Community Testing Practices for Autism within the Autism and Developmental Disabilities Monitoring Network

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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

Robinson Williams, A., Amoakohene, E., Maenner, M. J., Zahorodny, W., DiRienzo, M., Grzybowski, A., Hall‐Lande, J., Pas, E. T., Bakian, A. V., Lopez, M., Patrick, M., Shenouda, J., & Shaw, K. A. (2024). Community testing practices for autism within the autism and developmental disabilities monitoring network. Paediatric and Perinatal Epidemiology. https://doi.org/10.1111/ppe.13077

Details

Date
2024 
Type
Peer-Reviewed Article 
Publisher
Wiley