Still Left Behind: Fewer Black School-Aged Youth Receive ASD Diagnoses Compared to White Youth.
Serene Habayeb, Lauren Kenworthy, Andrea De La Torre and 1 others
PMID 34089141WHAT IT FOUND
Among 514 children with first ASD diagnoses at one clinic, Black children were less likely than White children to receive their first diagnosis after age 6.
Higher parent-reported autism symptoms predicted later diagnosis more strongly for Black children.
Key findings
01In 514 children with first-time ASD diagnoses, White children received their first diagnosis at an older average age than Black children.
02When diagnoses were split at age 6, fewer Black children than expected and more White children than expected were in the later-diagnosis group.
03Higher parent-reported autism symptom scores predicted a later first diagnosis more strongly for Black children than for White children.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study used records from one outpatient clinic in the Washington, DC area, so the results may not apply to other settings or regions. The sample was highly educated, and socioeconomic status was not collected, so differences by socioeconomic status cannot be examined. Cognitive testing was missing for many younger children and was analysed in only 306 participants, so IQ findings do not cover the whole sample. The study did not record prior non-ASD diagnoses or earlier health-care contacts, so it cannot show why some children were diagnosed later. The data were cross-sectional, so the results cannot prove that race or symptoms caused later diagnosis. No information on co-occurring intellectual disability was available, although intellectual disability may interact with race and diagnosis timing. Autism symptom and emotional data came from parent report, and cultural factors may affect how parents complete these questionnaires.
Declared interests
No funding or conflict-of-interest information is reported in the supplied text.
The easy way to misread this
Do not read this as evidence that Black children have fewer ASD diagnoses overall or that they are diagnosed later. The study analysed only children who already had a first ASD diagnosis at one clinic, and Black children were less likely than White children to be in the later-diagnosis group.