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

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TitleRacial/ethnic disparities in the identification of children with autism spectrum disorders.
Publication TypeJournal Article
Year of Publication2009
AuthorsMandell, DS, Wiggins, LD, Carpenter, LArnstein, Daniels, J, DiGuiseppi, C, Durkin, MS, Giarelli, E, Morrier, MJ, Nicholas, JS, Pinto-Martin, JA, Shattuck, PT, Thomas, KC, Yeargin-Allsopp, M, Kirby, RS
JournalAm J Public Health
Volume99
Issue3
Pagination493-8
Date Published2009 Mar
ISSN1541-0048
KeywordsAutistic Disorder, Child, Confidence Intervals, Continental Population Groups, Cross-Sectional Studies, Ethnic Groups, Female, Health Status Disparities, Humans, Logistic Models, Male, Odds Ratio, Population Surveillance, Risk Assessment, United States
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.

DOI10.2105/AJPH.2007.131243
Alternate JournalAm J Public Health
PubMed ID19106426
PubMed Central IDPMC2661453
Grant ListK01 MH067628-01A2 / MH / NIMH NIH HHS / United States
K01 MH067628-05 / MH / NIMH NIH HHS / United States
K01 MH067628-03 / MH / NIMH NIH HHS / United States
K01 MH067628-02 / MH / NIMH NIH HHS / United States
K01 MH067628-04 / MH / NIMH NIH HHS / United States
K01 MH067628 / MH / NIMH NIH HHS / United States
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