title: Disparities in adversity among children with autism spectrum disorder: a population-based study.
abstract: OBJECTIVE
  People with autism spectrum disorders (ASDs) experience disparities in health. An important but overlooked risk factor for health disparities in the ASD population is adverse childhood experiences (ACEs). The purpose of this study was to identify the prevalence of ACEs among families of children with and without ASD, using a population-based sample.
  
  
  METHODS
  Data from the 2011 to 2012 National Survey of Child Health were analyzed to estimate prevalence of ACEs among families of children with and without ASD, age 3 to 17 years (ASD=1611; estimated population=1 165 34). The child's ASD status was obtained from parent report; ACEs were assessed with the modified Adverse Childhood Experiences Scale. Bivariate and multinomial logistic regression analyses were utilized to investigate the relationship between ACEs and childhood ASD status.
  
  
  RESULTS
  ASD status among children was significantly and independently associated with higher probability of reporting one to three ACEs (adjusted relative risk ratio [aRRR] 1.53; 95% CI: 1.16-2.0; p<0.010) and four or more ACEs (aRRR 1.99; 95% CI: 1.35-2.91; p<0.010).
  
  
  CONCLUSIONS
  Children with ASD may experience a greater number of family and neighborhood adversities, potentially compromising their chances for optimal physical and behavioral health outcomes. Assessment and reduction of ACEs among families of young people with ASD could potentially contribute to the reduction of population health disparities.
authors.affiliation: Department of Rehabilitation Sciences, Temple University, Philadelphia, PA, USA. klberg@temple.edu.|Children's Hospital of Philadelphia, Philadelphia, PA, USA. klberg@temple.edu.
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Berg
authors.affiliation: School of Social Work, University of Washington, Seattle, WA, USA.
authors.forename: Cheng-Shi
authors.initials: CS
authors.lastname: Shiu
authors.affiliation: Department of Disability & Human Development, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Kruti
authors.initials: K
authors.lastname: Acharya
authors.affiliation: University of Chicago Medicine, Chicago, IL, USA.
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Stolbach
authors.affiliation: Department of Disability & Human Development, University of Illinois at Chicago, Chicago, IL, USA.|University of Chicago Comer Children's Hospital and Kennedy Research Center on Intellectual and Developmental Disabilities, Chicago, IL, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Msall
mesh_terms: D000293:Adolescent; D000067877:Autism Spectrum Disorder / Q000453:epidemiology*; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005190:Family; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D015995:Prevalence; D000067073:Psychological Trauma / Q000453:epidemiology*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012306:Risk; D014481:United States / Q000453:epidemiology