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TABLE 2

Key Question 3: Are There Differences in the Quality of Care Provided to Children With ASD From Different Racial and/or Ethnic Backgrounds and/or SESs?

Author, YearSample Size, NStudy Sample Age, yStudy SettingResearch DesignTypes of Disparities AddressedResults
Blanche et al,22  2015 28 (15 parents; 13 children with ASD) 3–8 Home and clinic Descriptive qualitative analysis Ethnicity Lack of professionals who understand Hispanic family values and cultural beliefs, as well as language barriers, made treatment difficult. There was often a lack of information available in Spanish for Hispanic families. 
Magaña et al,27  2012 1959 children with ASD and 2455 children with other developmental disabilities 0–18 n/a; survey Secondary analysis of national survey Race, ethnicity, SES African American and Hispanic parents reported higher odds of their doctor not spending enough time with them, not being sensitive to family values and customs, not making them feel like a partner in their child’s health, and not providing enough information compared with non-Hispanic white parents. Families with an annual income <200% of the FPL were more likely to report that their child’s doctor did not spend enough time with them or listen to them than those at or >200% of the FPL. Parents of children with autism were more likely to report that their doctor did not spend enough time with their child, that their doctor did not listen, that their providers were not sensitive to the family’s values and customs, and that doctors did not provide enough information than parents of typically developing children. The disparities between African American and white children in reporting having a doctor who did not spend enough time with them was greater for children with autism than for those with other developmental disabilities. Likewise, the difference in reports of having a doctor who did not listen between Hispanic and white children was greater for children with autism than for those with other developmental disabilities. 
Montes and Halterman,30  2011 35 386 children with ASD 0–17 n/a; survey Secondary analysis of national survey Race, ethnicity Fewer parents of African American children with ASD reported that the doctor spent enough time with their child, that the doctor was sensitive to their values and customs, and that the doctor helped them feel like a partner in the care of their child compared with parents of white children with ASD. African American parents of children with ASD most commonly reported that their child sometimes or never received family-centered care as compared with all other studied groups. Fewer parents of white and African American children with ASD reported receiving family-centered care compared with those whose child had special needs other than ASD. 
Parish et al,28  2012 1755 children with ASD and 2659 children with other developmental disabilities 0–18 n/a; survey Secondary analysis of national survey Ethnicity Hispanic children with ASD and other developmental disabilities were more likely to have providers who (1) did not spend enough time with them, (2) were not culturally sensitive, and (3) did not make the parent(s) feel like a partner compared with non-Hispanic white children. Hispanic children were also more likely to have unmet routine or preventive care needs. 
Author, YearSample Size, NStudy Sample Age, yStudy SettingResearch DesignTypes of Disparities AddressedResults
Blanche et al,22  2015 28 (15 parents; 13 children with ASD) 3–8 Home and clinic Descriptive qualitative analysis Ethnicity Lack of professionals who understand Hispanic family values and cultural beliefs, as well as language barriers, made treatment difficult. There was often a lack of information available in Spanish for Hispanic families. 
Magaña et al,27  2012 1959 children with ASD and 2455 children with other developmental disabilities 0–18 n/a; survey Secondary analysis of national survey Race, ethnicity, SES African American and Hispanic parents reported higher odds of their doctor not spending enough time with them, not being sensitive to family values and customs, not making them feel like a partner in their child’s health, and not providing enough information compared with non-Hispanic white parents. Families with an annual income <200% of the FPL were more likely to report that their child’s doctor did not spend enough time with them or listen to them than those at or >200% of the FPL. Parents of children with autism were more likely to report that their doctor did not spend enough time with their child, that their doctor did not listen, that their providers were not sensitive to the family’s values and customs, and that doctors did not provide enough information than parents of typically developing children. The disparities between African American and white children in reporting having a doctor who did not spend enough time with them was greater for children with autism than for those with other developmental disabilities. Likewise, the difference in reports of having a doctor who did not listen between Hispanic and white children was greater for children with autism than for those with other developmental disabilities. 
Montes and Halterman,30  2011 35 386 children with ASD 0–17 n/a; survey Secondary analysis of national survey Race, ethnicity Fewer parents of African American children with ASD reported that the doctor spent enough time with their child, that the doctor was sensitive to their values and customs, and that the doctor helped them feel like a partner in the care of their child compared with parents of white children with ASD. African American parents of children with ASD most commonly reported that their child sometimes or never received family-centered care as compared with all other studied groups. Fewer parents of white and African American children with ASD reported receiving family-centered care compared with those whose child had special needs other than ASD. 
Parish et al,28  2012 1755 children with ASD and 2659 children with other developmental disabilities 0–18 n/a; survey Secondary analysis of national survey Ethnicity Hispanic children with ASD and other developmental disabilities were more likely to have providers who (1) did not spend enough time with them, (2) were not culturally sensitive, and (3) did not make the parent(s) feel like a partner compared with non-Hispanic white children. Hispanic children were also more likely to have unmet routine or preventive care needs. 

n/a, not applicable.

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