Early Autism Spectrum Disorder (ASD) diagnosis improves long-term child development and families' ability to cope with this disorder. Latino children are diagnosed with ASDs at older ages and at the point of more severe symptoms, putting them and their families at significant disadvantage. Interventions addressing family, community, and health care systems factors hold promise for improving access to ASD diagnostic services for minority children. The goal of this project is to develop an evidence-based intervention to reduce ethnic differences in ASD care among Latinos. To accomplish this goal, we will develop a survey of 350 Latino parents of either typically-developing children or children with ASDs, to assess common beliefs about autism in Latino communities, and to assess which community factors, health beliefs, and health care system factors are associated with delays in ASD diagnosis. The survey will be conducted at three sites within the Autism Treatment Network: Oregon Health & Science University in Portland, Oregon; University of Colorado/The Children's Hospital in Denver; and University of Pennsylvania/Children's Hospital of Philadelphia. Based on the barriers found in the survey, we will develop a pilot community-based patient navigator intervention designed to reduce barriers to care. This research will be incorporated into a career development plan that includes increasing the Principal Investigator's knowledge and skills in the areas of autism diagnosis and treatment, mental health disparities, interventional study design, and community-based research. The results of this research will be published in peer-reviewed journals and used as the basis for an NIH-funded proposal to conduct a multi-site test of the intervention designed in this project. Over 120,000 U.S. Latino children have been diagnosed with an ASD, a figure that likely underestimates the true prevalence. This project will help such children achieve earlier diagnosis and better long-term prognosis.

Public Health Relevance

The goal of this project is to develop an evidence-based intervention to improve rates of early diagnosis and treatment of autism spectrum disorders in Latino children. We will achieve this goal through surveying Latino parents to identify barriers to care and then developing a pilot patient navigator intervention designed to reduce the barriers that we identified. This research will be incorporated into a career development plan that includes increasing the Principal Investigator's knowledge and skills in the areas of autism diagnosis and treatment, mental health disparities, interventional study design, and community-based research.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23MH095828-04
Application #
8829340
Study Section
Mental Health Services in MH Specialty Settings (SRSP)
Program Officer
Hill, Lauren D
Project Start
2012-04-05
Project End
2017-03-31
Budget Start
2015-04-01
Budget End
2016-03-31
Support Year
4
Fiscal Year
2015
Total Cost
$179,521
Indirect Cost
$13,298
Name
Oregon Health and Science University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Zuckerman, Katharine E; Friedman, Nora D B; Chavez, Alison E et al. (2017) Parent-Reported Severity and Health/Educational Services Use Among US Children with Autism: Results from a National Survey. J Dev Behav Pediatr 38:260-268
Zuckerman, Katharine; Lindly, Olivia Jasmine; Chavez, Alison Elizabeth (2017) Timeliness of Autism Spectrum Disorder Diagnosis and Use of Services Among U.S. Elementary School-Aged Children. Psychiatr Serv 68:33-40
Riley, Andrew R; Wagner, David V; Tudor, Megan E et al. (2017) A Survey of Parents' Perceptions and Use of Time-out Compared to Empirical Evidence. Acad Pediatr 17:168-175
Zuckerman, Katharine E; Chavez, Alison E; Reeder, Julie A (2017) Decreasing Disparities in Child Development Assessment: Identifying and Discussing Possible Delays in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). J Dev Behav Pediatr 38:301-309
Lindly, Olivia; Thorburn, Sheryl; Heisler, Karen et al. (2017) Parent disclosure of complementary health approaches used for children with autism spectrum disorder: Barriers and facilitators. Complement Ther Med 35:47-52
Zuckerman, Katharine E; Lindly, Olivia J; Reyes, Nuri M et al. (2017) Disparities in Diagnosis and Treatment of Autism in Latino and Non-Latino White Families. Pediatrics 139:
Lipstein, Ellen A; Lindly, Olivia J; Anixt, Julia S et al. (2016) Shared Decision Making in the Care of Children with Developmental and Behavioral Disorders. Matern Child Health J 20:665-73
Zuckerman, Katharine E; Lindly, Olivia J; Sinche, Brianna (2016) Parent Beliefs About the Causes of Learning and Developmental Problems Among Children With Autism Spectrum Disorder: Results From a National Survey. Am J Intellect Dev Disabil 121:432-47
Lindly, Olivia J; Chavez, Alison E; Zuckerman, Katharine E (2016) Unmet Health Services Needs Among US Children with Developmental Disabilities: Associations with Family Impact and Child Functioning. J Dev Behav Pediatr 37:712-723
Zuckerman, Katharine E; Lindly, Olivia J; Sinche, Brianna K et al. (2015) Parent health beliefs, social determinants of health, and child health services utilization among U.S. school-age children with autism. J Dev Behav Pediatr 36:146-57

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