Race, class contribute to disparities autism diagnoses

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21 Nov 2017, 1:52 am

Spectrum News

Quote:
The prevalence of autism continues to increase across the United States, regardless of socioeconomic class, according to a new study1. Overall, black and Hispanic children are less likely than their white peers to have an autism diagnosis.

The findings highlight persistent racial disparities in autism prevalence: White children are about 19 percent more likely than black children and 65 percent more likely than Hispanic children to be diagnosed with autism.

Autism prevalence in the U.S. has more than doubled since 2002. Researchers have looked to changes in the condition’s diagnostic definition and greater awareness among parents as possible explanations for this rise.

They have also assumed that access to good schools and medical care would explain much of why white children and those of high socioeconomic status are more likely than black and Hispanic children and those of low socioeconomic status to be diagnosed with autism.

The new study upended many of these assumptions.

The findings suggest that socioeconomic status doesn’t fully explain the differences in prevalence across race and ethnicity.

Durkin and her colleagues analyzed surveillance data from the U.S. Census Bureau and the U.S. Centers for Disease Control and Prevention’s (CDC) Autism and Developmental Disabilities Monitoring Network. The CDC database includes health and education records for more than 1.3 million children at age 8. Of those, the clinicians identified 13,396 children who either had an autism diagnosis or would meet the criteria for a diagnosis.

The team used census data on the proportion of adults with college degrees in a neighborhood as a proxy for socioeconomic status. They stratified the results by race and ethnicity to determine whether socioeconomic status alters their findings on prevalence.

Autism prevalence rose almost evenly among high-, middle- and low-socioeconomic groups between 2002 and 2010, the researchers found. The rates increased from 3.9 to 9.3 per 1,000 children in the low-socioeconomic group, from 6.2 to 11.6 in the middle class and from 7.9 to 13.4 in the high-socioeconomic group.

This was a surprise. The research team had expected that prevalence in the high-socioeconomic group in 2002 was “the true prevalence” and that the numbers for that class would stabilize over time, Durkin says. “But it really didn’t.”

When the researchers looked more closely within each racial and ethnic group, they found that differences in prevalence across socioeconomic classes either stayed the same or became smaller.

Surprisingly, the rate of autism among black children in the high socioeconomic group was higher than that among white or Hispanic children between 2002 and 2010.

“It’s intriguing that in higher-social-class blacks, there’s no shortage of autism,” Durkin says. “Black children are much more likely to be in the low-socioeconomic group than white children,” she says. The finding supports the idea that lack of access to diagnostic services contributes to the overall lower prevalence of autism in black children.


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DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity

“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman