Differences Between Black and White Caregivers in the Association Between Autism Diagnostic Process Satisfaction and Service Use.

The study included only 174 of 389 eligible Black or White caregivers, and the sample came from one large academic medical center in the Midwest, so it may not apply to other settings or regions. White caregivers who completed the survey had higher median incomes and lived in less socially vulnerable neighborhoods than White caregivers who did not, so White satisfaction and service use may be inflated. Black and White families were compared, but other racial and ethnic groups and families who did not speak English were not included. Satisfaction was measured with a survey that was not formally cognitively validated, and it included only one question about respect for cultural and family values. Caregivers reported satisfaction and service use about 4 years after the diagnostic evaluation, so memory and current experiences may have shaped answers. The study did not know the timing, dose, or intensity of services, and caregiver service reports may have been inaccurate because families may not understand treatment terms. The study measured associations, not whether changing satisfaction would change service use. Families with very low satisfaction at the medical center may have been less willing to take part in research at that institution. The small sample prevented separate analysis of families who identify as Black, bi-racial, or African.

The only funding statement supplied names the Maternal and Child Health Bureau. No additional conflicts of interest are reported in the supplied text.

Do not read this as proof that improving diagnostic satisfaction will increase service use. The study was retrospective and measured associations, and it did not test whether changing satisfaction changed service use.