Kim Hyejung, Karakaya Muhammet Furkan, Skinner Mandy, Baker Diana
Binghamton University, Binghamton, NY, 13902, USA.
Hobart and William Smith Colleges, Geneva, NY, USA.
J Autism Dev Disord. 2025 Mar;55(3):1010-1030. doi: 10.1007/s10803-024-06247-z. Epub 2024 Feb 28.
In recent years, the Autism and Developmental Disabilities Monitoring Network has observed a shift in racial disparities in autism. To delineate the historical shift of racial disproportionality in US autism prevalence, our literature review examines three key topics: publication trends concerning racial disproportionality in autism, discernible national and state-level patterns, and underlying factors contributing to the disproportionality. Using the PRISMA framework, we synthesized 24 empirical studies on racial disproportionality in autism and its change over time. These studies explored national patterns and spatiotemporal variations to provide a comprehensive understanding of racial disparities in autism. Studies indicated similar national patterns for Black and Asian racial groups; both groups had had mixed results around the turn of the millennium. By 2007, the Asian group was overrepresented again. Hispanic and Native American groups have consistently been underrepresented. However, significant spatiotemporal variations were found, suggesting that these disparities might reflect inherent inequalities within the current identification and classification system. The patterns of racial disproportionality in autism seem to be influenced by numerous factors. These include varying state definitions of autism, disparities in resource distribution, differences in symptom recognition across cultures, service preferences, cultural mismatches between professionals and families, and prevailing biases and stigmas, as revealed by the reviewed studies. These findings prompt a closer look into the causes and implications of these disparities, offering the underlying issues within the current diagnostic system and highlighting the need for further research to ensure equal educational opportunities regardless of disabilities and race/ethnicity.
近年来，自闭症与发育障碍监测网络观察到自闭症种族差异的转变。为了描绘美国自闭症患病率中种族不均衡的历史转变，我们的文献综述考察了三个关键主题：关于自闭症种族不均衡的发表趋势、可辨别的国家和州层面模式，以及造成这种不均衡的潜在因素。我们使用PRISMA框架，综合了24项关于自闭症种族不均衡及其随时间变化的实证研究。这些研究探索了国家模式和时空变化，以全面了解自闭症的种族差异。研究表明，黑人和亚裔种族群体在全国呈现出相似的模式；在千年之交前后，这两个群体的结果都参差不齐。到2007年，亚裔群体再次占比过高。西班牙裔和美国原住民群体一直占比过低。然而，研究发现了显著的时空变化，这表明这些差异可能反映了当前识别和分类系统中固有的不平等。自闭症种族不均衡的模式似乎受到多种因素的影响。这些因素包括各州对自闭症的不同定义、资源分配的差异、不同文化间症状识别的差异、服务偏好、专业人员与家庭之间的文化不匹配，以及综述研究所揭示的普遍偏见和污名。这些发现促使我们更深入地研究这些差异的原因和影响，揭示当前诊断系统中的潜在问题，并强调需要进一步研究以确保无论残疾状况和种族/族裔，都能获得平等的教育机会。
