Association Between Pediatrician Screening Practices and Age at the Time of Autism Diagnosis Among Latino Children

Association Between Pediatrician Screening Practices and Age at the Time of Autism Diagnosis Among Latino Children by Irma S. Díaz MPH, Ponce School of Medicine, 2009 BS, Interamerican University of Puerto Rico, 2007 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Public Health Walden University November 2017 Abstract Autism spectrum disorder (ASD) is a lifelong developmental disability that affects all ethnic groups and is twice as frequent among boys than girls. The Centers for Disease Control and Prevention stated that 1 in 68 children are diagnosed with ASD. Despite guidance from the American Academy of Pediatrics and clinical evidence that suggests that ASD can be diagnosed as early as 24 months of age, most diagnoses occur at age 4 or even later, resulting in fewer opportunities for children to receive early ASD treatment and help them reach the best outcome possible. There is limited information about the appropriate referral practices adopted by pediatricians, the accuracy of ASD testing tools, and ASD studies conducted among the Latino children. The purpose of this study was to examine the associations between age of diagnosis and the screening/referral practices of doctors. Data from the 2011 Pathways Survey (N = 134) were analyzed with bivariate and multivariate statistics, including chi-square with cross-tabulation and multinomial logistic regression. No statistically significant associations were found among the dependent variable “age when the parent was told by a doctor that child had ASD,” and the independent variables “pediatrician conducted screening” (p > 0.05), “pediatrician conducted screening after parent had a developmental concern” (p > 0.05), and “doctor referred the child to a specialist after parent had a developmental concern” (p > 0.05). The results should be interpreted with caution due to the small sample size of Hispanic children with ASD diagnoses in the dataset. Additional studies are needed that can measure pediatrician screening patterns among the Hispanic/Latino children, thereby producing positive changes that can decrease associated morbidity and mortality among this population.Autism spectrum disorder (ASD) is a lifelong developmental disability that affects all ethnic groups and is twice as frequent among boys than girls. The Centers for Disease Control and Prevention stated that 1 in 68 children are diagnosed with ASD. Despite guidance from the American Academy of Pediatrics and clinical evidence that suggests that ASD can be diagnosed as early as 24 months of age, most diagnoses occur at age 4 or even later, resulting in fewer opportunities for children to receive early ASD treatment and help them reach the best outcome possible. There is limited information about the appropriate referral practices adopted by pediatricians, the accuracy of ASD testing tools, and ASD studies conducted among the Latino children. The purpose of this study was to examine the associations between age of diagnosis and the screening/referral practices of doctors. Data from the 2011 Pathways Survey (N = 134) were analyzed with bivariate and multivariate statistics, including chi-square with cross-tabulation and multinomial logistic regression. No statistically significant associations were found among the dependent variable “age when the parent was told by a doctor that child had ASD,” and the independent variables “pediatrician conducted screening” (p > 0.05), “pediatrician conducted screening after parent had a developmental concern” (p > 0.05), and “doctor referred the child to a specialist after parent had a developmental concern” (p > 0.05). The results should be interpreted with caution due to the small sample size of Hispanic children with ASD diagnoses in the dataset. Additional studies are needed that can measure pediatrician screening patterns among the Hispanic/Latino children, thereby producing positive changes that can decrease associated morbidity and mortality among this population. Association Between Pediatrician Screening Practices and Age at the Time of Autism Diagnosis Among Latino Children by Irma S. Díaz MPH, Ponce School of Medicine, 2009 BS, Interamerican University of Puerto Rico, 2007 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Public Health Walden University November 2017