Disparities in Diagnostic Categories Among Latinx Children within the Fragile Families and Child Wellbeing Study

Background:

Latinx child has vastly grown in the US population. Recent data from the CDC indicates that the gap in rate of autism spectrum diagnosis between Latinx and non-Latinx white children has decreased over time. However, disparities in the types of developmental diagnoses that Latinx children receive have persisted over time and across sociodemographics.

Objectives:

To explore racial/ethnic differences in diagnoses of developmental disabilities among a sample of primarily unmarried mothers. Present data that indicates disparities in autism diagnoses between Latinx and non-Latinx white children.

Methods:

This study analyzed used data collected from multiple waves of the Fragile Families and Child Wellbeing study, in order to take into account important demographic factors as well as socio-economic factors associated with likelihood to have developmental disorder. The key predictor, race of mother, was gather in wave 1 (birth). In addition, from the same time point, mother’s age, mother’s marital status at baby birth, country of origin, and child gender were collected. From wave 4 (5 years old), parent’s report on child’s social problems, withdrawn symptoms, and internal behavioral symptoms were collected. Data in wave 5 (9 years old) provided diagnosis of developmental disorders that we focus on. Wave 5 also provided data regarding whether parents were married or cohabiting, maternal education, five-categories of Federal Poverty Line, child’s age in months, number of children under 18 years old living in mother’s household. By using baseline and follow-up surveys, we created a binary variable indicating whether a child had a disruption of insurance coverage over 9 years since their birth. First, multivariate logistic regression was used to assess racial disparities in likelihood of diagnosis of four developmental illnesses of focus and any diagnosis. In addition, we conducted multivariate multinomial regression to assess relative likelihood of diagnosis of ADD/ADHD, ID/DD, and language disorders over Autism to assess a question whether Latinx mothers are particularly subject to misdiagnosis of autism.

Results:

A series of multivariate logistic regression provided evidence for racial disparities in diagnosis of developmental disabilities even after controlling for key covariates. Compared to non-Latino mom, Latinx mothers were 0.58 times less likely to have their kids to diagnosed with ADD/ADHD (p<.01). Regarding Autism, Latinx mom were 0.08 times less likely to have their kids to diagnosed when compared to non-Latinx mothers (p<.01). Findings from multivariate multinomial regression showed racial disparities on likelihood to be diagnosed with ASD was most conspicuous, in particular for Latinx mothers of children with any developmental disorder. Compared to non-Latinx mothers, Latinx mothers were 6.12 times more likely to have their kids diagnosed with ADD/ADHD over Autism (p<.05). Latinx mothers were 16.98 times (p<.01) and 10.41 (p<.01) times more likely to have their kids diagnosed with ID/DD and language disorder, respectively, over autism.

Conclusions:

The results indicate that Latinx children are less likely to be diagnosed with ASD. These results suggest disparities in the diagnostic process among Latinx children, particularly when there is a healthcare disruption. Implications for reducing disparities are discussed.