Autism Prevalence and the Intersectionality of Assigned Sex at Birth, Race, and Ethnicity on Age of Diagnosis.
Jessica E Goldblum, Tyler C McFayden, Stephanie Bristol and 3 others
PMID 37584770WHAT IT FOUND
Autism prevalence was 2.65% overall, but Black, Asian, and Hispanic/Latinx children were diagnosed earlier than white and non-Hispanic children.
Females were diagnosed later than males, with the greatest delays seen in non-Hispanic white, Black, or Asian females.
Key findings
01Black, Asian, and Hispanic/Latinx children were diagnosed earlier than white and non-Hispanic children.
02Females were diagnosed one year later than males overall, with non-Hispanic white, Black, or Asian females facing the longest delays.
03Children with an intellectual disability, older children, and those with insurance gaps or non-English home languages were diagnosed later or earlier depending on specific demographic interactions.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study relied on parent reports, which are subject to forward telescoping bias, where parents may recall the age of diagnosis as being closer to the present than it actually was. Autism symptom severity was not included in the analysis because the available data was considered too subjective. The study excluded American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander, and Some Other Race children from the age of diagnosis analysis due to small sample sizes. The findings may be skewed by the presence of intellectual disability, which was also caregiver-reported and likely underreported, and which strongly predicted earlier diagnosis.
Declared interests
The authors report no conflicts of interest. The study was funded by the Maternal and Child Health Bureau.
The easy way to misread this
Do not interpret the earlier diagnosis ages in Black, Asian, and Hispanic/Latinx children as evidence of equitable access to care. The authors suggest this may reflect higher rates of co-occurring intellectual disability in these groups, which leads to earlier identification, rather than better screening for autism alone.