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Title: Racial/ethnic and Socioeconomic Differences in Screening Toddlers for Autism Spectrum Disorders Using the M-CHAT

Citation Type: Dissertation/Thesis

Publication Year: 2014

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Abstract: Universal screening of toddlers for autism spectrum disorder (ASD) in pediatric practice is recommended to potentially reduce racial/ethnic and socioeconomic disparities in timing of diagnosis. Early diagnosis of ASD has been associated with higher parent education and income but not with ethnicity in some studies, while others report that economically disadvantaged children and African American and Latino children are diagnosed later or not at all (Fombonne, 2003; Fountain, King, & Bearman, 2011; Liptak et al., 2008). Screening for ASD may currently be more common among lower income and minority children (Arunyanart et al., 2012). The current sample of 18,669 children was drawn from screening sites at the University of Connecticut (n = 9587, 51.4%) or Georgia State University (n = 9082, 48.6%). Socioeconomic status (SES) was estimated by Census Tract median income data. Most analyses compared children in the Majority group (White children; n= 6169, 68.9%) and the Minority group (all other racial/ethnic groups; n= 2789, 31.3%). Small but significant disparities by race/ethnicity, controlling for median income, were observed in child age at M-CHAT screening, age at M- CHAT Follow-up Interview (FUI), and time from M-CHAT to FUI. Black/African American and Latino children were screened and followed up at later ages, but not evaluated later, perhaps due to differential attrition. Minority and lower income children also had higher scores on the M- CHAT, but Majority and higher income children had higher scores on the M-CHAT FUI. Minority and lower income children screened positive more frequently on certain individual M- CHAT items, including all reverse-scored items, while Majority children screened positive more frequently on certain M-CHAT FUI items. Finally, positive predictive value (PPV) of the M- CHAT and M-CHAT FUI procedure did not differ by race/ethnicity, in contrast to previous studies. In conclusion, standardized screening procedures employed in the current study largely eliminated disparities in screening, follow-up, and evaluation for ASD in toddlers. Item response patterns also differed by both race/ethnicity and SES, underscoring the need for vigilance and support for parent understanding of M-CHAT items in pediatric practice.

Url: https://opencommons.uconn.edu/cgi/viewcontent.cgi?article=6656&context=dissertations

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Authors: Herlihy, Lauren, E

Institution: University of Connecticut

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Degree: Doctor of Philosophy

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Pages: 97

Data Collections: IPUMS NHGIS

Topics: Education, Health, Race and Ethnicity

Countries: United States