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Autism detected later in minority children: Study


(CBS/AP) Autism should be diagnosed as early as possible, but minority children tend to be diagnosed later than white children. New research is beginning to try to uncover why - and to raise awareness of the warning signs so more parents know they can seek help even for a toddler.

PICTURES - Autism-spectrum disorders: 24 warning signs

"The biggest thing I want parents to know is we can do something about it to help your child," Dr. Rebecca Landa, autism director at Baltimore's Kennedy Krieger Institute, said. She's exploring the barriers that different populations face in getting that help.

Even when diagnosed in toddlerhood, minority youngsters have more severe developmental delays than their white counterparts, Landa's early research shows. She says cultural differences in how parents view developmental milestones and how they interact with doctors may play a role.

For example, tots tend to point before they talk, but pointing is rude in some cultures and may not be missed by a new parent, Landa says. Or maybe the mom's worried that her son isn't talking yet but the family matriarch, her grandmother, says don't worry - Cousin Harry spoke late, too, and he's fine. Or maybe the pediatrician dismissed the parents' concern, and they were taught not to question doctors.

The American Academy of Pediatrics recommends that children be screened for autism starting at 18 months, and it's possible to detect the condition as early as 14 months of age. While there's no cure, behavioral and other therapies are thought to work best when started very young.

But on average, U.S. children aren't diagnosed until they're about 4 1/2 years old, according to government statistics.

Studies show that white kids may be diagnosed with autism as much as a year and a half earlier than black and other minority children, University of Pennsylvania autism expert David Mandell said, who led much of that work. Socioeconomics can play a role, if minority families have less access to health care or less education. Mandell found in one of his studies that black children with autism were more likely than whites to get the wrong diagnosis during their first visit with a specialist.

Landa discovered another surprising fact while leading a toddler treatment program at Kennedy Krieger Institute: Even when autism was detected early, minority children had more severe symptoms than their white counterparts. By one measure of language development, the minority patients lagged four months behind the white autistic kids, Landa reported in the Journal of Autism and Developmental Disorders.

Landa's small study involved 84 participants, 19 of whom were black, Asian or Hispanic. But the enrolled families all were middle class, Landa said, meaning socioeconomics couldn't explain the difference.

One of the study's participants, Marlo Lemon, ignored family and friends who told her not to worry that her son Matthew, then 14 months, wasn't babbling. Boys are slower to talk than girls, they said.

"I just knew something was wrong," recalls Lemon, of Randallstown, Md.

Her pediatrician listened and sent the family to a government "early intervention" program that, like in most states, provides free testing and treatment for young children's developmental delays. Matthew was enrolled in developmental therapy by age 18 months, and was formally diagnosed with autism when he turned 2. He was enrolled in toddler treatment programs where in many of his classes, he was the only African-American, Lemon said.

Now 7, Matthew still doesn't speak but Lemon says he is making huge strides, learning letters by tracing them in shaving cream to tap his sensory side, for example, and using a computer-like tablet that "speaks" when he pushes the right buttons.

Lemon, who quit working full-time so she could bring Matthew to therapy every day and now works past-time counseling families about finding services early, said "I want other minority families to get involved early, be relentless."

For a campaign called "Why wait and see?" Landa is developing videos that show typical and atypical behaviors and plans to ask Maryland pediatricians to show them to parents. Early warning signs in children include not responding to their name by 12 months or pointing to show interest by 14 months, avoiding eye contact, wanting to play alone, not playing pretend, and behavioral problems such as flapping their hands or spinning in circles.

An estimated 1 in 110 children have an autism spectrum disorder, according to the CDC. While there is no cure, types of early intervention treatment include behavior and communication approaches, dietary approaches, medication, or complementary and alternative medicine. 

The CDC has more on autism treatments.

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