Disparities in diagnosis and access to health services for children with autism: data from the National Survey of Children's Health.
OBJECTIVE
Earlier assessment of autism improves outcomes. In addition, children with autism have significant need for medical care. Therefore, identification of factors associated with delays in the early diagnosis of autism and with decreased access to care has the potential to lead to interventions that will improve health and well-being. The aim of this study was to determine whether differences occur in the age-specific prevalence of autism or in access to health care in children of traditionally underserved populations.


METHODS
Data from the National Survey of Children's Health of 2003/2004 were used. Diagnosis of autism and its severity were based on parental report.


RESULTS
The prevalence of autism was lower for Latinos (26/10,000) than for non-Latinos (51/10,000). Whites and blacks had comparable rates. The lowest preschool rate of autism (16/10,000) occurred in poor children. Latinos and poor families rated their children's autism as more severe. Being black, Latino, or poor was associated with decreased access to services, while having Medicaid or State Children's Health Insurance Program was linked with better access to some services.


CONCLUSIONS
Disparities in the prevalence and parent-reported severity of autism and in access to health care were found for children with autism. Programs for children in general (e.g., universal screening for autism) and programs that target traditionally underserved groups of children, their families, and their health care providers should be tested and implemented to optimize case finding of children with autism and to eliminate disparities in access to care and to early intervention.
Liptak
Gregory S
GS
Department of Pediatrics Upstate Medical University, University Hospital, Syracuse, New York 13210, USA. Liptakg@upstate.edu
Benzoni
Lauren B
LB
Mruzek
Daniel W
DW
Nolan
Karen W
KW
Thingvoll
Melissa A
MA
Wade
Christine M
CM
Fryer
G Edgar
GE
D000293:Adolescent; D000367:Age Factors; D001321:Autistic Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006302:Health Services Research / Q000706:statistics & numerical data; D006306:Health Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008484:Medicaid / Q000706:statistics & numerical data; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data; D013221:State Health Plans / Q000706:statistics & numerical data; D014481:United States; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D001741:Black or African American