Autism Spectrum Disorder Among US Children (2002–2010): Socioeconomic, Racial, and Ethnic Disparities

Durkin, Maureen S.; Maenner, Matthew J.; Baio, Jon; Christensen, Deborah; Daniels, Julie L.; Fitzgerald, Robert T.; Imm, Pamela; Lee, Li‐Ching; Schieve, Laura A.; Braun, Kim Van Naarden; Wingate, Martha S.; Yeargin‐Allsopp, Marshalyn

doi:10.2105/ajph.2017.304032

Cited by 233 publications

(129 citation statements)

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“…Non‐Hispanic black and Hispanic children were less likely than non‐Hispanic white children to have a diagnosis of ASD noted in service records. Racial and ethnic disparities in ASD diagnosis are well‐documented in a variety of clinical and surveillance reports [Bernier, Mao, & Yen, ; Durkin et al, ; Liptak et al, ; Mandell et al, ; Mandell et al, ; Mandell et al, ]. Some perceived barriers to ASD diagnosis reported by non‐Hispanic black and Hispanic parents are confusion and frustration with the diagnostic process, high levels of stigma in some communities, lack of parental information about ASD, limited English proficiency, and provider dismissal of parental concerns [Parish et al, ; Zuckerman et al, ; Zuckerman et al, ].…”

Section: Discussionmentioning

confidence: 99%

“…Other variables that contribute to delayed ASD diagnosis are co‐occurring psychiatric and neurological disorders, fewer ASD symptoms, fewer functional limitations, and lack of intellectual disability [Durkin et al, ; Mandell et al, ; Ratto et al, ; Shatttuck et al, ; Maenner et al, ]. Parents who have children diagnosed with ASD later than others often attribute their first concerns to a behavioral or medical problem rather than a developmental problem [Daley, ].…”

Section: Introductionmentioning

confidence: 99%

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Disparities in Documented Diagnoses of Autism Spectrum Disorder Based on Demographic, Individual, and Service Factors

et al. 2019

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The objectives of our study were to (a) report how many children met an autism spectrum disorder (ASD) surveillance definition but had no clinical diagnosis of ASD in health or education records and (b) evaluate differences in demographic, individual, and service factors between children with and without a documented ASD diagnosis. ASD surveillance was conducted in selected areas of Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin. Children were defined as having ASD if sufficient social and behavioral deficits and/or an ASD diagnosis were noted in health and/or education records. Among 4,498 children, 1,135 (25%) had ASD indicators without having an ASD diagnosis. Of those 1,135 children without a documented ASD diagnosis, 628 (55%) were not known to receive ASD services in public school. Factors associated with not having a clinical diagnosis of ASD were non‐White race, no intellectual disability, older age at first developmental concern, older age at first developmental evaluation, special education eligibility other than ASD, and need for fewer supports. These results highlight the importance of reducing disparities in the diagnosis of children with ASD characteristics so that appropriate interventions can be promoted across communities. Autism Res 2020, 13: 464–473. © 2019 International Society for AutismResearch,Wiley Periodicals, Inc. Lay Summary Children who did not have a clinical diagnosis of autism spectrum disorder (ASD) documented in health or education records were more likely to be non‐White and have fewer developmental problems than children with a clinical diagnosis of ASD. They were brought to the attention of healthcare providers at older ages and needed fewer supports than children with a clinical diagnosis of ASD. All children with ASD symptoms who meet diagnostic criteria should be given a clinical diagnosis so they can receive treatment specific to their needs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Disparities in Documented Diagnoses of Autism Spectrum Disorder Based on Demographic, Individual, and Service Factors

et al. 2019

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“…Autism spectrum disorder (ASD) is a family of neurodevelopmental disorders characterized by repetitive or stereotyped behaviors and deficits in social interactions. An estimated 11.9 in 1,000 children in the United States have ASD [Durkin et al, ]. The American Academy of Child and Adolescent Psychiatry recommends the use of multiple treatment modalities in ASD [2014].…”

