Disparities in Diagnoses Received Prior to a Diagnosis of Autism Spectrum Disorder

This study estimated differences by ethnicity in the diagnoses assigned prior to the diagnosis of autism. In this sample of 406 Medicaid-eligible children, African-Americans were 2.6 times less likely than white children to receive an autism diagnosis on their first specialty care visit. Among children who did not receive an autism diagnosis on their first visit, ADHD was the most common diagnosis. African-American children were 5.1 times more likely than white children to receive a diagnosis of adjustment disorder than of ADHD, and 2.4 times more likely to receive a diagnosis of conduct disorder than of ADHD. Differences in diagnostic patterns by ethnicity suggest possible variations in parents’ descriptions of symptoms, clinician interpretations and expectations, or symptom presentation.

[1]  E. Fombonne,et al.  Validation of the diagnosis of autism in general practitioner records , 2004, BMC public health.

[2]  M. Aman,et al.  Pharmacotherapy for Hyperactivity in Children with Autism and Other Pervasive Developmental Disorders , 2000, Journal of autism and developmental disorders.

[3]  Thyde M Dumont-Mathieu,et al.  Screening for autism in young children: The Modified Checklist for Autism in Toddlers (M-CHAT) and other measures. , 2005, Mental retardation and developmental disabilities research reviews.

[4]  M. Cuccaro,et al.  Brief report: Professional perceptions of children with developmental difficulties: The influence of race and socioeconomic status , 1996 .

[5]  C. Rice,et al.  Prevalence of autism in a US metropolitan area. , 2003, JAMA.

[6]  W. Stone,et al.  Early Concerns of Parents of Children With Autistic and Nonautistic Disorders , 2004 .

[7]  Margaret A. Pericak-Vance,et al.  Investigation of autism and GABA receptor subunit genes in multiple ethnic groups , 2006, Neurogenetics.

[8]  S. Bölte,et al.  Stability and Interpersonal Agreement of the Interview-Based Diagnosis of Autism , 2001, Psychopathology.

[9]  Cynthia D. Zubritsky,et al.  Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders , 2005, Pediatrics.

[10]  M. Cuccaro,et al.  Professional perceptions of children with developmental difficulties: the influence of race and socioeconomic status. , 1996, Journal of autism and developmental disorders.

[11]  M. Abrahamowicz,et al.  Profile of Referrals for Early Childhood Developmental Delay to Ambulatory Subspecialty Clinics , 2001, Journal of child neurology.

[12]  Judith A. Hall,et al.  Improving physicians' interviewing skills and reducing patients' emotional distress. A randomized clinical trial. , 1995, Archives of internal medicine.

[13]  Helen Tager-Flusberg,et al.  A principal components analysis of the Autism Diagnostic Interview-Revised. , 2003, Journal of the American Academy of Child and Adolescent Psychiatry.

[14]  J. Constantino,et al.  Validation of a Brief Quantitative Measure of Autistic Traits: Comparison of the Social Responsiveness Scale with the Autism Diagnostic Interview-Revised , 2003, Journal of autism and developmental disorders.

[15]  J. Listerud,et al.  Race differences in the age at diagnosis among medicaid-eligible children with autism. , 2002, Journal of the American Academy of Child and Adolescent Psychiatry.

[16]  Y Nagai,et al.  Parental perception of behavioral symptoms in Japanese autistic children , 1987, Journal of autism and developmental disorders.

[17]  Margaret A. Pericak-Vance,et al.  Factor Analysis of Restricted and Repetitive Behaviors in Autism Using the Autism Diagnostic Interview-R , 2003, Child psychiatry and human development.

[18]  Eric Fombonne,et al.  Autism Spectrum Disorders: Early Detection, Intervention, Education, and Psychopharmacological Management , 2003, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[19]  F. Glascoe Parents' concerns about children's development: prescreening technique or screening test? , 1997, Pediatrics.

[20]  David S Mandell,et al.  The role of culture in families' treatment decisions for children with autism spectrum disorders. , 2005, Mental retardation and developmental disabilities research reviews.

[21]  Branko Cesnik,et al.  What do medical students know about computers? , 1993, The Medical journal of Australia.

[22]  C. Hoven,et al.  Depressive and disruptive disorders and mental health service utilization in children and adolescents. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[23]  F. Minow,et al.  Evaluation of attention problems in children with autism and children with a specific language disorder , 2001, European Child & Adolescent Psychiatry.

