학술논문

Timing of the Diagnosis of Autism in African American Children
Document Type
article
Source
Pediatrics. 146(3)
Subject
Cognitive and Computational Psychology
Biomedical and Clinical Sciences
Psychology
Clinical Research
Pediatric
Autism
Brain Disorders
Behavioral and Social Science
Mental Health
Prevention
Intellectual and Developmental Disabilities (IDD)
Aetiology
2.4 Surveillance and distribution
Mental health
Black or African American
Age Factors
Autism Spectrum Disorder
Child
Child
Preschool
Databases
Genetic
Delayed Diagnosis
Female
Humans
Male
Medical and Health Sciences
Psychology and Cognitive Sciences
Pediatrics
Biomedical and clinical sciences
Health sciences
Language
Abstract
ObjectivesAfrican American (AA) children affected by autism spectrum disorder (ASD) experience delays in diagnosis and obstacles to service access, as well as a disproportionate burden of intellectual disability (ID) as documented in surveillance data recently published by the US Centers for Disease Control and Prevention. Our objective in this study was to analyze data from the largest-available repository of diagnostic and phenotypic information on AA children with ASD, and to explore the wide variation in outcome within the cohort as a function of sociodemographic risk and specific obstacles to service access for the purpose of informing a national approach to resolution of these disparities.MethodsParents of 584 AA children with autism consecutively enrolled in the Autism Genetic Resource Exchange across 4 US data collection sites completed event history calendar interviews of the diagnostic odysseys for their children with ASD. These data were examined in relation to developmental outcomes of the children with autism and their unaffected siblings.ResultsThe average age of ASD diagnosis was 64.9 months (±49.6), on average 42.3 months (±45.1) after parents' first concerns about their children's development. The relationship between timing of diagnosis and ASD severity was complex, and ID comorbidity was not predicted in a straightforward manner by familial factors associated with cognitive variation in the general population.ConclusionsThese findings document significant opportunity to expedite diagnosis, the need to further understand causes of ID comorbidity, and the necessity to identify effective approaches to the resolution of disparities in severity-of-outcome for AA children with autism.