Differences in Processes Underlying Autism Service Engagement Among Latina and Non-Latina Mothers.

Latino children on the autism spectrum experience less access to autism services and more barriers to service-use than non-Latino White children. Yet, existing research leaves unanswered questions about how cultural, family, and service system-level processes contribute to autism service-use disparities. This study aimed to qualitatively explore how Latina and non-Latina mothers experience similar encounters with autism services. Twenty Latina and non-Latina mothers completed semi-structured interviews regarding their experiences accessing services. Data were analyzed using applied thematic analysis. Ethnicity-based differences emerged in mothers' service-use motivations (i.e., desiring ongoing support vs. eventual departure), service evaluations (i.e., dissatisfaction vs. satisfaction), and service-seeking approaches (i.e., proactive vs. reactive). Findings illustrate how these processes underlying service engagement may contribute to service disparities for Latino children.

Sleep Education and Training among Practicing Clinical Psychologists in the United States and Canada.

Introduction: Clinical psychologists often treat patients with a sleep disorder. Cognitive-behavioral treatments can independently, or in combination with medical interventions, effectively improve sleep health outcomes. No studies have examined sleep education and training among practicing clinical psychologists.Method: Actively practicing clinical psychologists were recruited through psychological associations' e-mail listservs across the United States and Canada. Respondents (N = 200) provided information about: 1) duration and format of formal sleep education and training; 2) perceived self-efficacy to evaluate and treat sleep disorders; and 3) interest in further sleep training.Results: Clinical psychologists reported a median of 10.0 hours of didactic sleep training (range 0-130 hours) across their training or career. Ninety-five percent reported no clinical sleep training during graduate school, internship, or post-doctoral fellowship. In terms of evaluation and treatment, 63.2% reported feeling at least "Moderately Prepared" to evaluate a patient's sleep and 59.5% felt at least "Moderately Prepared" to treat a common sleep disorder (insomnia disorder). However, most endorsed using insomnia disorder treatment approaches inconsistent with empirically supported guidelines. The vast majority (99.3%) desired additional sleep training across a variety of delivery formats.Discussion: Many clinical psychologists engaged in active patient care have received minimal formal sleep training. Despite this, they felt prepared to evaluate and treat sleep disorders. Their treatment recommendations were not aligned with evidence-based standards. This may result in a delay to, or absence of, effective treatment for patients, underscoring the critical need for sleep training among clinical psychologists. It is essential to improve sleep competencies for the field.

Mothers' Adjustment to Autism: Exploring the Roles of Autism Knowledge and Culture.

INTRODUCTION: Autism spectrum disorder (ASD) service-use disparities are well-documented among racial/ethnic minorities. Yet the nuanced impact that culture has on barriers to ASD service-use has not been sufficiently explored among these populations. This study explores the interrelatedness of culture and service-use barriers (i.e., parent ASD knowledge and adjustment) among culturally diverse mothers of children with ASD. METHODS: Twenty mothers from the Boston area participated in semi-structured qualitative interviews regarding their experiences with ASD. Applied thematic analysis was used to analyze data stratified by ethnicity (Latina vs. non-Latina) and nativity (immigrant vs. U.S. born). RESULTS: All mothers had similar gains in ASD knowledge after their children's ASD diagnoses. Non-Latina mothers (immigrant and U.S. born) felt empowered by their gained ASD knowledge, while Latina mothers struggled to fully accept their child's diagnosis and were unable to apply their general ASD knowledge to better understand their child's ASD-related needs. Culturally based stigma against ASD, including rejection from the Latino community and internalized self-blame, appeared to drive Latina mothers' beliefs that ASD is an invalid diagnosis for their child. CONCLUSION: Latina mothers' desire for community acceptance in the context of ASD stigma was a particularly salient cultural value among Latina mothers in this sample. Findings suggest that parent-focused ASD education programs may not sufficiently address ASD service-use disparities for Latina mothers. Rather, ASD education programs that address informational and cultural needs may better promote ASD adjustment among ethnic minority families.