From 2014 to 2060, it is estimated that individuals of Hispanic or Latino/a origin will increase to about 115% (Colby & Ortman, 2015). Given the growing presence of this population in the United States, there are various implications for clinicians and professionals serving Latino/a individuals who have autism and related developmental disabilities.
It is estimated that the current prevalence of autism among children is 1 in 59 (Baio et al., 2018). For children who come from diverse racial and ethnic backgrounds, obtaining a diagnosis of autism may present its own unique challenges, such as low socioeconomic status, decreased access to health insurance, and having English as a second language. As a Spanish-speaking clinician who worked with Latino/a families who had children with autism, most, if not all, of my clients were of low socioeconomic status and had caregivers who were monolingual Spanish speakers. Working with these families led me to see firsthand the unique challenges that perhaps other ethnic and racial groups do not face as often, such as high turnover rate with behavior therapists due to the neighborhood the client lived in or having to directly communicate with me as the supervisor who was in the home once a week instead of with the therapist who was there multiple days a week due to language barriers.
Particularly for the Latino/a community, knowledge and perceptions of autism, parent and family factors, and health care system factors are three barriers identified regarding Latino/a children not receiving a diagnosis of autism (Zuckerman et al. 2014). Caregivers of Latino/a children with autism often express that there is limited knowledge and developmental resources pertaining to autism in the Latino/a community, which prevents early diagnosis and services to take place (Zuckerman et al., 2014). Even when developmental resources are available, they lack in quality, are poorly translated into Spanish, or use medical jargon, which is problematic for caregivers of lower reading levels. Moreover, knowledge of autism is perhaps even less in Latin American countries, where autism “does not exist” and there is a stigma regarding mental health and disabilities.
As clinicians and professionals who work with diverse populations, we should be more culturally competent and thoroughly take cultural and linguistic factors into consideration when planning for assessment and treatment. Fostering cultural competence can lead to great outcomes for clients of diverse ethnic and cultural backgrounds receiving services because it can strengthen the quality of services. Some considerations that clinicians and professionals are advised to take into account include having a culturally relevant, respectful, and collaborative approach to delivering treatment instead of imposing values and interventions that do not align with Latino/a values (e.g., family and respect; Parra Cardona et al., 2009). For instance, although I identify as Latina, I was born in the United States, which is not the case for the caregivers of the clients I was serving. Although we share the Latino/a culture, I also grew up with American values, which can differ from Latino/a values. I remember oftentimes where I would advocate for strengthening the client’s independence with self-help skills, such as showering, and observing that caregivers were not completely following procedures that they had agreed to. It was not until I did some self-reflection that I realized I was imposing some of my personal American values on the families I was working with. Even though I recognized that mother figures value taking care of things for others in the family in the Latino/a culture, I was not being respectful or mindful of that aspect and instead imposing what I thought was “correct” as a second-generation Latina working with Latino/a families who immigrated to the U.S.
Another way for clinicians to be more mindful of cultural and linguistic factors includes being aware of when racial microaggressions are emitted, which are verbal or non-verbal behaviors, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults toward people of color. Examples of this include assuming a Spanish-speaking family is from Mexico when in actuality they are from a country in South America or assuming a Latino/a individual automatically speaks Spanish. Instead of assuming things about a culture, we should simply ask the families we serve. And instead of approach services as an “it’s my way or the highway approach,” clinicians should instead collaborate with the families they serve to further promote the well-being of the client.
References
Baio, J. Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., … Dowling, N. F. (2018). Prevalence of Autism Spectrum Disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2014. Morbidity and Mortality Weekly Report Surveillance Summary 2018, 67, 1-23. doi: 10.15585/mmwr.ss6706a1
Colby, S. L. & Ortman, J. M. (2015). Projections of the Size and Composition of the U.S. Population: 2014 to 2060, Current Population Reports, P25-1143, U.S. Census Bureau, Washington, DC, 2014.
Zuckerman, K. E., Sinche, B., Mejia, A., Cobina, M., Becker, T., & Nicolaidis, C. (2014). Latino parents’ perspectives of barriers to autism diagnosis. Academic Pediatric, 14, 301-308. doi: 10.1016/j.acap.2013.12.004
