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Cited by 116Autism Spectrum Disorder ResearchChild Nutrition and Feeding IssuesFamily and Disability Support Research

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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.

Open access
Jo, Heejoo, Schieve, Laura A., Rice, Catherine E., Yeargin-Allsopp, Marshalyn, Tian, Lin H., Blumberg, Stephen J., Kogan, Michael D., Boyle, Coleen A.·2015·Maternal and Child Health Journal
DOI 10.1007/s10995-015-1683-4PMC PMC4500845
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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.

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Fig. 1 Estimated prevalence of CSHCN aged 3–17 years with ASD by race/ethnicity/language, United States, 2009–2010. Racial/ethnic and primary household language groups were categorized as: 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). aPrevalence estimate is significantly different from NHW children
Fig. 1 Estimated prevalence of CSHCN aged 3–17 years with ASD by race/ethnicity/language, United States, 2009–2010. Racial/ethnic and primary household language groups were categorized as: 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). aPrevalence estimate is significantly different from NHW childrenCC BY · PubMed Central
Fig. 2 Estimated prevalence of ASD by race/ethnicity/language, parent-assessed severity, and age at diagnosis among children aged 5–17 years at survey, United States, 2009–2010. Weighted prevalence estimates are per 1000 non-institutionalized children in the US population. aAge at diagnosis is <5 years. bAge at diagnosis is ≥5 years. c P < 0.05 two-tailed z test comparing the prevalence estimate within each race/ethnicity/language group to the prevalence estimate among NHW children
Fig. 2 Estimated prevalence of ASD by race/ethnicity/language, parent-assessed severity, and age at diagnosis among children aged 5–17 years at survey, United States, 2009–2010. Weighted prevalence estimates are per 1000 non-institutionalized children in the US population. aAge at diagnosis is <5 years. bAge at diagnosis is ≥5 years. c P < 0.05 two-tailed z test comparing the prevalence estimate within each race/ethnicity/language group to the prevalence estimate among NHW childrenCC BY · PubMed Central

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Metadata

Authors
Jo, H., Schieve, L. A., Rice, C. E., Yeargin-Allsopp, M., Tian, L. H., Blumberg, S. J., Kogan, M. D., & Boyle, C. A.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Health Resources and Services Administration (US)
Corresponding author
Jo, Heejoo
ORCID
Venue
Maternal and Child Health Journal
Publisher
Springer Science and Business Media LLC
Published
2015-02-21
Volume
19
Issue
8
Pages
1687-1697
ISSN
  • 1092-7875 (ISSN-L)
  • 1573-6628
DOI
10.1007/s10995-015-1683-4
PMC
PMC4500845
OpenAlex
W2118526446
Cited by
116
References
53
Citations by year
2026: 1 · 2025: 8 · 2024: 7 · 2023: 11 · 2022: 15 · 2021: 19 · 2020: 18 · 2019: 10 · 2018: 6 · 2017: 10 · 2016: 8 · 2015: 2
FWCI
5.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Maternal and Child Health Journal (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
National Institutes of Health (CC999999)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
  • Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
Keywords
autism spectrum disorder, age at diagnosis, racial and ethnic disparities, Hispanic children, non-Hispanic Black children, autism prevalence, ASD severity, underidentification, children with special health care needs
MeSH terms
Autism Spectrum Disorder, Adolescent, Black or African American, Child, Child, Preschool, Ethnicity, Family Characteristics, Female, Health Surveys, Hispanic or Latino, Humans, Language, Male, Population Surveillance, Severity of Illness Index, Socioeconomic Factors, United States, Prevalence, Black People, White People, Racial Groups

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