Race and Ethnic Discrepancies in Developmental Surveillance and EI

Research shows that minority children are less likely than White children to be identified with an autism spectrum disorder (ASD) and are underrepresented in early intervention (EI). This may be due to the fact that minority children are less likely to begin the process of early ASD identification via developmental surveillance receipt from health care providers. Existing research on race ethnicity and early detection focuses primarily on developmental screening or developmental monitoring in isolation of one another. Recent work shows that the combination of developmental screening and monitoring is a better predictor of young children actually receiving early intervention referrals and other community based mental health services. Despite a large body of research investigating predictors of developmental screening very little work focuses on developmental monitoring --and almost none focuses on the conjoint receipt of screening and monitoring. The primary purpose of this project is to determine whether racial/ethnic discrepancies in the conjoint receipt of developmental screening and monitoring exist and if differences in developmental surveillance receipt predict racial/ethnic discrepancies of identified ASD in children under the age of 3. Furthermore additional analyses will rank states according to their (a) conjoint developmental screening and monitoring rates and (b) their racial/ethnic discrepancies in conjoint developmental screening and monitoring. These analyses address align with priority research and surveillance activities in the Autism Cares Act (2014) in that implementation of conjoint screening and monitoring improves value-based care delivery initiatives and targets a noted health workforce need that will improve access to EI and other mental health services for children with ASD. Analyses will use metrics available from the National Surveys of Children's Health (NSCH 2007; 2012; 2016; 2017) which are publicly available public health datasets that include variables related to developmental screening and monitoring. For all analyses data will first be analyzed from the NSCH (2007) to establish expected relationships and then replicate with data from the 2012 and 2016 iterations of the survey. We will conduct a series of logistic regression models stratifying on conjoint developmental screening and monitoring developmental screening or monitoring alone and no surveillance to determine if racial/ethnic discrepancies in ASD diagnosis differ according to developmental surveillance receipt. Furthermore we will conduct analyses displaying (a) state level variation in conjoint developmental screening and monitoring and (b) racial/ethnic discrepancies in receipt of conjoint developmental screening and monitoring. All state level analyses will be presented graphically with easy to interpret spatial coding mapping software. The dissemination plan includes early detection peerreviewed articles and one-pagers targeting policy makers on the relationship between conjoint screening and monitoring with ASD identification and early intervention.

Barger B, Benevides T, Riszk S, et al. Race/ethnic inequities in conjoint monitoring and screening for U.S. children 3 and under: disparities in monitoring and screening. Dis Health J. Preprint posted online August 13, 2021. doi:10.1016/j.dhjo.2021.101179 DOI:10.1016/j.dhjo.2021.101179 August 2021 Dis Health J.

Barger B, Rice C, Benevides T, Salmon A, Sanchez-Alvarez S, Crimmins D. Are developmental monitoring and screening better together for early autism identification across race and ethnic groups? J Autism Dev Disord. Published online March 5, 2021. doi:10.1007/s10803-021-04943-8 DOI:10.1007/s10803-021-04943-8 March 2021 33666797 J Autism Dev Disord.