The Autism Society Event and Education Recordings Archive

Discussed in this presentation will be the diagnostic disparities and functional challenges of Autism Spectrum Disorder (ASD) in ethnic minority populations, as African Americans and generally receive their diagnosis late and miss critical windows of opportunity to receive early intervention services. The learning objectives are: 1) identify diagnostic disparities in ASD in African American preschoolers, 2) identify diagnostic, participation, and performance challenges reported by parents of African American preschoolers with ASD and implications to professional practice, and 3) discuss recommendations for initiatives to improve early diagnosis of ASD in ethnic minority populations. The purpose of this study was to explore the relationship between symptom severity and functional difficulties with age at diagnosis for ASD, as well as describe the diagnostic experiences and functional challenges encountered by preschool-aged children of African American descent with ASD.

A sequential explanatory design was chosen for this mixed methods study to first quantitatively analyze responses from the 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) and then qualitatively gather personal accounts using interviews from parents of African American preschool-aged children with ASD. The research questions for this study were: 1) how does symptom severity relate to age of diagnosis, 2) how does the degree of reported functional challenges relate to age of diagnosis, and 3) how do parents describe adaptive functioning challenges related to performance and participation? Parents who responded to the NS-CSHCN and provided demographic responses identifying themselves as having a child of African American background with a diagnosis of ASD, as well as indicated ASD severity level and degree of functional challenges (N = 224), were selected for the quantitative component of the study using subpopulation features of SPSS® Version 21-Complex Samples. Qualitative participants were selected through convenience sampling (N = 3), as recruitment efforts were aimed at local clinical and community-based therapy providers who provide services to preschool-aged children with ASD and agreed to allow solicitation of their families for participation in this study. Initially a minimum of 5 qualitative participants were recruited who identified themselves as parents of a child under 6 years of age of African American descent with ASD, with 3 parents completing the study.

Regression analysis of the quantitative data from the NS-CSHCN questions related to age at diagnosis, degree of functional challenge, and ASD severity were first completed, being followed by qualitative interviews conducted using the Short Child Occupational Profile (SCOPE) Parent Interview Extended Format and Parent Report Form and later coded for themes using NVivo 10. No significant relationships were found using general linear between model for age at diagnosis and symptom severity or degree of functional challenges. Qualitative themes that emerged included challenges with the diagnosis process, routines and transitions, communication, family and home environment, and school and community environments. The results highlight the need to enhance screening for early signs of ASD and improve interventions to address challenges across multiple environments for children of ethnic minority backgrounds, with implication for practice being provided.