White children are screened for autism up to two years earlier than their Black and Hispanic peers in Georgia, according to new research from the University of Georgia.
Led by a team of researchers from the UGA Mary Frances Early College of Education, the study found Georgia's safety net program Babies Can't Wait was more likely to screen Black and Hispanic children for autism. Babies Can't Wait provides early intervention services for children from birth to age 3 and their families under the federally funded Individuals with Disabilities Education Act. But further examination of the data suggests that may be a result of their white peers being screened for the condition before referral to the program.
"What we're seeing is that minoritized children are getting to diagnostic services two years later than other kids," said Ashley Harrison, lead author of the study and a professor of educational psychology. "If a child gets to diagnostic services two years later than other kids, we're missing some of these prime developmental windows.
"It's two years less of early intervention. And that is likely going to result in a cascade of more developmental delays."
The findings highlight continued inequities in autism screening timelines. But the study also shows the vital role early intervention programs can play in identifying the condition in underserved populations.
"In terms of how well we're doing with universal autism screening, we haven't yet accomplished that."
White children screened for autism before joining Babies Can't Wait
The study relied on data from more than 32,000 infants and toddlers enrolled in Babies Can't Wait between 2018 and 2022. More than 12,600 received an autism screening.
Of those, about one in every five white children received their screening before joining Babies Can't Wait compared to only about one in 10 Black children, the researchers found.
"Understanding points of access provides the foundation for lessening barriers for early screening," said Jennifer Brown, co-author of the study and a professor in the UGA College of Education. "This information is useful for building efforts to increase access to autism screening for all children.
"These findings illustrate the important role that Babies Can't Wait is providing in screening so young children can receive intervention services individualized to their strengths and needs."
It's two years less of early intervention. And that is likely going to result in a cascade of more developmental delays.
Ashley Harrison, College of Education
After joining the program, Black children were 1.21 times more likely to be screened in the program than their white peers, while Hispanic children were 1.58 times more likely to be screened than non-Hispanic children. Children from families with private insurance were also more likely to be screened, as were male children, the study found.
"What we saw was that many of the white families were already screened by the time they were enrolled in Babies Can't Wait," Harrison said. "In the autism world, minoritized groups really aren't benefiting as much from early screening, and because they aren't being screened as readily, there are delays in diagnosis. If we intervene earlier, we have a better chance of making a difference."
Early interventions improve autism symptoms but require early diagnosis
Early diagnosis is key to accessing important services, such as behavioral, occupational and speech therapies among others. These therapies can help children with autism improve their social, communication and functional skills.
If children aren't being screened until they're older, they're missing out on interventions that could benefit them as they grow up, the researchers said.
That's where programs like Babies Can't Wait come in.
If we intervene earlier, we have a better chance of making a difference.
Ashley Harrison
"Babies Can't Wait is a great resource - if we can get kids there," Harrison said. "Most of the services are free or covered by insurance, and they're very effective. But only about 15% to 20% of eligible kids are accessing these services."
That's likely because people don't know the program exists. And if they do, they may be unsure whether they qualify or how to access services.
Highly publicizing Babies Can't Wait and other programs like it in places parents are likely to see them (for example, pediatrician offices and day cares) is a start, the researchers said. But new approaches are needed to raise awareness of these services.
Published in the Journal of Autism and Developmental Disorders, the study was co-authored by Karrah Bowman, Kristen Bub, Jennifer Brown, Rebecca Lieberman-Betz and Cynthia Vail.
