The abstract:
Racial and ethnic disparities in accessing health care have been described in children with autism spectrum disorder (ASD). In a retrospective chart review of 152 children with ASD, children of parents whose primary language was English were significantly more likely to have both social skills and communication goals within their individualized education plan (IEP) compared to children of parents whose primary language was not English. Additionally, children of primary English speakers received significantly more hours of direct services from their state disability program. After controlling for demographic covariates, findings suggest that language barriers may negatively affect parents’ abilities to access health care services for their child with ASD. Acculturation factors must therefore be considered when analyzing disparities in autism.
From the article:
Study results show that children whose parents spoke English as a primary language received significantly more hours of services provided by CA DDS Regional Centers than children whose parents primarily spoke a language other than English. These results are supported by previous studies showing a link between English–Spanish language barriers and reduced access to ASD-specific health care services (Liptak et al. 2008; Mandell et al. 2009) and are particularly meaningful as 53% of parents in our sample spoke Spanish as a primary language and only 34% spoke English as a primary language. It is of note that while primary language is major component and indicator of acculturation (Schumann 1986) acculturation is multi-dimensional by nature and not all components of acculturation were accounted for by this study.
Additionally, significant differences in IEP goal content were found by this study. Analyses showed that children of parents whose primary language was English were significantly more likely to have both social skills goals and communication skills goals listed in their IEP. The maintenance and continued evaluation of IEPs is dependent in large part on parent involvement [e.g. according to Disability Rights California, neither federal nor state law limits the number of IEPs a parent can request per year; parents may request initial special education service assessments (California Education Code 2001) and parents are encouraged to contribute to IEP meetings by reporting on their child’s academic, developmental and functional needs, the strengths of their child and concerns regarding education enhancement opportunities (California Education Code 2010)]. The discrepancy in the quality of IEPs found by this study may represent differences in the variable profile of ASD across primary language, but may also reflect the heightened challenge faced by parents whose primary language is not English to advocate for specific, appropriate IEP content. It is possible that the language barrier between parents whose primary language is not English and CA public school administrators and teachers plays a role in rendering the content of these IEPs less specific to the needs of a child with ASD, considering previous publications citing challenges associated with language barriers in IEP meetings (Cheatham 2010; Lian and Fontánez-Phelan 2001; Salas 2004)
