Journal of Autism and Developmental Disorders

, Volume 42, Issue 9, pp 1967–1973 | Cite as

Differences in Autism Symptoms Between Minority and Non-Minority Toddlers

  • Saime Tek
  • Rebecca J. LandaEmail author
Original Paper


Little is known about whether early symptom presentation differs in toddlers with ASD from ethnic minority versus non-minority backgrounds. Within a treatment study for toddlers with ASD, we compared 19 minority to 65 Caucasian children and their parents on variables obtained from the Mullen Scales of Early Learning, Autism Diagnostic Observation Schedule, and Communication and Symbolic Behavior Scales Caregiver Questionnaire. The majority of parents were from the upper classes irrespective of ethnic membership. Minority children had lower scores in language, communication, and gross motor than non-minority children. Findings indicate that subtle communication delays may be undetected or presumed unremarkable by parents of minority toddlers, and that more significant delays are needed to prompt the search for intervention services.


Autism spectrum disorder Toddlers Early symptoms Minority 



Autism spectrum disorders


Diagnostic and statistical manual IV, text revision


Communication and Symbolic Behavior Scales Developmental Profile


Autism Diagnostic Observation Schedule


Socio-economic status



We would like to thank the toddlers and families who participated in this study. We also thank the research staff at the Kennedy Krieger REACH laboratory in the Center for Autism and Related Disorders who contributed to this project through scheduling, data organization, data collection, and data processing. Rebecca Landa, principal investigator, thanks the National Institute of Mental Health for support of her research through grant #154MH066417, the Maternal and Child Health Research Program—Maternal and Child Health Bureau (Combatting Autism Act), Health Resources and Services Administration, Department of Health and Human Services the Health Resources and Services Administration grant R40 MC 15594, and the Krieger Foundation for their funding.


