Autism Diagnosis and Socioeconomic Status

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Provocative new research discovers children living in neighborhoods where incomes are low and fewer adults have bachelor’s degrees, are less likely to be diagnosed with autism spectrum disorder (ASD) compared to kids from more affluent neighborhoods.

University of Wisconsin-Madison investigators lead the multi-institution study which reviewed if the skewed ASD prevalence was the result of inadequate screening and failure to assign a diagnosis among vulnerable children.

The study appears in the American Journal of Public Health.

Maureen Durkin and her team found that the incidence, or the number of children diagnosed with autism, increased during the study period. In fact, during the eight years of the study, the overall prevalence of ASD in children more than doubled, increasing from 6.6 to 14.7 cases per thousand children. Prevalence pertains to the total number of children who have an ASD diagnosis.

Her team analyzed education and health care data for 1.3 million eight year-old children from a Centers for Disease Control and Prevention population-based surveillance program, with sites in 11 states across the U.S.: Alabama, Arizona, Arkansas, Colorado, Georgia, Maryland, Missouri, New Jersey, North Carolina, Utah, and Wisconsin.

The study merged this autism surveillance data with U.S. Census measures of socioeconomic status, such as number of adults who have bachelor’s degrees, poverty, and median household incomes in the census tracts studied.

The study does not prove children from lower socioeconomic backgrounds are not getting the diagnoses and support they need, Durkin says, but it does indicate that’s the most likely scenario.

In support of this hypothesis, the study found that children who had intellectual disabilities were equally likely to be diagnosed with ASD irrespective of their socioeconomic backgrounds.

In addition, studies in Sweden and France — which have universal health care and fewer barriers for citizens to access medical care — found no association between socioeconomic status and rates of autism diagnoses.

In addition, studies in Sweden and France — which have universal health care and fewer barriers for citizens to access medical care — found no association between socioeconomic status and rates of autism diagnoses.

Those countries also probably have a much smaller spread in socioeconomic status.

Affluent people tend to wait longer to have children in the U.S. I wonder whether the parents' age at the time of conception/pregnancy really influences the development of autism and operates as a confounding factor in this study.