title: Age at Autism Spectrum Disorder (ASD) Diagnosis by Race, Ethnicity, and Primary Household Language Among Children with Special Health Care Needs, United States, 2009-2010.
abstract: We examined prevalence of diagnosed autism spectrum disorder (ASD) and age at diagnosis according to child's race/ethnicity and primary household language. From the 2009-2010 National Survey of Children with Special Health Care Needs, we identified 2729 3-17-year-old US children whose parent reported a current ASD diagnosis. We compared ASD prevalence, mean diagnosis age, and percentage with later diagnoses (≥5 years) across racial/ethnic/primary household language groups: non-Hispanic-white, any language (NHW); non-Hispanic-black, any language (NHB); Hispanic-any-race, English (Hispanic-English); and Hispanic-any-race, other language (Hispanic-Other). We assessed findings by parent-reported ASD severity level and adjusted for family sociodemographics. ASD prevalence estimates were 15.3 (NHW), 10.4 (NHB), 14.1 (Hispanic-English), and 5.2 (Hispanic-Other) per 1000 children. Mean diagnosis age was comparable across racial/ethnic/language groups for 3-4-year-olds. For 5-17-year-olds, diagnosis age varied by race/ethnicity/language and also by ASD severity. In this group, NHW children with mild/moderate ASD had a significantly higher proportion (50.8 %) of later diagnoses than NHB (33.5 %) or Hispanic-Other children (18.0 %). However, NHW children with severe ASD had a comparable or lower (albeit non-significant) proportion (16.4 %) of later diagnoses than NHB (37.8 %), Hispanic-English (30.8 %), and Hispanic-Other children (12.0 %). While NHW children have comparable ASD prevalence and diagnosis age distributions as Hispanic-English children, they have both higher prevalence and proportion of later diagnoses than NHB and Hispanic-Other children. The diagnosis age findings were limited to mild/moderate cases only. Thus, the prevalence disparity might be primarily driven by under-representation (potentially under-identification) of older children with mild/moderate ASD in the two minority groups.
authors.affiliation: Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, MS-E86, 1600 Clifton Road, Atlanta, GA, 30333, USA, heejoojo@usc.edu.
authors.forename: Heejoo
authors.initials: H
authors.lastname: Jo
authors.forename: Laura A
authors.initials: LA
authors.lastname: Schieve
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Rice
authors.forename: Marshalyn
authors.initials: M
authors.lastname: Yeargin-Allsopp
authors.forename: Lin H
authors.initials: LH
authors.lastname: Tian
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Blumberg
authors.forename: Michael D
authors.initials: MD
authors.lastname: Kogan
authors.forename: Coleen A
authors.initials: CA
authors.lastname: Boyle
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D000067877:Autism Spectrum Disorder / Q000175:diagnosis* / Q000208:ethnology; D044383:Black People / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007802:Language; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D044469:Racial Groups; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data