Research has repeatedly shown the positive effects of early diagnosis and intervention in improving the quality of life and symptom trajectory of individuals with autism spectrum disorder (ASD). Immigrant and racial/ethnic minority children are diagnosed with ASD at significantly older ages, and have access to interventions later than their White peers. Recent efforts to address diagnostic disparities have focused on universal ASD screening in pediatric primary care. However, little is known about immigrant families’ experiences with ASD screening and with navigating subsequent referrals after receiving a positive ASD screen. In the current study, we explored cultural influences on: mothers’ perceptions of child development and disability, communication with pediatric healthcare providers, and perceived benefits of Early Intervention services. We interviewed 26 mothers (14 US-born and 12 immigrant—representing twelve different nationalities) of children who screened positively for ASD in primary care but did not receive an ASD diagnosis after a formal evaluation (i.e., false positive ASD screen). Mothers completed semi-structured qualitative interviews that explored their perceptions of child development, experiences with the ASD screening and developmental evaluation process, and experiences with developmental services. Data were stratified by U.S. nativity and analyzed using applied thematic analysis. Immigrant mothers described different ways of monitoring child development than US-born mothers, and described a mismatch between their own views and the child development frameworks used in the U.S. Due to this mismatch, immigrant parents may be less likely to raise concerns to their pediatricians, and therefore may particularly benefit from routine screening. This paper uses data from a supplemental study to a larger clinical trial. The clinical trial registration number is NCT02359084.

研究一再表明早期诊断和干预在改善自闭症谱系障碍（ASD）个体的生活质量和症状轨迹方面的积极作用。移民和种族/少数族裔儿童被诊断出患有 ASD 的年龄明显较大，并且比他们的白人同龄人更晚获得干预。最近解决诊断差异的努力集中在儿科初级保健中的普遍 ASD 筛查上。然而，对于移民家庭在 ASD 筛查方面的经历以及在接受 ASD 筛查阳性后导航后续转诊的经验知之甚少。在目前的研究中，我们探讨了文化对以下方面的影响：母亲对儿童发育和残疾的看法、与儿科医疗保健提供者的沟通以及早期干预服务的感知益处。我们采访了 26 名母亲（14 名美国出生和 12 名移民——代表 12 个不同国籍）的儿童，他们在初级保健中筛查出 ASD 阳性，但在正式评估后未接受 ASD 诊断（即假阳性 ASD 筛查）。母亲们完成了半结构化的定性访谈，探讨了他们对儿童发展的看法、ASD 筛查和发展评估过程的经验以及发展服务的经验。数据按美国出生分层，并使用应用主题分析进行分析。移民母亲描述了与美国出生的母亲不同的监测儿童发展的方式，并描述了他们自己的观点与美国使用的儿童发展框架之间的不匹配 由于这种不匹配，移民父母可能不太可能向儿科医生提出担忧，因此可能特别受益于常规筛查。本文将补充研究的数据用于更大规模的临床试验。临床试验注册号为NCT02359084。