Prospects for Leveling the Playing Field for Black Children With Autism - 29/08/23
, Anna M. Abbacchi, MS b, Brandon K. May, PhD, MSW, BCBA-D b, Cheryl Klaiman, PhD c, Yi Zhang, MS b, Jennifer K. Lowe, PhD d, Natasha Marrus, MD, PhD b, Ami Klin, PhD c, Daniel H. Geschwind, MD, PhD dRésumé |
Among the many race-based health disparities that have persistently plagued the US population,1 the disproportionate burden of adverse neurodevelopmental outcomes to Black children affected by autism spectrum disorder (ASD) is particularly devastating given its major lifelong consequences. Recently, in 3 successive reports from the Autism and Developmental Disabilities Monitoring (ADDM) program of the US Centers for Disease Control and Prevention (CDC) (birth cohort years 2014, 2016, and 2018), we and our collaborators reported that although the prevalence of community-diagnosed ASD had equalized for Black and non-Hispanic White (NHW) children in the United States, there has persisted a pronounced racial disparity in the proportion of ASD-affected children with comorbid intellectual disability (ID), on the order of 50% for Black children with ASD vs 20% for White children with ASD.2 Here, we provide data to support the following: much earlier diagnosis is possible; early diagnosis alone is not likely to close the ID comorbidity disparity; and judicious efforts over care as usual are necessary to ensure that Black children have access to timely implementation of developmental therapy, for which we observed promising associations with improved cognitive and adaptive outcomes in our sample.
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| Dr. Constantino and Ms. Abbacchi contributed equally to this work. |
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| This work was made possible by National Institutes of Health (NIH) Grant R01 MH100027 (Daniel H. Geschwind, P.I.), NIH Grant P50 HD103525 (John N. Constantino, P.I.), and a gift from the Steward Family Foundation to Washington University. |
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| This article is part of a special series devoted to addressing bias, bigotry, racism, and mental health disparities through research, practice, and policy. The series is edited by Assistant Editor Eraka Bath, MD, Deputy Editor Wanjikũ F.M. Njoroge, Associate Editor Robert R. Althoff, MD, PhD, and Editor-in-Chief Douglas K. Novins, MD. |
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| Author Contributions Conceptualization: Constantino, Abbacchi, Lowe, Marrus, Klin, Geschwind Data curation: Constantino Formal analysis: Constantino, Abbacchi, Klaiman, Zhang Funding acquisition: Constantino, Klin, Geschwind Investigation: Constantino, Abbacchi, Klin, Geschwind Methodology: Constantino, Abbacchi, May, Klaiman, Lowe, Klin, Geschwind Project administration: Constantino, Abbacchi, May, Klaiman, Lowe Resources: Constantino Software: Constantino Supervision: Constantino, Abbacchi, May, Klaiman, Lowe, Klin, Geschwind Validation: Constantino Visualization: Constantino Writing – original draft: Constantino, Abbacchi, May, Klaiman Writing – review and editing: Constantino, Abbacchi, Lowe, Marrus, Klin, Geschwind |
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| The authors gratefully acknowledge the commitment of the participating families to promote and ensure equity in the science and clinical treatment of autism spectrum disorder (ASD) and the support of clinical diagnostic and intervention planning efforts in St. Louis made possible through the Waitlist Reduction and Training Services program of the Missouri Department of Mental Health. |
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| Disclosure: Dr. Constantino has received royalties from Western Psychological Services for the commercial distribution of the Social Responsiveness Scale (SRS-2). Dr. Klin is inventor of technologies deployed by EarliTec Diagnostics, Inc., of which he is an equity holder. EarliTec is a company that develops medical devices for early diagnosis of ASD and gives a portion of its revenue to support treatment of children with ASD. Drs. May, Klaiman, Lowe, Marrus, and Geschwind and Mss. Abbacchi and Zhang have reported no biomedical financial interests or potential conflicts of interest. |
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| All statements expressed in this column are those of the authors and do not reflect the opinions of the Journal of the American Academy of Child and Adolescent Psychiatry. See the Guide for Authors for information about the preparation and submission of Letters to the Editor. |
Vol 62 - N° 9
P. 949-952 - septembre 2023 Retour au numéro
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