Predictors of Autism Spectrum Disorder and ADHD: Results from the National Survey of Children's Health.
Alexis Federico, Anja Zgodic, Kate Flory and 4 others
PMID 37838574WHAT IT FOUND
Girls were less often reported to have ADHD, autism, or both than boys among U.S. children.
Black, Hispanic, and multiple/other race children were less often reported to have ADHD and both diagnoses, while Hispanic children were more often reported to have autism only.
Key findings
01In the adjusted model, girls had lower odds than boys of ADHD-only (OR: 0.44), ASD-only (OR: 0.20), and ADHD+ASD (OR: 0.31).
02Black, Hispanic, and multiple/other race children had lower adjusted odds of ADHD-only and ADHD+ASD than white children; Hispanic children had lower adjusted odds of ADHD-only (OR: 0.67) and higher adjusted odds of ASD-only (OR: 1.44).
03Low birthweight was associated only with higher adjusted odds of ADHD-only (OR: 1.18); preterm birth was associated with higher adjusted odds in all diagnostic groups (ADHD OR: 1.35, ASD OR: 1.30, ADHD+ASD OR: 2.47); and intellectual disability was associated with higher adjusted odds of ADHD-only (OR: 4.62), ASD-only (OR: 40.54), and ADHD+ASD (OR: 46.06).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The outcomes were parent-reported diagnoses, not confirmed by clinicians or medical records. The study included only children older than five, so it does not describe younger children or adults. The survey response rate may mean responders differ from nonresponders. The study is from the United States, so the patterns may not apply elsewhere. The study cannot show that any factor causes a diagnosis; it reports associations. Some sociodemographic associations were very small to small in size.
Declared interests
The supplied publication types list NIH extramural research support. The paper’s conflict statement says the other authors have no relevant conflicts of interest.
The easy way to misread this
Do not conclude that Black, Hispanic, and multiple/other race children have fewer true ADHD or comorbid disorders. The study used parent-reported diagnoses, and the authors say lower reported diagnosis may reflect access, stigma, or alternative diagnoses rather than lower need.