SAN FRANCISCO – Hispanic children with autism were nearly twice as likely to have a learning disability or speech problem compared with their peers in an analysis of data on 913 children with autism spectrum disorders.
The presence of these co-occurring conditions might help explain why Hispanic children are diagnosed with autism at lower rates and at older ages compared with white non-Hispanic children, Stephanie E. Bean hypothesized.
Stephanie E. Bean
The higher rate of diagnosed "speech problems" in Hispanic children is not surprising, since many Hispanic households speak more than one language at home, she said in a poster presentation and interview at the annual meeting of the American Academy of Child and Adolescent Psychiatry.
"Because language delay is a factor of autism, it might be that the speech problem masks the autism spectrum disorder diagnosis," said Ms. Bean, a graduate student in public health at Johns Hopkins University, Baltimore.
The researchers adjusted for the effects of parental education and socioeconomic status.
Ms. Bean and her associates analyzed data from a subset of the National Survey of Children's Health drawn from phone interviews with parents of children aged 3-17 years who had a current autism spectrum disorder diagnosis. Average age was 10 years, and 10% were Hispanic.
Previous data from the Autism and Developmental Disabilities Monitoring Network suggest that the U.S. prevalence of autism spectrum disorders in 2008 was 12 per 1,000 in non-Hispanic white children, 10 per 1,000 in non-Hispanic blacks, and 8 per 1,000 in Hispanics (MMWR 2012;61[SS03]:1-19). A separate study of Medicaid records of children with autism showed that African American children were diagnosed 18 months later than were white children, on average, and Hispanic children received diagnoses even later (J. Am. Acad. Child. Adolesc. Psychiatry 2002;41:1447-53).
Another report suggested that psychiatric and neurodevelopmental conditions co-occurring with autism might lead to diagnostic misclassification and delay some children with autism spectrum disorders from receiving the early interventions that produce the greatest improvements, Ms. Bean said (Pediatrics 2012 Jan. 23 [doi:10.1542/peds.2011-1717]).
In the current study, anxiety disorders were 78% less likely in the 7% of children who were African American, compared with the 82% of white children. (Hispanics can be of any race.) This is in line with a previous study showing lower rates of anxiety diagnoses in African American children, she noted (J. Am. Acad. Child Adolesc. Psychiatry 1995;34:67-72).
No significant associations were found between race/ethnicity and other problems that commonly co-occur with autism, including attention-deficit/hyperactivity disorder, developmental delays, depression, behavior or conduct problems, epilepsy or seizure disorders, or hearing problems.
Learning disability was the most common co-occurring condition in the cohort as a whole, affecting 75% of children, and 87% of the children had an individualized education program. Mothers were the survey respondents in 79% of cases, and 74% of parents had achieved more than a high school diploma. Parents reported that 48% had family incomes greater than 300% of the federal poverty level, that 96% of children were insured at the time of the survey, and that 95% had been insured consistently over the prior year.
Ms. Bean reported having no financial disclosures.