David S. Mandell ^1*, Lisa S. Wiggins ², Laura Amstein Carpenter ³, Julie Daniels ⁴, Carolyn DiGuiseppi ⁵, Maureen S. Durkin ⁶, Ellen Giarelli ⁷, Michael J. Morrier ⁸, Joyce S. Nicholas ³, Jennifer A. Pinto-Martin ⁷, Paul T. Shattuck ⁹, Kathleen C. Thomas ¹⁰, Marshalyn Yeargin-Allsopp ², Russell S. Kirby ¹¹

¹ University of Pennsylvania
² Centers for Disease Control and Prevention
³ Medical University of South Carolina
⁴ Cecil G. Sheps Center for Health Services Research
⁵ University of Colorado at Denver
⁶ University of Wisconsin School of Medicine and Public Health
⁷ University of Pennsylvania School of Nursing
⁸ Emory University
⁹ George Warren Brown School of Social Work at Washington University, St Louis
¹⁰ University of North Carolina, Chapel Hill
¹¹ University of South Florida, Tampa

^* To whom correspondence should be addressed. E-mail: mandelld{at}mail.med.upenn.edu.

	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. For some children with ASD, 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.

Key Words: Child and Adolescent Health, Access to Care, Mental Health, Race/Ethnicity

This article has been cited by other articles:

				M. D. Kogan, S. J. Blumberg, L. A. Schieve, C. A. Boyle, J. M. Perrin, R. M. Ghandour, G. K. Singh, B. B. Strickland, E. Trevathan, and P. C. van Dyck Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007 Pediatrics, November 1, 2009; 124(5): 1395 - 1403. [Abstract] [Full Text] [PDF]