  1. American Psychological Association. (2000). Diagnostic and statistical manual of mental disorders; volume IV-TR. Washington, DC: American Psychological Association.Google Scholar
  2. Begeer, S., Bouk, S. E., Boussaid, W., Terwogt, M. M., & Koot, H. M. (2009). Underdiagnosis and referral bias of autism in ethnic minorities. Journal of Autism Developmental Disorders, 39, 142–148.CrossRefGoogle Scholar
  3. Centers for Disease Control and Prevention (CDC). (2006). Mental health in the United States: Parental report of diagnosed autism in children aged 417 yearsUnited States, 20032004. Retrieved from
  4. Centers for Disease Control and Prevention (CDC). (2010). Autism spectrum disorders (ASDs): What should you know? Retrieved from
  5. Costello, E. J., Keeler, G. P., & Angold, A. (2001). Poverty, race/ethnicity and psychiatric disorder: A study of rural children. American Journal of Public Health, 91, 1494–1498.PubMedCrossRefGoogle Scholar
  6. Cuccaro, M. L., Brinkley, J. S., Abramson, R. K., Hall, A., Wright, H. H., Gilbert, J. R., et al. (2007). Autism in African–American families: Clinical-phenotypic findings. American Journal of Medical Genetics Part B: Neuropsychiatry Genetics, 144, 1022–1026.CrossRefGoogle Scholar
  7. Danesco, E. R. (1997). Parental belief on childhood disability: Insights on culture, child development and intervention. International Journal of Disability, Development and Education, 44, 41–52.CrossRefGoogle Scholar
  8. Desai, P. P., Hendrie, H. C., & Evans, R. M. (2003). Genetic variation in apolipoprotein D affects the risk of Alzheimer disease in African–Americans. American Journal of Medical Genetics Part B: Neuropsychiatry Genetics, 116, 98–101.CrossRefGoogle Scholar
  9. Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, S., Nicholas, J. S., et al. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: Evidence from a U.S. cross-sectional study. PLoS ONE, 5(7), e11551. doi: 10.1371/journal.pone.0011551.PubMedCrossRefGoogle Scholar
  10. Fombonne, E. (2003). Epidemiological surveys of autism and other pervasive developmental disorders: An update. Journal of Autism and Developmental Disorders, 33, 365–382.PubMedCrossRefGoogle Scholar
  11. Fountain, C., King, M. D., & Bearman, P. S. (2010). Age of diagnosis for autism: individual and community factors across 10 birth cohorts. Journal of Epidemiology and Community Health, 65, 503–510. doi: 10.1136/jech.2009.104588.Google Scholar
  12. Gradin, C. (2008). Poverty among minorities in the United States: Explaining the racial poverty gap for Blacks and Latinos, Working Papers 96, Society for the Study of Economic Inequality. Retrieved from
  13. Hilton, C. L., Fitzgerald, R. T., Jackson, K. M., Maxim, R. A., Bosworth, C. C., Shattuck, P. T., et al. (2009). Brief report: Under-representation of African Americans in autism genetic research: A rationale for inclusion of subjects representing diverse family structures. Journal of Autism and Developmental Disorders, 40, 633–639.CrossRefGoogle Scholar
  14. Hollingshead, A. B. (1975). Four factor index of social status. Working Paper, Department of Sociology, Yale University, New Haven.Google Scholar
  15. Landa, R., Holman, K., & Garrett-Mayer, E. (2007). Social and communication development in toddlers with early and later diagnosis of autism spectrum disorders. Archives of General Psychiatry, 64, 853–864.PubMedCrossRefGoogle Scholar
  16. Liptak, G. S., Benzoni, L. B., Mruzek, D. W., Nolan, K. W., Thingvoll, M. A., Wade, C. M., et al. (2008). Disparities in diagnosis and utilization of health services for children with autism: Data from the national survey of children’s health. Journal of Developmental and Behavioral Pediatrics, 29, 152–160.PubMedCrossRefGoogle Scholar
  17. Lord, C., Rutter, M., DiLavore, P., & Risi, S. (1999). Autism diagnostic observation schedule. Los Angeles, CA: Western Psychological Services.Google Scholar
  18. Mandell, D. S., Ittenbach, R. F., Levy, S. E., & Pinto-Martin, J. A. (2007). Disparities in diagnoses received prior to a diagnosis of autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 1795–1802.PubMedCrossRefGoogle Scholar
  19. Mandell, D. S., Listerud, J., Levy, S. E., & Pinto-Martin, J. A. (2002). Race differences in the age at diagnosis among Medicaid-eligible children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 4, 1447–1453.CrossRefGoogle Scholar
  20. Mandell, D., & Novak, M. (2005). The role of culture in families’ treatment decisions for children with autism spectrum disorders. Mental Retardation and Developmental Disabilities Research Reviews, 11, 110–115.PubMedCrossRefGoogle Scholar
  21. Mandell, D. S., Novak, M. M., & Zubritsky, C. D. (2005). Factors associated with the age of diagnosis among children with autism spectrum disorders. Pediatrics, 116, 1480–1486.PubMedCrossRefGoogle Scholar
  22. Mandell, D. S., Wiggins, L. D., Carpenter, L. A., Daniels, J., DiGuiseppi, C., Durkin, M. S., et al. (2009). Racial/ethnic disparities in the identification of children with autism spectrum disorders. American Journal of Public Health, 99, 493–498.PubMedCrossRefGoogle Scholar
  23. Mullen, E. M. (1995). Mullen scales of early learning (AGS ed.). Circle Pines, MN: American Guidance Service.Google Scholar
  24. Pachter, L. M., & Dworkin, P. H. (1997). Maternal expectations about normal child development in 4 cultural groups. Archives of Pediatrics and Adolescent Medicine, 151, 1144–1150.PubMedCrossRefGoogle Scholar
  25. Post, D. M., Cegala, D. J., & Marinelli, T. M. (2001). Teaching patients to communicate with physicians: The impact of race. Journal of the National Medical Association, 93, 6–12.PubMedGoogle Scholar
  26. Rogers-Adkinson, D. L., Ochoa, T. A., & Delgado, B. (2003). Developing cross-cultural competence: Serving families of children with significant developmental needs. Focus on Autism and Other Developmental Disabilities, 18, 4–8.CrossRefGoogle Scholar
  27. Schopler, E., Andrews, C., & Strupp, K. (1979). Do autistic children come from upper middle class parents? Journal of Autism and Developmental Disorders, 9, 139–152.PubMedCrossRefGoogle Scholar
  28. Veling, W., Susser, E., Van Os, J., Mackenbach, J. P., Selten, J. P., & Hoek, H. W. (2008). Ethnic density of neighborhoods and incidence of psychotic disorders among immigrants. American Journal of Psychiatry, 165, 66–73.PubMedCrossRefGoogle Scholar
  29. Wetherby, A., & Prizant, B. (2002). CSBS DP manual: Communication and symbolic behavior scales developmental profile. Baltimore, MD: Paul H. Brookes.Google Scholar
  30. Zhang, J., Wheeler, J. J., & Richey, D. (2006). Cultural validity in assessment instruments for children with autism from a Chinese cultural perspective. International Journal of Special Education, 21, 109–114.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral Sciences, Center for Autism and Related Disorders, Kennedy Krieger InstituteJohns Hopkins University School of MedicineBaltimoreUSA

Personalised recommendations