Lyall Kristen, Dickerson Aisha S, Green Annette M, Frndak Seth, Croen Lisa A, Ames Jennifer L, Avalos Lyndsay A, Aschner Judy L, Bush Nicole R, Camargo Carlos A, D'Sa Viren, Dager Stephen R, Dunlop Anne L, Ferrara Assiamira, Ganiban Jody M, Gern James E, Gissandaner Tre D, Graff J Carolyn, Hertz-Picciotto Irva, Hipwell Alison E, Ma Tengfei, Miller Meghan, Murphy Laura, Karagas Margaret R, Kelly Rachel S, Margolis Amy, Koinis-Mitchell Daphne, McEvoy Cindy T, Messinger Daniel, Nguyen Ruby, Oken Emily, Ozonoff Sally, Page Grier P, Schantz Susan L, Schmidt Rebecca J, Shuster Coral L, Schweitzer Julie B, Sheinkopf Stephen J, Stanford Joseph B, Trevino Cindy O, Weiss Scott T, Volk Heather E, Joseph Robert M
AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Autism Res. 2025 Mar;18(3):648-659. doi: 10.1002/aur.3296. Epub 2025 Jan 8.
Prevalence of autism diagnosis has historically differed by demographic factors. Using data from 8224 participants drawn from the Environmental influences on Child Health Outcomes (ECHO) Program, we examined relationships between demographic factors and parent-reported autism-related traits as captured by the Social Responsiveness Scale (SRS; T score > 65) and compared these to relations with parent-reported clinician diagnosis of ASD, in generalized linear mixed effects regression analyses. Results suggested lower odds of autism diagnosis, but not of SRS T > 65, for non-Hispanic Black children (adjusted odds ratio [OR] = 0.76, 95% CI 0.55, 1.06) relative to non-Hispanic White children. Higher maternal education was associated with reduced odds of both outcomes (OR = 0.73, 95% CI 0.51, 1.05 for ASD autism diagnosis and 0.4, 95% CI 0.29, 0.55 for SRS score). In addition, results suggested a lower likelihood of autism diagnosis but a higher likelihood of an SRS score > 65 in Black girls. Findings suggest lower diagnostic recognition of autism in non-Hispanic Black children, despite a similar degree of SRS-assessed autism-related traits falling in the clinically elevated range. Further work is needed to address this disparity.
从历史上看，自闭症诊断的患病率因人口统计学因素而异。利用来自环境对儿童健康结果（ECHO）项目的8224名参与者的数据，我们在广义线性混合效应回归分析中，研究了人口统计学因素与家长报告的社会反应量表（SRS；T分数>65）所捕捉的自闭症相关特征之间的关系，并将这些关系与家长报告的临床诊断为自闭症谱系障碍（ASD）的关系进行了比较。结果表明，相对于非西班牙裔白人儿童，非西班牙裔黑人儿童被诊断为自闭症的几率较低，但SRS的T分数>65的几率并不低（调整后的优势比[OR]=0.76，95%可信区间0.55，1.06）。母亲受教育程度较高与这两种结果的几率降低相关（ASD自闭症诊断的OR=0.73，95%可信区间0.51，1.05；SRS分数的OR=0.4，95%可信区间0.29，0.55）。此外，结果表明黑人女孩被诊断为自闭症的可能性较低，但SRS分数>65的可能性较高。研究结果表明，非西班牙裔黑人儿童对自闭症的诊断识别率较低，尽管SRS评估的自闭症相关特征在临床升高范围内的程度相似。需要进一步开展工作来解决这一差异。
