Department of Communication Sciences and Disorders, North Carolina Central University, Durham, North Carolina, USA.
Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Autism Res. 2024 Jun;17(6):1072-1082. doi: 10.1002/aur.3168. Epub 2024 May 28.
Recent findings from the Centers for Disease Control and Prevention's (CDC) Autism and Developmental Disabilities Monitoring (ADDM) Network's 2020 prevalence report indicate that disparities in autism diagnoses between Black and White youth have narrowed, reflecting improved screening, awareness, and access to services (Maenner et al., 2023. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C.: 2002), 72, 1-14.). Claims of reducing disparities beyond prevalence rates, however, are not fully supported, as indicated by the reality that Black youth whose screenings indicate autistic traits are still not being referred for full evaluation or early intervention services at the same rate as their White peers (Major et al., 2020. Autism, 24, 1629-1638; Smith et al., 2020. Pediatrics, 145, S35-S46.). Black 8-year-olds identified as autistic still experience disparate educational placements (Waitoller et al., 2010. The Journal of Special Education. 44, 29-49.) where services may not be autism-specific or have Individual Education Plan goals only focused on "behavior problems" (Severini et al., 2018. Journal of Autism and Developmental Disorders, 48, 3261-3272.), are served in the most restrictive environments (Skiba et al., 2006. Exceptional Children, 72, 411-424.) and lack consistent augmentative and alternative communication support (Pope et al., 2022. American Journal of Speech-Language Pathology, 31, 2159-2174.). Additionally, ADMM researchers report consistent disparities in the identification of co-occurring intellectual disability where Black autistic children have significantly more co-occurrences than White autistic children. The purpose of this commentary is to first examine the assertion that the narrowed gap indicates, "…improved…access to services among historically underserved groups," (p. 9) (Maenner et al., 2023. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C.: 2002), 72, 1-14.). We will then recommend strategies to address the ongoing disparities.
最近，疾病控制与预防中心（CDC）自闭症和发育障碍监测（ADDM）网络的 2020 年患病率报告中的发现表明，黑人和白人青少年自闭症诊断的差异已经缩小，这反映了筛查、意识和服务获取方面的改善（Maenner 等人，2023. 发病率和死亡率周报. 监测摘要（华盛顿特区：2002），72, 1-14.）。然而，声称在患病率之外缩小了差距并没有得到充分支持，因为现实情况是，那些筛查显示具有自闭症特征的黑人青少年仍未像他们的白人同龄人那样被转介进行全面评估或早期干预服务（Major 等人，2020. 自闭症，24, 1629-1638；Smith 等人，2020. 儿科学，145, S35-S46.）。被确定为自闭症的黑人 8 岁儿童仍然面临不同的教育安置（Waitoller 等人，2010. 特殊教育杂志. 44, 29-49.），这些服务可能不是针对自闭症的，或者个人教育计划目标仅关注“行为问题”（Severini 等人，2018. 自闭症杂志和发育障碍，48, 3261-3272.），在最受限制的环境中服务（Skiba 等人，2006. 特殊儿童，72, 411-424.），缺乏一致的辅助和替代沟通支持（Pope 等人，2022. 美国言语语言听力杂志，31, 2159-2174.）。此外，ADMM 研究人员报告称，在共同发生智力残疾的识别方面存在一致的差异，黑人自闭症儿童的共同发生率明显高于白人自闭症儿童。本评论的目的首先是审查缩小差距表明，“……改善……服务获取机会，为历史上服务不足的群体提供服务”（第 9 页）（Maenner 等人，2023. 发病率和死亡率周报. 监测摘要（华盛顿特区：2002），72, 1-14.）。然后，我们将建议解决持续存在的差距的策略。
