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Racial/ethnic disparities in the identification of children with autism spectrum disorders

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Authors:
Summary:

This US-based study sought to determine the association between race/ethnicity and documented autism spectrum disorders (ASDs) in a cohort of 2568 children aged 8 years who were identified as meeting surveillance criteria for ASD through abstraction of evaluation records from multiple sources. Fifty-eight percent of children had a documented autism spectrum disorder. Analyses adjusted for gender, IQ, birthweight, and maternal education revealed that children who were Black (OR, 0.79), Hispanic (OR, 0.76), or of other race/ethnicity (OR, 0.65) were less likely than were White children to have a documented ASD. This disparity persisted for Black children, regardless of IQ, and was concentrated for children of other ethnicities when IQ was <70.

Comment:
couldn’t find data on NZ rates of ASD by ethnicity but thought this paper raised an interesting issue. As the authors state, there are ethnic differences in the way clinicians report ASD; they are more likely to make a diagnosis of intellectual delay than ASD for Black and Hispanic children. This suggests that these children may be missing out on appropriate care. Dr Jill Bevan-Brown’s research at Massey identified unique issues for Māori whānau caring for someone with ASD. As a result, a DVD was produced for whānau and support agencies. ‘In my shoes’ was released in January 2009 and can be ordered through the following websites:
Reference: Am J Public Health. 2009;99(3):493-8.
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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