Racial/ethnic disparities in the identification of children with autism spectrum

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AMERICAN JOURNAL OF PUBLIC HEALTH Vol. 99 Issue 3 Mar 2009

Racial/ethnic disparities in the identification of children with autism spectrum

disorders.

Authors:

Mandell, S

Wiggins, D

Carpenter, Arnstein

s,

DiGuiseppi, Carolyn

Durkin, Maureen S

Giarelli, Ellen

Morrier, J

, Joyce S

Pinto-, A

Shattuck, T

, Kathleen C

Yeargin-Allsopp, Marshalyn

Kirby, S

Affiliation: University of Pennsylvania School of Medicine, Department of

Psychiatry, Center for Mental Health Policy and Services Research, 3535 Market

Street, Philadelphia, PA 19104, USA. mandelld@...

Abstract: OBJECTIVES: We sought to examine racial and ethnic disparities in the

recognition of autism spectrum disorders (ASDs). METHODS: Within a multisite

network, 2568 children aged 8 years were identified as meeting surveillance

criteria for ASD through abstraction of evaluation records from multiple

sources. Through logistic regression with random effects for site, we estimated

the association between race/ethnicity and documented ASD, adjusting for gender,

IQ, birthweight, and maternal education. RESULTS: Fifty-eight percent of

children had a documented autism spectrum disorder. In adjusted analyses,

children who were Black (odds ratio [OR] = 0.79; 95% confidence interval [CI] =

0.64, 0.96), Hispanic (OR = 0.76; CI = 0.56, 0.99), or of other race/ethnicity

(OR = 0.65; CI = 0.43, 0.97) were less likely than were White children to have a

documented ASD. This disparity persisted for Black children, regardless of IQ,

and was concentrated for children of other ethnicities when IQ was lower than

70. CONCLUSIONS: Significant racial/ethnic disparities exist in the recognition

of ASD. For some children in some racial/ethnic groups, the presence of

intellectual disability may affect professionals' further assessment of

developmental delay. Our findings suggest the need for continued professional

education related to the heterogeneity of the presentation of ASD.}

PreMedline Identifier (PMID): 19106426