Autism can affect anyone, and yet there are stark disparities in how children of different races, ethnicities and income level are diagnosed and treated1.
Latino children are often overlooked in the United States. They comprise one-fourth of all children in the country under age 18 and are expected to make up one-third by 2050. However, U.S. prevalence data have consistently shown that fewer Latino children than white or Black children are diagnosed with autism2. Other research indicates that Latino children tend to be diagnosed later than white children3.
These findings are concerning, given the importance of identifying autism early and intervening to enhance a child’s social-communication skills. Researchers and clinicians need to consider the cultural factors that may influence autism diagnosis and treatment, develop new assessment tools and programs dedicated to the Latino population, and explore other means to lower the disparities.
My colleagues and I propose that much of the difference in autism prevalence between Latino and white children stems from structural inequalities within the education and healthcare systems. But social workers are in a prime position to help identify and support Latino children with autism4. Because they often serve children from low-income or ethnic minority groups, they have ample opportunity to enhance autism diagnosis and treatment for Latino children — especially when they are trained in antiracist practices and cultural humility.
We reviewed the literature on Latino children and autism and identified three main areas of opportunity for social workers to address disparities in autism diagnosis and treatment.
The first pertains to those who work directly with individual Latino children and families. We urge these social workers to learn about autism and cultural humility, or the ability to be aware of one’s own cultural values and biases and to reflect on how that perspective shapes one’s worldview. Although social workers are trained to be cognizant of people’s differences in race, ethnicity, income, gender and ability, few have training on autism or its intersection with cultural factors. Including this information in training courses for social workers can help them to better identify Latino children who may have autism, and to provide these families with information and community resources.
Other opportunities for improvement relate to social workers at institutions such as schools and hospitals, and at organizations focused on crafting new policies. We suggest that these social workers incorporate Latina and Latino Critical Race Theory, or ‘LatCrit,’ into their practice. LatCrit is a theoretical framework to help people recognize the oppression and discrimination the Latino community encounters. To practice LatCrit, social workers learn to explore their own biases about the Latino community, learn about the history of oppression in the Latino community and learn how to recognize the community’s strengths that can be built upon and embedded in a culturally responsive practice, to collaborate with community agencies that serve the Latino population and to actively recruit more Latino individuals into the social-work profession.
With these areas of opportunity in mind, we developed Parents Taking Action (PTA), an education program for Latino families of children with autism. To create PTA, we adapted existing information about autism diagnosis, treatments and services for the Latino community. We trained Latina community health workers, or ‘promotoras,’ who themselves are mothers of autistic children, to deliver information about autism to other Latina mothers. This includes information about advocacy strategies, evidence-based techniques to enhance children’s social communication and self-care strategies. We provided some information in the form of audio-recorded novelas, or short stories, narrated by actors, to make it more culturally relevant.
We know this approach can work. We tested PTA in a study involving 96 Latino families with an autistic child5. Half of these families received PTA training in their homes and in their preferred language over the course of 14 weeks. Compared with controls, children in families that got the intervention received more evidence-based services. And Latina mothers in these families showed an increase in their use of social-communication intervention strategies with their children.
We challenge all social workers to be strategic in incorporating culturally relevant frameworks into their research and practice. In so doing, social workers can help dismantle the forces that limit Latino children’s access to autism diagnosis and treatment services.
Kristina Lopez is assistant professor of social work at Arizona State University in Phoenix.
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