Demographic Correlates of Autism: How Do Associations Compare Between Diagnosis and a Quantitative Trait Measure?
Kristen Lyall, Aisha S Dickerson, Annette M Green and 40 others
PMID 39778060WHAT IT FOUND
Black children had lower odds of receiving an autism diagnosis than White children, but their parent-reported autism traits were similar.
Higher maternal education linked to lower trait scores. This suggests diagnostic disparities exist even when symptoms are present, so low diagnosis rates in marginalized groups may reflect access barriers rather than lower need.
Key findings
01In fully adjusted models, children of non-Hispanic Black mothers had lower odds of autism diagnosis (OR=0.74, 95% CI: 0.55, 1.06) compared to children of non-Hispanic White mothers, though this confidence interval included the null.
02Associations between Black race and high autism trait scores (SRS >65) were null in adjusted models, indicating trait levels were similar despite lower diagnosis rates.
03Higher maternal education was associated with reduced odds of both autism diagnosis and high trait scores, with the strongest association seen for trait scores (OR=0.40 for highest education level).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Autism diagnosis was defined by parent report of a clinician diagnosis, not direct clinical verification, which introduces potential error. The sample oversampled for autism (6.7% prevalence vs ~2% in the US) due to the inclusion of familial and preterm cohorts, though sensitivity analyses excluding these groups yielded similar results. Data on household income was missing for 54% of the sample, so it could not be included in primary analyses. The study relied on maternal race as a proxy for child race and used broad categories, which may not capture the complexity of racial identity or structural racism. Some racial groups had small sample sizes, leading to wide confidence intervals and less certainty in those specific estimates.
Declared interests
The study was supported by the National Institutes of Health (N.I.H., Extramural). The text does not list specific financial conflicts of interest for the authors.
The easy way to misread this
Do not interpret the lower odds of diagnosis for Black children as evidence that they have fewer autism traits. The study found that trait scores were similar across racial groups, suggesting the disparity lies in diagnosis or access to care, not symptom presence.