title: Autism spectrum disorders and race, ethnicity, and nativity: a population-based study.
abstract: OBJECTIVE
  Our understanding of the influence of maternal race/ethnicity and nativity and childhood autistic disorder (AD) in African Americans/blacks, Asians, and Hispanics in the United States is limited. Phenotypic differences in the presentation of childhood AD in minority groups may indicate etiologic heterogeneity or different thresholds for diagnosis. We investigated whether the risk of developing AD and AD phenotypes differed according to maternal race/ethnicity and nativity.
  
  
  METHODS
  Children born in Los Angeles County with a primary AD diagnosis at ages 3 to 5 years during 1998-2009 were identified and linked to 1995-2006 California birth certificates (7540 children with AD from a cohort of 1,626,354 births). We identified a subgroup of children with AD and a secondary diagnosis of mental retardation and investigated heterogeneity in language and behavior.
  
  
  RESULTS
  We found increased risks of being diagnosed with AD overall and specifically with comorbid mental retardation in children of foreign-born mothers who were black, Central/South American, Filipino, and Vietnamese, as well as among US-born Hispanic and African American/black mothers, compared with US-born whites. Children of US African American/black and foreign-born black, foreign-born Central/South American, and US-born Hispanic mothers were at higher risk of exhibiting an AD phenotype with both severe emotional outbursts and impaired expressive language than children of US-born whites.
  
  
  CONCLUSIONS
  Maternal race/ethnicity and nativity are associated with offspring's AD diagnosis and severity. Future studies need to examine factors related to nativity and migration that may play a role in the etiology as well as identification and diagnosis of AD in children.
authors: Departments of Epidemiology, and.
authors: Tracy A
authors: TA
authors: Becerra
authors: Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California; and.
authors: Ondine S
authors: OS
authors: von Ehrenstein
authors: Departments of Epidemiology, and.
authors: Julia E
authors: JE
authors: Heck
authors: Departments of Epidemiology, and.
authors: Jorn
authors: J
authors: Olsen
authors: Departments of Epidemiology, and.
authors: Onyebuchi A
authors: OA
authors: Arah
authors: Departments of Psychiatry and Behavioral Sciences, and.
authors: Shafali S
authors: SS
authors: Jeste
authors: Family Medicine, University of California, Los Angeles, Los Angeles, California.
authors: Michael
authors: M
authors: Rodriguez
authors: Departments of Epidemiology, and britz@ucla.edu.
authors: Beate
authors: B
authors: Ritz
mesh_terms: D001741:Black or African American; D001213:Asian; D002140:California / Q000453:epidemiology; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology*; D002675:Child, Preschool; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D009035:Mothers; D044469:Racial Groups; D044465:White People
keywords: autistic disorder; continental population groups; emigration and immigration; epidemiology