The 130th Annual Meeting of APHA

Abstract #33251

David S Mandell, ScD¹, John Listerud, Md, PhD¹, Susan E Levy, MD², and Jennifer A Pinto-Martin, PhD³. (1) Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA 19104, (215) 662-2504, mandelld@mail.med.upenn.edu, (2) Children's Seashore House, Children's Hospital of Philadelphia, 3405 Civic Center Blvd, Philadelphia, PA 19104, (3) University of Pennsylvania School of Nursing, 420 Guardian Drive, Room 419 NEB, Philadelphia, PA 19104

PURPOSE: to examine racial differences in 1) the age at which children first receive an autistic spectrum disorder (ASD) diagnosis, and 2) time spent in the mental health system until an ASD diagnosis is received. BACKGROUND: Research suggests that the earlier children with ASD enter treatment, the better their outcomes. Recent studies suggest that there are there are no differences by race in the prevalence or incidence of autism; however, studies have found significant differences in practice regarding the assignation of psychiatric diagnoses, use of mental health services and treatment. METHODS: Using Medicaid mental health claims from Philadelphia, Pennsylvania, 406 children were identified who received services in 1999 related to a diagnosis of ASD. Medicaid claims from 1993-1999 were used to identify the date that children had their first specialty mental health visit, date of first diagnosis, and the number of visits occurring between those two dates. Linear regression was used to examine the relationship among race, age at first diagnosis of autistic spectrum disorder, time in mental health treatment and number of visits until the diagnosis was made. RESULTS: On average, white children were first diagnosed with autism at 6.3 years of age, compared with 7.9 years for African-American children. African-American children had an average of 13 visits over 10 months before a diagnosis of ASD was made, compared with four visits over four months for white children. CONCLUSIONS: The disparities found in this study may be the result of differences in help-seeking, advocacy and support, and clinician behaviors.

Learning Objectives: At the conclusion of this session, participants will

• understand the core features of autistic disorder;
• be aware of factors associated with the delayed diagnosis of this disorder;
• be able to list three reasons why early recognition of autistic disorder is important;
• list three possible reasons race may play a role in the delayed diagnosis of autism;
• be aware of the strengths and limitations of using administrative data to study low-prevelance, potentially disabling conditions such as autism.

Keywords: Child and Adolescent Mental Health, African American

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.