Understanding the Oral Health Beliefs and Experiences in Latino Families of Children with ASD and Typically Developing Children

Background:

Oral care is related to overall health and quality of life. Oral health of children is of particular importance because those with early childhood caries are at higher risk for developing gingivitis, periodontal disease, and other adverse health problems as they age. Culturally influenced factors that affect dental care utilization may include behaviors, beliefs, attitudes, and values, such as diet, infant feeding practices, care of primary teeth, concern for oral health, and dental knowledge. Research has shown that Latinos are less likely to believe in the need for regular professional dental care, more likely to have misperceptions about oral health, and less likely to have access to dental care than the general population. Similarly, children with Autism Spectrum Disorder (ASD) have also experienced oral care related disparities regarding access to trained dentists and receiving sub-standard care. To date, minimal research has explored oral health beliefs in Latino families with ASD and typically developing children, and little is known about how these families experience oral care.

Objectives:

Using a qualitative description methodology, this study examined oral health attitudes, beliefs, and practices in Latino families with and without children with Autism Spectrum Disorder (ASD).

Methods:

Participants were 18 English or Spanish-speaking Latino families with children aged between 6 and 12 years. Of the total, eight families had typically developing (TD) children, and 10 families had a child with ASD. The qualitative description approach consisted of conducting one-on-one, semi-structured interviews. Each family participated in three interviews: two caregiver interviews (36 total parent/caregiver interviews), and one child interview (18 total child interviews) for a total of 54 interviews. One of two bilingual study team members, both with extensive interview experience, conducted interviews in either English or Spanish. Parent/caregiver interviews lasted 30-180 minutes, and child interviews lasted 2-20 minutes. All interviews were audio-recorded, transcribed verbatim by a professional service, and translated if necessary. Transcripts were iteratively coded using thematic analysis by two coders, with the research team providing input on the coding scheme in order to reach a final consensus regarding findings.

Results:

Three themes arose from the interviews including Vulnerability and Mistrust, Putting Children First, and Acculturation and Cultural Practices. The Latino families described dissatisfaction with dental treatments and costs. They highlighted fear of the dentist and health care providers, due to their ethnic minority status, as key factors inhibiting receipt of dental care. Additionally, families discussed prioritizing other occupations of daily living over oral care routines. Finally, they shared cultural influences on oral care habits that were passed on from their varied upbringing.

Conclusions:

These findings contribute to the literature discussing barriers to oral care among underserved Latino families. Understanding the importance of social and cultural influences on patients’ health beliefs and behaviors, and considering how these factors interact at multiple levels of the health care delivery system, will assist in devising future interventions. Future programs need to take these issues into account to assure quality health care delivery to diverse patient populations