Section: Introductionmentioning

confidence: 99%

Treatment patterns in children with autism in the United States

et al. 2019

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Children with autism receive different types of non‐drug treatments. We aimed to describe caregiver‐reported pattern of care and its variability by geography and healthcare coverage in a US‐wide sample of children aged 3–17 years. We recruited caregivers from the Simons Foundation Powering Autism Research for Knowledge (SPARK) cohort. Two online questionnaires (non‐drug treatment, Autism Impact Measure) were completed in September/October 2017. Primary outcome measures were caregiver‐reported types and intensities of treatments (behavioral, developmental/relationship, speech and language (SLT), occupational, psychological, “other”; parent/caregiver training) in the previous 12 months. Main explanatory variables were geography and type of healthcare coverage. We investigated associations between the type/intensity of treatments and geography (metropolitan/nonmetropolitan) or coverage (Medicaid vs privately insured by employer) using regression analysis. Caregivers ( n = 5,122) were mainly mothers (92.1%) with mean ( SD ) age of 39.0 (7.3) years. Mean child age was 9.1 (3.9) years; mostly males (80.0%). Almost all children received at least one intervention (96.0%). Eighty percent received SLT or occupational therapy, while 52.0% received both. Behavioral therapy and SLT were significantly more frequent and more intense in metropolitan than in nonmetropolitan areas. No consistently significant associations were seen between healthcare coverage and frequency or intensity of interventions. At least one barrier such as “waiting list” and “no coverage” was reported by 44.8%. In conclusion, in children sampled from SPARK, we observed differences between metropolitan and nonmetropolitan areas, while we did not find significant differences between those privately insured versus Medicaid. Autism Res 2019, 12: 517–526 © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. Lay Summary The American Academy of Child and Adolescent Psychiatry recommends the use of multiple treatment modalities in autism spectrum disorder (ASD). We wanted to understand what types of treatment children (aged 3–17 years) with ASD receive in the United States, how and where the treatments take place and for how long. We invited caregivers from Simons Foundation Powering Autism Research for Knowledge (“SPARK ,” https://sparkforautism.org/ ) to complete the study questions online. Participants reported on utilization of conventional, non‐drug treatments for ASD, including behavioral interventions, developmental/relationship interventions, speech and language therapy (SLT), occupational therapy, psychological therapy, and parent/caregiver training. People that completed the study ( n = 5,122) were primarily mothers of the child with ASD (92%); most of the children were boys (80%). ...

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“…The persistent gap is consistent with work showing relatively constant gaps in socio‐economic status between families with a child with autism spectrum disorder between 2002 and 2010 (Durkin et al . ).…”

Section: Discussionmentioning

confidence: 97%

Trajectories of poverty and economic hardship among American families supporting a child with a neurodisability

Rothwell

Gariépy

Elgar

et al. 2019

J intellect Disabil Res

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Background Caring for a child with a neurodisability (ND) impacts the financial decisions, relationships and well‐being of family members, but evidence on the economic trajectories of families throughout the life course is missing. Methods Using data from the Panel Study of Income Dynamics, we tracked the families of 3317 children starting 5 years before childbirth until the child reached 20 years of age. We used regression and latent growth curve modelling to estimate trajectories of poverty and economic hardship over time. Results Families with a child with an ND had higher rates of poverty and economic hardship prior to childbirth and persistently over time. Analysis uncovered five latent trajectories for each indicator. After controlling for family and caregiver characteristics that preceded the birth of the child, raising a child with an ND was not associated with a unique trajectory of poverty. Families raising a child with an ND were however more likely to experience persistent economic hardship. Conclusions The study establishes descriptive evidence for how having a child with an ND relates to changes in family economic conditions. The social and economic conditions that precede the child's birth seem to be driving the economic inequalities observed later throughout the life course.

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Autism Spectrum Disorder Among US Children (2002–2010): Socioeconomic, Racial, and Ethnic Disparities

Abstract: A positive SES gradient in ASD prevalence according to US surveillance data prevailed between 2002 and 2010, and racial and ethnic disparities in prevalence persisted during this time among low-SES children.

Cited by 233 publications

References 24 publications

Disparities in Documented Diagnoses of Autism Spectrum Disorder Based on Demographic, Individual, and Service Factors

Disparities in Documented Diagnoses of Autism Spectrum Disorder Based on Demographic, Individual, and Service Factors

Treatment patterns in children with autism in the United States

Trajectories of poverty and economic hardship among American families supporting a child with a neurodisability

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