Lindsay Sally, Li Yiyan, Joneja Simran, Hsu Shaelynn
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto.
Disabil Rehabil. 2025 Mar;47(5):1061-1080. doi: 10.1080/09638288.2024.2364823. Epub 2024 Jun 12.
Although the health benefits of early diagnosis and therapeutic approaches for children and youth with autism spectrum disorder (ASD), racial disparities persist. This systematic review explored the experiences of racism and racial disparities in health care among children and youth with ASD and their caregivers.
We conducted a systematic review, drawing on six international databases. Two reviewers screened titles, abstracts, and full texts. Thirty-seven studies met our inclusion criteria and we applied a narrative synthesis to develop themes.
Four themes were identified: (1) experiences and aspects of racism and racial disparities (i.e., language and cultural barriers, poor quality health care interactions, stereotypes and discrimination, family and community stigma, and indirect barriers); (2) racial disparities in health care (i.e., screening and referral, diagnosis, health care services, and care coordination and medication); (3) facilitators to accessing health care services; and (4) recommendations from caregivers.
This review highlights the extensive racial disparities experienced by children with autism. More research is needed to explore youth's perspectives on racism in addition to exploring potential interventions to address racial disparities and improve health equity for youth with ASD.
尽管早期诊断和治疗方法对自闭症谱系障碍(ASD)儿童和青少年有益健康,但种族差异依然存在。本系统评价探讨了患有ASD的儿童和青少年及其照顾者在医疗保健方面的种族主义经历和种族差异。
我们利用六个国际数据库进行了系统评价。两名评审员筛选了标题、摘要和全文。37项研究符合我们的纳入标准,我们采用叙述性综合分析法来确定主题。
确定了四个主题:(1)种族主义和种族差异的经历及方面(即语言和文化障碍、低质量的医疗保健互动、刻板印象和歧视、家庭和社区污名以及间接障碍);(2)医疗保健方面的种族差异(即筛查和转诊、诊断、医疗保健服务以及护理协调和用药);(3)获得医疗保健服务的促进因素;(4)照顾者的建议。
本评价突出了自闭症儿童所经历的广泛种族差异。除了探索解决种族差异和改善ASD青少年健康公平性的潜在干预措施外,还需要更多研究来探讨青少年对种族主义的看法。