[24]  M. Prior,et al.  Comparison of clinical symptoms in autism and Asperger's disorder. , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[25]  C. Lord,et al.  Autism from 2 to 9 years of age. , 2006, Archives of general psychiatry.

[26]  S. Larson,et al.  Pediatric Residents' Responses That Discourage Discussion of Psychosocial Problems in Primary Care , 2005, Pediatrics.

[27]  E. Fombonne Epidemiological Surveys of Autism and Other Pervasive Developmental Disorders: An Update , 2003, Journal of autism and developmental disorders.

[28]  N. Powe,et al.  Race, gender, and partnership in the patient-physician relationship. , 1999, JAMA.

[29]  J. Pinto-Martin,et al.  Characteristics of Children with Autistic Spectrum Disorders Served in Comprehensive Community-based Mental Health Settings , 2005, Journal of autism and developmental disorders.

[30]  Tony Charman,et al.  Screening and surveillance for autism and pervasive developmental disorders , 2022 .

[31]  G. Baird,et al.  Outcome at 7 years of children diagnosed with autism at age 2: predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time. , 2005, Journal of child psychology and psychiatry, and allied disciplines.

[32]  L. Lotspeich,et al.  Behavioral phenotypic variation in autism multiplex families: evidence for a continuous severity gradient. , 2002, American journal of medical genetics.

[33]  E. Bonde Comorbidity and subgroups in childhood autism , 2000, European Child & Adolescent Psychiatry.

[34]  M. Stewart,et al.  Communication patterns of primary care physicians. , 1997, JAMA.

[35]  Patricia Howlin,et al.  Diagnosis in Autism , 1997 .

[36]  M. Cuccaro,et al.  Race and gender differences in the treatment of psychiatric disorders in young adolescents. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[37]  G. Remington,et al.  Clomipramine Versus Haloperidol in the Treatment of Autistic Disorder: A Double-Blind, Placebo-Controlled, Crossover Study , 2001, Journal of clinical psychopharmacology.

[38]  M. Beach,et al.  Delving below the surface. Understanding how race and ethnicity influence relationships in health care. , 2006, Journal of general internal medicine.

[39]  B. Bernstein,et al.  Pediatricians' Approaches to Developmental Problems: Has the Gap Been Narrowed? , 1994, Journal of developmental and behavioral pediatrics : JDBP.

[40]  Deborah D. Hatton,et al.  Problem behavior in boys with fragile X syndrome. , 2002, American journal of medical genetics.

[41]  E. Fombonne,et al.  Pervasive developmental disorders in preschool children. , 2001, JAMA.

[42]  Tamara C Daley From symptom recognition to diagnosis: children with autism in urban India. , 2004, Social science & medicine.

[43]  D. Drotar,et al.  How Do Primary Care Physicians Identify Young Children with Developmental Delays? A National Survey , 2003, Journal of developmental and behavioral pediatrics : JDBP.

[44]  A. Pumariega,et al.  Influence of race on diagnosis in adolescent psychiatric inpatients. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[45]  D. Kearney,et al.  How good is general practice developmental screening? , 1990, BMJ.

[46]  T. Mcguire,et al.  Statistical discrimination in health care. , 2001, Journal of Health Economics.

[47]  Kalpna Shah What Do Medical Students Know about Autism? , 2001, Autism : the international journal of research and practice.

[48]  S. Goldstein,et al.  The Comorbidity of Pervasive Developmental Disorder and Attention Deficit Hyperactivity Disorder: Results of a Retrospective Chart Review , 2004, Journal of autism and developmental disorders.

[49]  C. Dirksen,et al.  Outpatient Psychotherapy for Borderline Personality Disorder Randomized Trial of Schema-Focused Therapy vs Transference-Focused Psychotherapy , 2014 .

[50]  H. Moss,et al.  Psychologic adjustment of human immunodeficiency virus-infected school-age children. , 1994, Journal of developmental and behavioral pediatrics : JDBP.

[51]  S. Bryson,et al.  Reliability and accuracy of differentiating pervasive developmental disorder subtypes. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[52]  G. Baird,et al.  Diagnosis of autism , 2003, BMJ : British Medical Journal.

[53]  T. Mcguire,et al.  Testing for statistical discrimination in health care. , 2005, Health services research.

[54]  D. Mandell,et al.  Disparities in the reporting and treatment of health conditions in children: an analysis of the Medical Expenditure Panel Survey. , 2006, Health services research.