Study reveals the social justice problem of autism

A child with autism is more likely to do well if his mother is white and educated.

This is the message of a study just released in the journal Pediatrics, and it’s something we need to pay attention to—now.

Researchers from Columbia University wanted to find out what happens to children with autism over time. So they looked at the records of more than 6000 children with autism who were enrolled in California’s Department of Developmental Services  (DDS). To get into DDS they had to be referred, and their diagnosis had to be confirmed by someone with expertise in autism.

What they found was that when it came to social and communication skills, for the most part the kids fell into groups ranging from low-functioning to high functioning. The kids did make progress; the most rapid gains were before age six, and the high-functioning kids tended to make more progress than the low-functioning ones. Even as they made progress they tended to stay in the group they started in—with one notable exception. That exception was a group the researchers called the “Bloomers”. These kids were low-functioning when they were diagnosed, but made rapid gains and ended up as high-functioning.

The researchers also looked at the birth records of the children, which gave them facts about the mother’s age, race, place of birth, education level, and whether she was on Medi-Cal, the California version of Medicaid (the public insurance for low-income people). This is where it gets really interesting. They found that:

  • Kids in the low-functioning groups were more likely to have mothers who were non-white and/or foreign-born, less-educated, and on Medi-Cal
  • Kids in the high-functioning groups were more likely to have mothers who were white, more educated, and not on Medi-Cal
  • Bloomers were more likely to have mothers who were white and educated

This is a real social justice problem.

The researchers didn’t have information on what kinds of services or treatments the kids got, so they couldn’t give an explanation for what they found. But they guessed, as all of us might, that children with more educated and affluent mothers not only had better home and neighborhood environments, but access to more and better services—and parents who were more able to fight for those services.

That makes total sense to me as the pediatrician of many autistic children, and is a social justice problem in and of itself. But there is even more that worried me reading this article. Why, for example, were fewer poor and minority kids in the high-functioning group? Do they slip through the cracks entirely because they are muddling through, and never get diagnosed or get services? And why are there fewer white and affluent kids in the low-functioning group? Is there something about being poor or minority that makes autism worse from the beginning?

Just last week the Centers for Disease Control came out with the news that one in 88 children has autism, up 23 percent since 2009. It’s five times more common in boys—the rate for them is one in 54. And here’s what makes the Pediatrics article even more worrisome: the biggest increases were among Hispanic and black children—their rates of autism went up 110 percent and 91 percent, respectively.  Not only is this a social justice problem, it’s a public health problem.

There is hope for many children with autism—this study shows that clearly. But it is fundamentally unfair when hope—or lack of it—is an accident of birth.

We say that we are a country founded on the idea that all men are created equal. Autism just may test us on this. If all men are created equal, if all children are equally deserving of a good future, it’s time to get to work. It’s time to put real money and real energy into understanding autism’s inequalities—and ending them.






6 thoughts on “Study reveals the social justice problem of autism

  1. The results of this study could be applied to just about ANY medical or social problem that plagues children.  Let’s face it.  Racial and economic disparities severely affect outcomes.  How about asthma and obesity?  How about getting a basic education?

    It’s a beautiful idea that “all men are created equal” but who honestly believes that opportunities are equal for all children in this country???

  2. Well I dont think its a race thing. I think that people of more economic status are more likely to get better care. I had two pregnancies one on medicaid and one with private health insurance… Can you guess which pregnancy I was treated better and got more care? You guess it my SECOND pregnancy. If you have any type of aid you are not treated to the best of anyones ability.

  3. Another attempt to make those who work hard and have success feel guilty for their achievements. It might actually be more productive to reintroduce the concepts of hard work and reward for results (not for aww shucks, trying a little bit) into our society and stop blaming those who succeed. Read the actual paper yourselves and see the limitations, the “findings” are a stretch.

  4. Are there any studies which show if glutathione helps kids with autism? I found out that the half-life of gluathione in creams, etc is 7 minutes, so it’s probably not effective if administered this way. I found holisitic patches with NO DRUGS in them that send wavelengths of energy into the body to let the body increase it’s own levels of gluathione up to 300%:
    These have been proven to be effective.
    I can provide more information

  5. I am hopeful and inclined to believe that the increased “rate of autism” among black and hispanic children is actually an increased rate of diagnosis as access to health care among minority groups improves in this country. These children likely went undiagnosed previously. 

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