Community Testing Practices for Autism within the Autism and Developmental Disabilities Monitoring Network
- Author(s)
- Ashley Robinson Williams, Esther Amoakohene, Matthew Maenner, Walter Zahorodny, Monica DiRienzo, Andrea Grzybowski, Jennifer A Hall-Lande, Elise T. Pas, Amanda Bakian, Maya Liza Lopez, Mary Patrick, Josephine Shenouda, Kelly Shaw
Description
Background: No data exist at the population level on what tests are used to aid in the diagnosis of autism spectrum disorder in community practice.
Objectives: To describe autism spectrum disorder testing practices to inform autism spectrum disorder identification efforts.
Methods: Data are from the Autism and Developmental Disabilities Monitoring Network, a multi-site surveillance system reporting prevalence estimates and characteristics of 8-year-old children with autism spectrum disorder. Percentages of children with autism spectrum disorder who received any autism spectrum disorder test or a "gold standard" test were calculated by site, sex, race, median household income, and intellectual ability status. Risk ratios were calculated to compare group differences.
Results: Of 5058 8-year-old children with autism spectrum disorder across 11 sites, 3236 (64.0%) had a record of any autism spectrum disorder test, and 2136 (42.2%) had a "gold standard" ADOS or ADI-R test. Overall, 115 children (2.3%) had both the ADOS and ADI-R in their records. Differences persisted across race, median household income, and intellectual ability status. Asian/Pacific Islander children had the highest percent receiving any ASD test (71.8%; other groups range: 57.4–66.0%), and White children had the highest percent receiving "gold standard" tests (46.4%; other groups range: 35.6–43.2%). Children in low-income neighborhoods had a lower percentage of any test (62.5%) and "gold standard" tests (39.4%) compared to medium (70.2% and 47.5%, respectively) and high (69.6% and 46.8%, respectively) income neighborhoods. Children with intellectual disability had a lower percentage of any ASD test (81.7%) and "gold standard" tests (52.6%) compared to children without intellectual disability (84.0% and 57.6%, respectively).
Conclusions: Autism spectrum disorder testing practices vary widely by site and differ by race and presence of co-occurring intellectual disability, suggesting opportunities to standardize and/or improve autism spectrum disorder identification practices.
Suggested Citation
Details
- Date
- 2024
- Type
- Peer-Reviewed Article
- Publisher
- Wiley