Racial Differences in Developmental Regression in Children With Autism Spectrum Disorders
BACKGROUND: Autism Spectrum Disorders (ASD) are common neurodevelopmental disorders that occur in 1 in 88 children. It has been reported that approximately one third of children with ASD have developmental regression. While there are no reported gender differences in rates of regression, it is unknown whether there are racial disparities in rates of regression.
OBJECTIVE: To determine the rate of developmental regression, and whether racial disparities exist in the rate of regression, among preschool-aged children in the Autism Treatment Network (ATN) database.
DESIGN/METHODS: Subjects included all non-Hispanic Black, non-Hispanic White, and Hispanic children ages 37-71 months in the ATN database with data from a parent form reporting whether each child experienced developmental regression. The rate of reported developmental regression was determined, and the rate of regression by race was evaluated. Logistic regression analysis was performed controlling for primary caregiver education, insurance status, and prior diagnosis of autism.
RESULTS: Among 2030 preschool-aged children in the ATN database, 1353 were included in the study. Of the children included in the study, 26.5% were reported to have experienced developmental regression. When controlling for insurance, primary caregiver education, and prior ASD diagnosis, there was a significant association between developmental regression and race (p=0.0004).
Non-Hispanic Black children were at about twice the odds of regression compared to non-Hispanic White children (OR 2.06, 95% CI 1.39-3.06, p=0.0004); and
Hispanic children are at about 1.5 times the odds of regression compared to non-Hispanic White children (OR 1.51, 95% CI 1.04-2.18, p=0.0301).
CONCLUSIONS: Approximately one quarter of the preschool-aged children with ASD in the ATN database were reported to have experienced developmental regression. Non-Hispanic Black and Hispanic preschool-aged children with ASD were significantly more likely to have developmental regression than non-Hispanic White preschool-aged children when controlling for several factors. Given this novel finding about autistic regression, further studies are needed to elucidate factors contributing to these racial/ethnic disparities in rates of regression in children with ASD.
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