. M. (2013). Racial and ethnic differences in subspecialty service use by children with autism. Pediatrics, 132(1), 94–100. https://doi.org/10.1542/peds.2012-3886.
Conners, B., Johnson, A., Duarte, J., Murriky, R., & Marks, K. (2019). Future directions of training and fieldwork in diversity issues in applied behavior analysis. Behavior Analysis in Practice, 12(4), 767–777. https://doi.org/10.1007/s40617-019-00349-2.
Durkin, M. S., Maenner, M. J., Baio, J., Christensen, D., Daniels, J., Fitzgerald, R., Imm, P., Lee, L.-C., Schieve, L. A., Van Naarden Braun, K., Wingate, M. S., & Yeargin-Allsopp, M. (2017). Autism spectrum disorder among US children (2002–2010): Socioeconomic, racial, and ethnic disparities. American Journal of Public Health, 107(11), 1818–1826. https://doi.org/10.2105/AJPH.2017.304032.
Flores, G., & Tomany-Korman, S. C. (2008). Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children. Pediatrics, 121(2), e286–e298. https://doi.org/10.1542/peds.2007-1243.
Grindle, C., Kovshoff, H., Hastings, R., & Remington, B. (2009). Parents’ experiences of home based applied behavior analysis programs for young children with autism. Journal of Autism & Developmental Disorders, 39(1), 42–56. https://doi.org/10.1007/s10803-008-0597-z.
Harris, P. A., Taylor, R., Minor, B. L., Elliott, V., Fernandez, M., O’Neal, L., McLeod, L., Delacqua, G., Delacqua, F., Kirby, J., & Duda, S. N. (2019). The REDCap Consortium: Building an international community of software partners. Journal of Biomedical Informatics, 95, 103208. https://doi.org/10.1016/j.jbi.2019.103208.
Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381. https://doi.org/10.1016/j.jbi.2008.08.010.
Iland, E. D., Weiner, I., & Murawski, W. W. (2012). Obstacles faced by Latina mothers of children with autism. Californian Journal of Health Promotion, 10, 25–36. https://doi.org/10.32398/cjhp.v10iSI-Latino.1480.
Jang, M., & Vordertrasse, A. (2019). Socioeconomic status and racial or ethnic differences in participation: Web-based survey. JMIR Research Protocol, 8(4), e11865. https://doi.org/10.2196/11865.
Linstead, E., Dixon, D. R., Hong, E., Burns, C. O., French, R., Novack, M. N., & Granpeesheh, D. (2017). An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder. Translational Psychiatry, 7(9), e1234. https://doi.org/10.1038/tp.2017.207.
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. https://doi.org/10.1352/1934-9556-51.3.141.
Mandell, D. S., Wiggins, L. D., Carpenter, L. A., Daniels, J., DiGuiseppi, C., Durkin, M. S., Giarelli, E., Morrier, M. J., Nicholas, J. S., Pinto-Martin, J. A., Shattuck, P. T., Thomas, K. C., Yeargin-Allsopp, M., & Kirby, R. S. (2009). Racial/ethnic disparities in the identification of children with autism spectrum disorders. American Journal of Public Health, 99(3), 493–498. https://doi.org/10.2105/AJPH.2007.131243.
National Resource Center for Patient/Family-Centered Medical Home. (n.d.). What is a Medical Home?. Retrieved March 25, 2021, from https://medicalhomeinfo.aap.org/overview/Pages/Whatisthemedicalhome.aspx.
Parish, S., Magana, S., Rose, R., Timberlake, M., & Swaine, J. G. (2012). Health care of Latino children with autism and other developmental disabilities: Quality of provider interaction mediates utilization. American Journal on Intellectual and Developmental Disabilities, 117(4), 304–315. https://doi.org/10.1352/1944-7558-117.4.304.
Peters-Scheffer, N., Didden, R., Mulders, M., & Korzilius, H. (2010). Low intensity behavioral treatment supplementing preschool services for young children with autism spectrum disorders and severe to mild intellectual disability. Research in Developmental Disabilities, 31(6), 1678–1684. https://doi.org/10.1016/j.ridd.2010.04.008.
Pew Research Center. (n.d.). Demographic profile of Hispanics in Massachusetts, 2014. https://www.pewresearch.org/hispanic/states/state/ma.
Singh, G., Strickland, B., Ghandour, R., & van Dyck, P. (2009). Geographic disparities in access to the medical home among US CSHCN. Pediatrics, 124(Suppl. 4), S352–S360. https://doi.org/10.1542/peds.2009-1255E
Smith, K. A., Gehricke, J. G., Iadarola, S., Wolfe, A., & Kuhlthau, K. A. (2020). Disparities in service use among children with autism: A systematic review. Pediatrics, 145(Suppl. 1), S35–S46. https://doi.org/10.1542/peds.2019-1895G.
U.S. Census Bureau. (n.d.). Quick facts—Massachusetts. https://www.census.gov/quickfacts/MA on 10/15/2020
Valerio, M. A., Rodriguez, N., Winkler, P., Lopez, J., Dennison, M., Liang, Y., & Turner, B. J. (2016). Comparing two sampling methods to engage hard-to-reach communities in a research priority setting. BMC Medical Research Methodology, 16, 146. https://doi.org/10.1186/s12874-016-0242-z.
Wiggins, L. D., Durkin, M., Esler, A., Lee, L. C., Zahorodny, W., Rice, C., Yeargin-Allsopp, M., Dowling, N. F., Hall-Lande, J., Morrier, M. J., Christensen, D., Shenouda, J., & Baio, J. (2019). Disparities in documented diagnoses of autism spectrum disorder based on demographic, individual, and service factors. Autism Research, 13(3), 464–473. https://doi.org/10.1002/aur.2255.
Yin, H. S., Johnson, M., Mendelsohn, A. L., Abrams, M. A., Sanders, L. M., & Dreyer, B. P. (2009). The health literacy of parents in the United States: A nationally representative study. Pediatrics, 124(Suppl. 3), S289–S298. https://doi.org/10.1542/peds.2009-1162E.
Zuckerman, K. E., Mattox, K. E., Donelan, K., Batbayar, O., Baghaee, A., & Bethell, C. (2013). Pediatrician identification of Latino children at risk for autism spectrum disorder. Pediatrics, 132(3), 445–453. https://doi.org/10.1542/peds.2013-0383.
Author Note
We thank Alexander Marte for assistance with data collection and the families that welcomed us into their homes to conduct these interviews.
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This project was supported by an internal seed grant awarded to Rocío Rosales by the University of Massachusetts Lowell.
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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the institutional review board at the University of Massachusetts, Lowell.
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Rosales, R., Leon, A., Serna, R.W. et al. A First Look at Applied Behavior Analysis Service Delivery to Latino American Families Raising a Child With Autism Spectrum Disorder. Behav Analysis Practice 14, 974–983 (2021). https://doi.org/10.1007/s40617-021-00572-w
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DOI: https://doi.org/10.1007/s40617-021-00572-w