Spotlight On Closing the Racial and Ethnic Gaps in the Identification of Autism Spectrum Disorder among 8-year-old Children

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The Autism and Developmental Disabilities Monitoring (ADDM) Network data found no overall difference in the percent of Black, White, Hispanic, and Asian or Pacific Islander children identified with ASD by 8 years of age in 2018. However, disparities still exist in some communities.

This finding is consistent with data from the ADDM Network for the 2016 surveillance year, published in March 2020. While significant progress has been made in closing the gap in the identification of ASD among 8-year-old children in certain racial and ethnic populations, the percent of Hispanic children identified with ASD was still lower in several communities when compared to White or Black children.

These findings, among 8-year-olds, may indicate that efforts to promote ASD identification are working but suggest that more can be done to improve ASD identification particularly among Hispanic children. Studies have shown that stigma, lack of access to healthcare services, and non-English primary language are potential barriers to identification of children with ASD, especially among Hispanic children (2). More work is needed to improve identification of ASD within Hispanic communities.

For the first time, the ADDM Network reported data on the percent of American Indian or Alaska Native (AI/AN) children identified with ASD. The percent of 8-year-old AI/AN children identified with ASD was slightly higher compared to White children; and similar to Black, Hispanic, and Asian or Pacific Islander children. Additional efforts are needed to collect more data on AI/AN children to provide a more detailed picture of ASD identification and access to services among this group.

Differences continue in ASD identification among Black children with co-occurring intellectual disability.

Although progress has been made in the equitable identification of ASD, concerns remain around the percentage (49.8%) of Black children identified with ASD and intellectual disability (ID), which is high compared to White or Hispanic children. ID is often seen in children with ASD and can indicate a type of substantial impairment. More work is needed to understand why this disparity continues to exist. A high percentage of children identified with ASD and ID might suggest a need for improvement in the evaluation and early identification of developmental concerns in children when a cognitive impairment is not present.

Future directions

The racial and ethnic gap in the identification of ASD are narrowing among 8-year-old children, and targeted community outreach and efforts to have all children screened for ASD are ongoing. The ADDM Network will continue to monitor the number and characteristics of children with ASD to find out if these patterns continue to change over time. This information can help states and communities develop and evaluate strategies to increase awareness and improve identification of ASD and referral to services.