Parents' reports of children's autism symptoms differ by race, study finds

December 6, 2017, Georgia State University
Credit: Georgia State University

Racial differences in parents' reports of concerns about their child's development to healthcare providers may contribute to delayed diagnosis of autism spectrum disorder (ASD) in black children, according to a study led by Georgia State University.

The study found that compared to white parents, black parents reported significantly fewer concerns related to symptoms of ASD in their children with the disorder. Black parents were less likely than white parents to report concerns about two ASD symptoms - social deficits and restricted and repetitive behaviors. The findings are published in the journal Autism.

Many parents begin reporting concerns about ASD during the child's first two years of life, and on average, children are diagnosed with ASD around their fourth birthday. However, black children are diagnosed with ASD at older ages than white children and children of other races. They are also nearly twice as likely as children of other races to be misdiagnosed with disruptive behavior disorders before receiving an ASD diagnosis.

Few studies have explored potential reasons for the racial disparity in ASD diagnosis, though some researchers have suggested unequal access to healthcare and clinician prejudice as explanations. Another possibility is that black parents may report concerns to healthcare providers in ways that de-emphasize ASD symptoms and focus on disruptive behaviors, which may hinder providers from adequately considering ASD. This study offered insight into delayed ASD diagnosis in black children by examining whether the concerns parents reported to providers about their child's development prior to diagnosis differed based on a parent's race.

Previous studies have found parents' characteristics influence their reports of concerns about their child's development. For instance, parents of lower socioeconomic status (SES) reported fewer concerns about their child's development than parents of higher SES. Also, parents of boys reported concerns about their child's development later than parents of girls.

Race may also influence parents' reports of concerns about their child's development. Studies of other neurodevelopmental disorders, such as ADHD, have found that black parents tend to underreport their children's ADHD symptoms and interpret ADHD symptoms as disruptive behavior. This phenomenon may also extend to ASD.

Participants in this study were 174 toddlers from metro Atlanta and Connecticut, ages 18- to 40-months, and their parents. The children were screened for risk, and those who screened positive were invited to a free diagnostic evaluation. Before the evaluation, their parents completed questions soliciting concerns about their child's behavior and development. Their responses were grouped into 10 categories of concerns, which were classified as either autism concerns (including speech/communication, social and restricted and repetitive behavior concerns) or non-autism concerns (including motor, general and disruptive behavior concerns).

The researchers found black parents reported fewer autism concerns than white parents. Race did not affect parent report of non-autism concerns, suggesting that the effect was specific to concerns about symptoms of ASD. Race did not influence parents' reports of concerns.

Race significantly affected how parents reported concerns about their children's social deficits and restricted and repetitive behaviors. Compared to black parents, white parents were 2.61 times more likely to report a social concern and 4.12 times more likely to report a concern about restricted and repetitive behaviors.

The findings have important clinical implications. Lower reporting of autism concerns by black may affect healthcare providers' abilities to identify who need further screening or evaluation.

"Reduced reporting of ASD symptoms may contribute to missed or delayed diagnosis in , since healthcare providers often rely on parent about typical ," said Meghan Rose Donohue, a co-author of the study and Ph.D. candidate in clinical psychology at Georgia State.

Explore further: Healthcare providers' responses to parental concerns can delay diagnosis of autism spectrum disorders

More information: Meghan Rose Donohue et al. Race influences parent report of concerns about symptoms of autism spectrum disorder, Autism (2017). DOI: 10.1177/1362361317722030

Related Stories

Healthcare providers' responses to parental concerns can delay diagnosis of autism spectrum disorders

April 15, 2015
Children with autism spectrum disorder (ASD) can develop symptoms before 2 years of age and usually can be diagnosed by 3 years of age; early identification of ASD is associated with improved long-term developmental outcomes. ...

Can a parent's concerns predict autism?

April 23, 2015
As co-director of the University of Alberta's Autism Research Centre, Lonnie Zwaigenbaum has devoted much of his career to understanding how to identify autism as early as possible. But despite his years of experience, Zwaigenbaum ...

Back-to-school worries for parents? 1 in 3 very concerned bullying, cyberbullying

August 21, 2017
Parents may also experience some nerves as their children prepare to head back to school.

Therapy for kids with autism pays off for moms, dads

August 11, 2017
(HealthDay)—Behavioral therapy for children with autism also benefits their parents, a new study finds.

Music therapy for children with autism does not improve symptoms

August 8, 2017
Among children with autism spectrum disorder, improvisational music therapy resulted in no significant difference in symptom severity compared to children who received enhanced standard care alone, according to a study published ...

Black, Hispanic children with autism more likely to regress than whites

May 6, 2014
Some children with autism appear to be developing normally when they are very young. They babble or even talk, make eye contact with their parents, and crawl and walk on schedule. Then suddenly, these skills seem to vanish.

Recommended for you

Scientists just beginning to understand autistic adults' unique health needs

May 11, 2018
In the 1990s, the prevalence of autism spectrum disorder (ASD) among children rose sharply. These children are now entering adulthood, yet physicians and scientists know very little about the health outcomes they might face. ...

Meet Nao, the robot that helps treat kids with autism

May 9, 2018
(HealthDay)—It may seem counterintuitive, but a robot might help kids with autism interact better with humans.

New study links strong pupillary light reflex in infancy to later autism diagnosis

May 7, 2018
A new study published in Nature Communications shows that infants who are later diagnosed with autism react more strongly to sudden changes in light. This finding provides support for the view that sensory processing plays ...

Scientists find possible autism biomarker in cerebrospinal fluid

May 2, 2018
Autism diagnosis is slow and cumbersome, but new findings linking a hormone called vasopressin to social behavior in monkeys and autism in people may change that. Low vasopressin in cerebrospinal fluid was related to less ...

New research shows that children with autism are able to create imaginary friends

May 2, 2018
Playing with an imaginary companion (IC) helps children learn essential social skills such as empathy with other people. It is often believed that autistic youngsters are incapable of creating pretend play pals—a further ...

EEG signals accurately predict autism as early as three months of age

May 1, 2018
Autism is challenging to diagnose, especially early in life. A new study in the journal Scientific Reports shows that inexpensive EEGs, which measure brain electrical activity, accurately predict or rule out autism spectrum ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.