WIP 83 - Examining the Association Between the Child Opportunity Index and Autism Diagnosis in Utah

Poster Number: WIP 83
Publication Number: WIP 83.779

Background: The relationship between childhood poverty, socioeconomic status, and health, especially concerning Autism Spectrum Disorders (ASD), reveals racial disparities in diagnosis and care access. Nonwhite children with ASD receive less specialist and preventive care compared to their white counterparts. Quality of care varies by race, with Black and Latino children encountering challenges, despite the broader healthcare access difficulties for individuals with intellectual disabilities. Black children often experience a three-year delay from initial developmental concerns to ASD diagnosis, consulting multiple physicians. These disparities result from structural racism across sectors. This study is the first to investigate how childhood poverty and neighborhood opportunity influence ASD diagnosis using the Child Opportunity Index (COI). The COI assesses opportunity levels, enabling exploration of the ASD diagnosis-environment relationship using education, health, environment, and socioeconomic data. This research can inform interventions to promote early autism detection.

Objective: The objective of this study is to examine the COI in a patient population of children being evaluated for ASD. Specifically, we aim to analyze the association between the COI and referral age, diagnosis age, time to diagnosis, and likelihood of ASD diagnosis.

Design/Methods: This retrospective cohort study will examine health records of children 2-17 years attending visits at a child development clinic. We have 7,703 unique patients seen from 2013-2023 with COI scores and demographic data. Descriptive statistics will be calculated for the COI and X domains: education, health and environment, and social and economic. We will compare the age of referral, age of diagnosis, and time to diagnosis across COI domains. Using a Poisson regression model we will estimate the likelihood of an ASD diagnosis based on COI overall scores. Preliminary analyses suggest that children living in Very Low areas of COI are LESS likely to receive an ASD diagnosis. We plan to complete the remaining analyses in December.