Demographic Correlates of Autism: How Do Associations Compare Between Diagnosis and a Quantitative Trait Measure?

Kristen Lyall; Aisha S Dickerson; Annette M Green; Seth Frndak; Lisa A Croen; Jennifer L Ames; Lyndsay A Avalos; Judy L Aschner; Nicole R Bush; Carlos A Camargo Jr; Viren D'Sa; Stephen R Dager; Anne L Dunlop; Assiamira Ferrara; Jody M Ganiban; James E Gern; Tre D Gissandaner; J Carolyn Graff; Irva Hertz-Picciotto; Alison E Hipwell; Tengfei Ma; Meghan Miller; Laura Murphy; Margaret R Karagas; Rachel S Kelly; Amy Margolis; Daphne Koinis-Mitchell; Cindy T McEvoy; Daniel Messinger; Ruby Nguyen; Emily Oken; Sally Ozonoff; Grier P Page; Susan L Schantz; Rebecca J Schmidt; Coral L Shuster; Julie B Schweitzer; Stephen J Sheinkopf; Joseph B Stanford; Cindy O Trevino; Scott T Weiss; Heather E Volk; Robert M Joseph; program collaborators for Environmental influences on Child Health Outcomes

doi:10.1002/aur.3296

Demographic Correlates of Autism: How Do Associations Compare Between Diagnosis and a Quantitative Trait Measure?

Autism Res. 2025 Jan 8. doi: 10.1002/aur.3296. Online ahead of print.

Authors

Kristen Lyall¹, Aisha S Dickerson², Annette M Green³, Seth Frndak², Lisa A Croen⁴, Jennifer L Ames⁴, Lyndsay A Avalos⁴, Judy L Aschner^{5

6}, Nicole R Bush⁷, Carlos A Camargo Jr⁸, Viren D'Sa⁹, Stephen R Dager¹⁰, Anne L Dunlop¹¹, Assiamira Ferrara⁴, Jody M Ganiban¹², James E Gern¹³, Tre D Gissandaner¹⁴, J Carolyn Graff¹⁵, Irva Hertz-Picciotto¹⁶, Alison E Hipwell¹⁷, Tengfei Ma¹⁸, Meghan Miller¹⁹, Laura Murphy²⁰, Margaret R Karagas²¹, Rachel S Kelly²², Amy Margolis¹⁴, Daphne Koinis-Mitchell⁹, Cindy T McEvoy²³, Daniel Messinger²⁴, Ruby Nguyen²⁵, Emily Oken²⁶, Sally Ozonoff¹⁹, Grier P Page³, Susan L Schantz²⁷, Rebecca J Schmidt¹⁹, Coral L Shuster²⁸, Julie B Schweitzer¹⁹, Stephen J Sheinkopf²⁹, Joseph B Stanford³⁰, Cindy O Trevino³¹, Scott T Weiss³², Heather E Volk³³, Robert M Joseph³⁴; program collaborators for Environmental influences on Child Health Outcomes

Collaborators

program collaborators for Environmental influences on Child Health Outcomes:
P B Smith, L K Newby, L P Jacobson, D J Catellier, R Gershon, D Cella

Affiliations

¹ AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA.
² Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
³ RTI International, Research Triangle Park, North Carolina, USA.
⁴ Division of Research, Kaiser Permanente Northern California, Pleasanton, California, USA.
⁵ Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA.
⁶ Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA.
⁷ Departments of Psychiatry and Pediatrics, University of California, San Francisco, California, USA.
⁸ Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁹ Department of Pediatrics, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
¹⁰ Department of Radiology, University of Washington, Seattle, WA, USA.
¹¹ Emory University School of Medicine, Atlanta, Georgia, USA.
¹² Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA.
¹³ Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
¹⁴ Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.
¹⁵ Departments of Health Promotion and Disease Prevention and Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
¹⁶ Department of Public Health Sciences, University of California Davis, Davis, California, USA.
¹⁷ Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
¹⁸ Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA.
¹⁹ Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis, Sacramento, California, USA.
²⁰ Department of Psychiatry and Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
²¹ Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
²² Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
²³ Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.
²⁴ Departments of Psychology and Pediatrics, University of Miami, Coral Gables, Florida, USA.
²⁵ Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
²⁶ Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA.
²⁷ Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
²⁸ Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA.
²⁹ University of Missouri, Columbia, Missouri, USA.
³⁰ Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah, USA.
³¹ University of Washington, Seattle, WA, USA.
³² Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
³³ Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA.
³⁴ Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA.

PMID: 39778060
DOI: 10.1002/aur.3296

Abstract

Prevalence of autism diagnosis has historically differed by demographic factors. Using data from 8224 participants drawn from the Environmental influences on Child Health Outcomes (ECHO) Program, we examined relationships between demographic factors and parent-reported autism-related traits as captured by the Social Responsiveness Scale (SRS; T score > 65) and compared these to relations with parent-reported clinician diagnosis of ASD, in generalized linear mixed effects regression analyses. Results suggested lower odds of autism diagnosis, but not of SRS T > 65, for non-Hispanic Black children (adjusted odds ratio [OR] = 0.76, 95% CI 0.55, 1.06) relative to non-Hispanic White children. Higher maternal education was associated with reduced odds of both outcomes (OR = 0.73, 95% CI 0.51, 1.05 for ASD autism diagnosis and 0.4, 95% CI 0.29, 0.55 for SRS score). In addition, results suggested a lower likelihood of autism diagnosis but a higher likelihood of an SRS score > 65 in Black girls. Findings suggest lower diagnostic recognition of autism in non-Hispanic Black children, despite a similar degree of SRS-assessed autism-related traits falling in the clinically elevated range. Further work is needed to address this disparity.

Keywords: autism; diagnosis; social responsiveness scale.

Grants and funding

NH/NIH HHS/United States