Identifying Predictors of Age of Diagnosis for Latino Children with ASD in a U.S. Sample

Background: Data from research, administrative, and public health surveillance efforts finds significant disparities in Autism Spectrum Disorder (ASD) screening and diagnosis of Latino children. Barriers that have been reported by parents often include family-level (e.g., low-income/low-resources; Liptak et al., 2008), provider-level (e.g., Spanish-speaking providers, differential treatment by providers; Zuckerman et al., 2014, 2017), and systemic-level (e.g., complexity of diagnostic system, Magaña et al., 2013) factors that present as significant obstacles. However, little is known about specific demographic or service level factors that promote earlier diagnosis among Latino children.

Objectives: The objective of this study was to identify demographic and service-level factors associated with the age of diagnosis for Latino children with ASD in a U.S. sample.

Methods: Latino families of children with ASD or Developmental Disabilities (DD) were recruited as part of a study examining the validity of Spanish-language diagnostic assessment tools. Families were recruited through parent support groups and clinics in the Midwest region of the United States. All families completed demographic questionnaires, the Autism Diagnostic Interview-Revised, and provided access to medical records to confirm their child’s diagnosis and age of first diagnosis for their respective disorders. The final sample included 46 children (ASD n = 28; DD n = 18).

Results: Variables examined as possible predictors included child sex, maternal employment, maternal marital status, maternal education, household income, Spanish as home language, age of first concern, receipt of early intervention, and receipt of early childhood special education services. No group differences were found across all variables of interest. Linear regression analyses were then run separately for the ASD and for the DD groups to identify the demographic and service-level that accounted for variances in age of diagnosis. Results from a stepwise linear regression analysis found that receipt of early intervention (β = -.44) and age of first concern (β = 0.41) were significant predictors of the age of diagnosis for children with ASD, accounting for 52.7% of the variance in age of diagnosis, R² = .53, F(2, 25) = 13.95, p < .001. Receiving early intervention was associated with a lower age of diagnosis, whereas the age of diagnosis increased when age of first concern increased. No significant factors emerged as predictive of age of diagnosis for children with DD.

Conclusions: In this study we examined demographic and service-level factors that could affect the age of diagnosis among Latino children with ASD. Overall, receiving early intervention and the child’s age when parents were first concerned were significantly associated with the age of diagnosis. These findings suggest that early diagnosis of Latino children with ASD can be facilitated through early entry into the early intervention system. This can be due to early access to professionals who are knowledgeable about ASD and can therefore assist families with referrals for diagnostic evaluations and can assist families in navigating the complex educational and health care systems. This research has significant implications for improving the early identification of Latino children with ASD.