Racial/Ethnic Disparities in the Identification of Children With Autism Spectrum Disorders
Racial/Ethnic Disparities in the Identification of Children With Autism Spectrum Disorders
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DOI：
10.2105/ajph.2007.131243
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发表时间：
2009-03-01
影响因子：
12.7
通讯作者：
Kirby, Russell S.
中科院分区：
文献类型：
--
作者：
Mandell, David S.;Wiggins, Lisa D.;Kirby, Russell S.
目标.我们试图研究种族和民族的差异，在认识自闭症谱系障碍（ASD）。在一个多站点网络中，通过从多个来源提取评估记录，确定了2568名8岁儿童符合ASD监测标准。通过对研究中心随机效应的逻辑回归分析，我们估计了种族/民族与记录的ASD之间的关联，并对性别、智商、出生体重和母亲教育进行了调整。58%的儿童患有自闭症谱系障碍。在校正分析中，黑人（比值比[OR] = 0.79; 95%置信区间[CI] = 0.64，0.96）、西班牙裔（OR=0.76; CI = 0.56，0.99）或其他种族/民族（OR= 0.65; CI = 0.43，0.97）的儿童比白色儿童更不可能有记录的ASD。这种差异在黑人儿童中持续存在，无论智商如何，当智商低于70时，这种差异集中在其他种族的儿童中。严重的种族/民族不平等存在于ASD的承认。对于某些种族/族裔群体中的某些儿童，智力残疾的存在可能会影响专业人员对发育迟缓的进一步评估。我们的研究结果表明，需要继续专业教育有关的异质性介绍ASD。(Am J公共卫生。2009;99：493-498. doi：10.2105/AJPH.2007.131243）
Objectives. We sought to examine racial and ethnic disparities in the recognition of autism spectrum disorders (ASDs).Methods. Within a multisite network, 2568 children aged 8 years were identified as meeting surveillance criteria for ASD through abstraction of evaluation records from multiple sources. Through logistic regression with random effects for site, we estimated the association between race/ethnicity and documented ASD, adjusting for gender, IQ, birthweight, and maternal education.Results. Fifty-eight percent of children had a documented autism spectrum disorder. In adjusted analyses, children who were Black (odds ratio [OR] = 0.79; 95% confidence interval [CI] = 0.64, 0.96), Hispanic (OR=0.76; CI = 0.56, 0.99), or of other race/ethnicity (OR= 0.65; CI = 0.43, 0.97) 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 lower than 70.Conclusions. Significant racial/ethnic dispatrities exist in the recognition of ASD. For some children in some racial/ethnic groups, the presence of intellectual disability may affect professionals' further assessment of developmental delay. Our findings suggest the need for continued professional education related to the heterogeneity of the presentation of ASD. (Am J Public Health. 2009;99: 493-498. doi:10.2105/AJPH.2007.131243)