Evaluation of childhood developmental milestones and the warning signs of autism as an effective educational and public health outreach tool for promotoras in south Texas

Data from the Texas Education Agency and Health Resources and Services Administration shows there are fewer autism diagnoses in school districts with higher rates of Hispanic children compared to districts with lower Hispanic rates. Theories such as inadequate access to healthcare, under diagnosis, cultural beliefs toward developmental disorders and a lack of parental education concerning normal developmental milestones attempt to explain the lower rates. There is insufficient data, however, to identify the cause of the lower rates. The South Texas-Mexico border region consists of over 90% Hispanics and suffers from a large shortage of physicians. This large Hispanic population and shortage of healthcare providers, combined with low levels of education, creates an easy situation for children with developmental delays to go unnoticed. We will pilot test a train-the-trainer community intervention designed specifically for promotoras by the Organization for Autism Research. Promotoras, lay healthcare workers, are effective at increasing knowledge concerning general health practices among ethnic minorities. We will train 50 promotoras from Cameron and Hidalgo counties in South Texas to identify normal childhood developmental milestones and recognize delays. We will assess the knowledge of promotoras using pre- and post-test questionnaires. A subset of these promotoras will educate Hispanic families from their community and administer pre- and post-test evaluations. This pilot intervention will provide data and enable researchers to understand the barriers in knowledge and recognition of childhood developmental milestones and delays. Additionally, follow up visits with families will measure the community impact of this health promotion tool for promotoras.