Journal of the American Academy of Child & Adolescent Psychiatry
ARTICLESRace Differences in the Age at Diagnosis Among Medicaid-Eligible Children With Autism
Section snippets
Subjects
All 406 children and adolescents in this sample were Medicaideligible residents of Philadelphia County during fiscal year 1999. They all had birth dates between January 1983 and May 1996. All received at least two Medicaid claims in FY 1999 for specialty mental health services related to a diagnosis of autistic disorder (ICD-9 code 299.00). Because data on diagnoses and service utilization were available starting from July 1992, and it was important for the purposes of this study to have
RESULTS
Table 1 provides information on the characteristics of the sample by race. African-American children were, on average, the oldest group, while white children were the youngest. The same was true of the amount of time eligible for Medicaid before the autistic disorder diagnosis was made. On average, white children first received their autism diagnosis at 6.3 years of age, compared with 7.9 years for African-American children and 8.8 years for Latino children. On average, white children entered
DISCUSSION
The results of this study suggest that large and important racial differences exist in the detection and diagnosis of children with autistic disorder. In this study, African-American children received their diagnosis on average a year and a half later than white children. While white children entered mental health services at an earlier age, this difference did not explain the difference in the age at diagnosis. Once in treatment, African-American children required three times the number of
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This work was supported by grants from the Centers for Disease Control (CCU32094) and the National Institute of Mental Health (5T32MH019292-12).