Zhu YiQin, Davis Naomi O, Franz Lauren, Goldstein Benjamin, Green Jennifer, Herkert Darby, Howard Jill, Reed Alexander, Spanos Marina, Dawson Geraldine
Duke University School of Medicine, 8 Searle Center Drive, Durham, NC, 27710, USA.
Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27705, USA.
J Autism Dev Disord. 2024 Oct 7. doi: 10.1007/s10803-024-06582-1.
We sought to understand whether a child's sex, age, race, ethnicity, caregiver education, family income, and/or number of endorsed autism signs are associated with a caregiver's decision to pursue an autism diagnostic evaluation after their child received a positive autism screen.
129 children, 17-30 months, received a positive autism screen on the Modified Checklist for Autism in Toddlers-Revised with Follow-Up, and all caregivers were offered ready access to a diagnostic evaluation by a trained professional in English or Spanish at no cost.
88 children received an evaluation and 41 did not. The likelihood of receiving an evaluation was associated with the child's race. Only 58.1% of Black children were evaluated, compared to 80% of Hispanic/Latino and 88.5% of White children. Children of Spanish-speaking caregivers showed high rates of evaluation completion (85.7%). Children who were evaluated versus were not evaluated did not significantly differ in terms of child's sex, number of autism signs endorsed by the caregiver, caregiver's education and preferred language (English versus Spanish), or household income.
Even though the present study removed many common barriers to receiving a timely diagnostic evaluation, caregivers of Black children were less likely to pursue an autism diagnostic evaluation for their child. Future research is needed to understand the needs and perspectives of Black families to promote engagement in clinical care and reduce disparities in receiving a timely autism diagnosis which is important for accessing supports and services that can improve children's outcomes.
我们试图了解儿童的性别、年龄、种族、族裔、照料者教育程度、家庭收入和/或认可的自闭症症状数量是否与照料者在其孩子自闭症筛查呈阳性后决定寻求自闭症诊断评估有关。
129名17至30个月大的儿童在《改良幼儿自闭症检查表（修订版）及随访》中自闭症筛查呈阳性，所有照料者均可免费获得由专业人员用英语或西班牙语提供的诊断评估服务。
88名儿童接受了评估，41名未接受评估。接受评估的可能性与儿童的种族有关。只有58.1%的黑人儿童接受了评估，相比之下，西班牙裔/拉丁裔儿童的这一比例为80%，白人儿童为88.5%。说西班牙语的照料者的孩子评估完成率较高（85.7%）。接受评估和未接受评估的儿童在性别、照料者认可的自闭症症状数量、照料者的教育程度和首选语言（英语与西班牙语）或家庭收入方面没有显著差异。
尽管本研究消除了许多接受及时诊断评估的常见障碍，但黑人儿童的照料者为其孩子寻求自闭症诊断评估的可能性较小。需要进一步研究以了解黑人家庭的需求和观点，以促进他们参与临床护理，并减少在及时获得自闭症诊断方面的差距，这对于获得能够改善儿童预后的支持和服务至关重要。
