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Autistic Minority Children Less Likely to Receive Specialty Care

Update Date: Jun 17, 2013 11:13 AM EDT
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Minority children with autism are significantly less likely than white children to have received sub-specialty care or procedures related to conditions that accompany autism spectrum disorders, according to a new study.

Past studies have found that African-American and Hispanic children with autism are generally diagnosed at a later age than white children.  However, the latest study is the first to describe disparities in the use of specialty services in gastroenterology, psychiatry or psychology.

"We think there are probably many reasons for these differences," lead researcher Dr. Sarabeth Broder-Fingert, of MassGeneral Hospital for Children and the Center for Child and Adolescent Health Research and Policy at Massachusetts General Hospital (MGH), said in a news release.

"Many autism-related medical symptoms - including gastrointestinal issues like constipation and neuropsychiatric issues such as anxiety or sleep disorders - are not well understood, so doctors may not realize children are having those symptoms," she added.

Researchers looked at records for more than 3,6000 patients aged 2 to 21 with a diagnosis of autism who received care at the Massachusetts General Hospital or its affiliated health centers from 2000 through 2010. Researchers analyzed data on each clinical visit, focusing particularly on specialty care in gastroenterology, psychiatry and psychology and to procedures including endoscopy, ultrasound, EEG, brain imaging and sleep studies.

Researchers said that 81 percent of the patients in the study were white, 5 percent were African-American and 7 percent were Hispanic.

The findings revealed that minority children were significantly less likely to have received either subspecialty care or procedures, with some of the most significantly differences in gastroenterology services, which were given to almost 14 percent of white children, but only 9 percent of African-American children and 10 percent of Hispanic children. Researchers said that minority children were less likely to have received an endoscopy or colonoscopy, and Hispanic children were much less likely to have had sleep studies or other neurological or neuropsychiatric tests.

"We know that many children with autism have gastrointestinal or sleep issues, and if those problems are not being diagnosed or treated, they can lead to additional behavior difficulties that can inhibit development," said Broder-Fingert. "Combining the challenges of accessing specialty services for any child with autism, regardless of race or ethnicity, with the recognized difficulties minority communities have accessing medical care in general can lead to these major disparities in the use of services."

Researchers said the next step is to study whether these differences in service use lead to differences in medical and behavioral outcomes.

"We hope this work can help doctors be aware of these disparities and be sure to look out for patients - especially minority patients - who might need specialty services, and that we can help parents of children with autism be aware that these conditions may occur in their children and ask their doctors for assistance," Broder-Fingert concluded.

The findings are published in the journal Pediatrics.

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