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(SDAS) Family Adversity and Health Disparities for Young Children with Autism


  • Toddlerhood (13-35 months)
  • Early Childhood (3-5 years)
  • Middle Childhood (6-11 years)
  • Adolescence (12-18 years)

Targeted/Underserved Population

  • African American
  • Hispanic/Latino
  • Asian/Pacific Islander


The disparities experienced by children with autism spectrum disorders (ASD) from racial and ethnic minority backgrounds are well-documented. However, little research has focused on family and community contextual factors, beyond socioeconomic status, that may underlie these observed racial/ethnic disparities in ASD diagnosis and treatment. Individuals with disabilities as well as adults from racial and ethnic minority backgrounds both report high numbers of adverse childhood experiences (ACES). ACES have been inversely linked to poorer adult well-being outcomes, such as physical health, mental illness and health behaviors and have been found to negatively impact access and utilization of health care. Based on the Anderson's (1995) Behavioral Model of Health Care Use in which enabling/inhibiting factors, such family and community-level variables, influence access and use of health care services (Andersen 1995), we hypothesize that greater stressors in a family's environment (adverse family experiences/ACES) will adversely impact the ability of minority caregivers to access and mobilize health care resources for their child with ASD and that conversely, family and community engagement may facilitate access to ASD services. Using the 2011-12 National Survey of Children's Health, the proposed study will explore 1) how adverse family experiences (modified ACES scale) contribute to the well-described disparities in ASD diagnosis and treatment among children from underrepresented minority groups and 2) what role individual and community protective factors may play in ameliorating these disparities through the following aims. In Aim 1, we will compare the frequency and type of adverse family experiences reported by racial/ethnic minority and White families. In Aim 2, we will create a statistical model to explain the relationship between adverse family experiences, ethnic minority status, and receipt of and timing of ASD diagnosis and treatment. In Aim 3, we will expand the statistical model to account for family and community factors that influence the relationship between adverse family experiences and timing and receipt of ASD diagnosis and treatment. Results of the proposed research could be used to design and develop targeted family supports and community interventions to reduce racial/ethnic disparities in early ASD diagnosis and treatment.


Listed is descending order by year published.

Berg KL, Shiu CS, Acharya K, Stolbach BC, Msall ME. Disparities in adversity among children with autism spectrum disorder: a population‐based study. Dev Med Child Neurol. 2016;58(11):1124-31.

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