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Cited by 267Autism Spectrum Disorder ResearchFamily and Disability Support ResearchChild Nutrition and Feeding Issues

Parental Socioeconomic Status and Risk of Offspring Autism Spectrum Disorders in a Swedish Population-Based Study

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Rai, Dheeraj, Lewis, Glyn, Lundberg, Michael, Araya, Ricardo, Svensson, Anna, Dalman, Christina, Carpenter, Peter, Magnusson, Cecilia·2012·Journal of the American Academy of Child & Adolescent Psychiatry
DOI 10.1016/j.jaac.2012.02.012
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Abstract

Objective Epidemiological studies in the United States consistently find autism spectrum disorders (ASD) to be overrepresented in high socioeconomic status (SES) families. These findings starkly contrast with SES gradients of many health conditions, and may result from SES inequalities in access to services. We hypothesized that prenatal measures of low, not high, parental SES would be associated with an increased risk of offspring ASD, once biases in case ascertainment are minimized.Method We tested this hypothesis in a population-based study in Sweden, a country that has free universal healthcare, routine screening for developmental problems, and thorough protocols for diagnoses of ASD. In a case-control study nested in a total population cohort of children aged 0 to 17 years living in Stockholm County between 2001 and 2007 (N = 589,114), we matched ASD cases (n = 4,709) by age and sex to 10 randomly selected controls. We retrieved parental SES measures collected at time of birth by record linkage.Results Children of families with lower income, and of parents with manual occupations (OR = 1.4, 95% CI = 1.3-1.6) were at higher risk of ASD. No important relationships with parental education were observed. These associations were present after accounting for parental ages, migration status, parity, psychiatric service use, maternal smoking during pregnancy, and birth characteristics; and regardless of comorbid intellectual disability.Conclusions Lower, not higher, socioeconomic status was associated with an increased risk of ASD. Studies finding the opposite may be underestimating the burden of ASD in lower SES groups.

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  • European countries report increased ASD prevalence among lower socioeconomic status families.

    “The U.S. reports a consistent pattern of increased ASD prevalence among higher socioeconomic status (SES) families (Baio et al. 2018; Durkin et al. 2010, 2017; Maenner et al. 2020; Pedersen et al. 2012), while European countries report increased prevalence among lower SES families (Delobel-Ayoub et al. 2015; Emerson 2012; Rai et al. 2012).”

    From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Rai et al. 2012

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  • The inconsistency in the association between SES and autism prevalence may reflect differences in availability and affordability of health services in countries like Sweden and France, but not in other countries like the United States.

    “For example, the inconsistency in the association between SES and autism prevalence may reflect differences in availability and affordability of health services in countries like Sweden (Rai et al., 2012) and France (Delobel‐Ayoub et al., 2015), but not in other countries like the United States (Durkin et al., 2017).”

    From Global prevalence of autism: A systematic review update (2022) · cites this paper as Rai et al., 2012

  • The country pattern may reflect different practices of autism screening and health services access between the U.S. and Scandinavian countries, and this hypothesis has direct data support.

    “These patterns may reflect different practices of autism screening and health services access between the U.S. vs. Scandinavian countries, and this hypothesis has direct data support.60”

    From Environmental Chemical Exposures and Autism Spectrum Disorders: A Review of the Epidemiological Evidence (2014) · cites this paper as [60]

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  1. [54]54. Dodds L, Fell DB, Shea S, Armson BA, Allen AC, Bryson S. The role of prenatal, obstetric and neonatal factors in the development of autism. J Autism Dev Disord. 2011;41:891-902.
  2. [55]55. Emerson E. Deprivation, ethnicity and the prevalence of intellec- tual and developmental disabilities. J Epidemiol Community Health. 2012;66:218-224.
  3. [56]56. Windham GCF. Autism spectrum disorders in relation to parental occupation in technical fields. Autism Res. 2009;2:183-191.
  4. [57]57. Daniels JL, Forssen U, Hultman CM, et al. Parental psychiatric disorders associated with autism spectrum disorders in the offspring. Pediatrics. 2008;121:e1357-e1362.
  5. [58]58. Williams E, Thomas K, Sidebotham H, Emond A. Prevalence and characteristics of autistic spectrum disorders in the ALSPAC cohort. Dev Med Child Neurol. 2008;50:672-677.
  6. [59]59. Bhasin T, Schendel D. Sociodemographic risk factors for au- tism in a US metropolitan area. J Autism Dev Disord. 2007;37: 667-677.
  7. [60]60. Larsson HJ, Eaton WW, Madsen KM, et al. Risk factors for autism: perinatal factors, parental psychiatric history, and socioeconomic status. Am J Epidemiol. 2005;161:916-925.
  8. [61]61. Croen LA, Grether JK, Selvin S. Descriptive epidemiology of autism in a California population: who is at risk? J Autism Dev Disord. 2002;32:217-224.
  9. [62]62. Fombonne E, Simmons H, Ford T, Meltzer H, Goodman R. Prevalence of pervasive developmental disorders in the British nationwide survey of child mental health. J Am Acad Child Adolesc Psychiatry. 2001;40:820-827.
  10. [63]63. Burd LS. Prenatal and perinatal risk factors for autism. J Perinat Med. 1999;27:441-450.

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Authors
Rai, D., Lewis, G., Lundberg, M., Araya, R., Svensson, A., Dalman, C., Carpenter, P., & Magnusson, C.
Affiliations
  • Avon and Wiltshire Mental Health Partnership NHS Trust (GB)
  • University of Bristol (GB)
  • Karolinska Institutet (SE)
Corresponding author
Rai, Dheeraj
ORCID
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2012-05
Volume
51
Issue
5
Pages
467-476.e6
ISSN
0890-8567 (ISSN-L)
DOI
10.1016/j.jaac.2012.02.012
OpenAlex
W2083052241
Semantic Scholar
0974235495fcbdf31ab5cf115fa528575b620f80
Cited by
267
References
53
Citations by year
2026: 12 · 2025: 16 · 2024: 15 · 2023: 23 · 2022: 27 · 2021: 23 · 2020: 25 · 2019: 28 · 2018: 19 · 2017: 15 · 2016: 9 · 2015: 21 · 2014: 18 · 2013: 11 · 2012: 4
FWCI
8.84
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Bristol Research (University of Bristol) (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
Stockholms Läns Landsting (2007008)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
autism spectrum disorder, parental socioeconomic status, low socioeconomic status, parental income, parental occupation, ASD risk factors, case ascertainment bias, universal health care, Stockholm County
MeSH terms
Adolescent, Child, Child Development Disorders, Pervasive, Child, Preschool, Cross-Sectional Studies, Educational Status, Employment, Female, Humans, Income, Infant, Infant, Newborn, Male, Intellectual Disability, Parents, Pregnancy, Risk Factors, Social Class, Sweden, Cohort Studies, Comorbidity, Case-Control Studies

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