Racial and Ethnic Differences in Behavioral Problems and Medication Use Among Children With Autism Spectrum Disorders.
Irina Quebles, Olga Solomon, Kathryn A Smith and 5 others
PMID 32936891WHAT IT FOUND
White children with autism were more likely to receive medication for behavioral issues than minority children, despite similar reported problem scores.
Sleep medications were prescribed equally across all groups. Clinicians should check that parent-report tools fit the family's culture before assuming a lack of need for treatment.
Key findings
01Medication use for behavioral challenges, total problem behaviors, hyperactivity, and conduct problems was highest among White children, with Hispanic children showing the lowest rates.
02When racial and ethnic minority children were grouped together, they had significantly lower adjusted odds ratios for Total Problem Behaviors and Conduct Problems on the CBCL compared to White children.
03There were no racial or ethnic differences in the prevalence of sleep disturbances or in the rates of medication use for sleep disturbances.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study could not determine cause and effect because data was collected at a single point in time. The sample was not randomly selected, so results may not apply to all children with autism. The registry requires parents to be fluent in written and spoken English, which excludes many families and may skew the cultural representation. Socioeconomic status and health insurance data were largely missing, so these factors could not be fully controlled for. The CBCL was not specifically normed for children with autism, and its cultural fit for minority families is uncertain.
Declared interests
Research support was provided by the National Institutes of Health, U.S. Government, and other federal agencies. No specific commercial conflicts of interest are detailed in the text.
The easy way to misread this
Do not conclude that minority children have fewer behavioral problems. The lower medication rates may reflect cultural differences in how parents report symptoms on standardized tools like the CBCL, or disparities in access to care, rather than a true difference in clinical need.