Prevalence of autism spectrum disorder in a large pediatric primary care network.
Kate E Wallis, Toore Adebajo, Amanda E Bennett and 4 others
PMID 36652297WHAT IT FOUND
Documented autism was more common among Asian, Black, publicly insured, and urban-site children than among White, privately insured, and suburban or rural children, and median age at first documented diagnosis was 3.93 years.
Key findings
01The prevalence of ASD was 3.2% across the cohort, and the median age of diagnosis was 3.93 years.
02Documented ASD prevalence was 5.4% among Asian children and 3.5% among Black children, compared with 2.7% among White children; it was 3.6% among publicly insured children and 2.8% among privately insured children, and 3.8% among children seen at urban sites and 2.8% among children seen at suburban or rural sites.
03No statistically significant differences in age of ASD documentation were identified for any socio-demographic factor, and multivariable models were not run.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study looked back at records in one pediatric network, so it could not confirm whether each ASD diagnosis was accurate. Some children may have been missed, and some may have been recorded as having ASD when they did not. Follow-up varied from 4 to 11 years, so younger children may not have been diagnosed yet, which could make the age of first documented diagnosis look earlier than it truly was. The analyses were exploratory and meant to generate hypotheses, not to prove why prevalence differed. The network had universal screening and close access to specialty care, so the results may not apply to areas with less screening or diagnostic access. Race and ethnicity groups in the records were broad, and important social factors such as parental education and maternal nativity were not available. The authors note possible selection bias, diagnostic substitution, and lifetime prevalence as alternative explanations for the high overall rate.
Declared interests
No author conflict of interest or funding statement appears in the supplied text. The publication types list NIH and U.S. government research support.
The easy way to misread this
Do not read the higher documented prevalence among Asian, Black, publicly insured and urban children as proof that these groups truly have more autism. The study used records from one network, could not confirm diagnoses, had variable follow-up, and the authors say the analyses were exploratory.