We examined racial and ethnic differences in the prevalence of behavioral problems measured by the Child Behavioral Checklist (CBCL), sleep disturbances measured by the Child Sleep Habits Questionnaire (CSHQ), and medication use among children with Autism Spectrum Disorders (ASD). We analyzed data from the Autism Treatment Network (ATN) dataset for 2,576 children ages 6 to 18 years of age diagnosed with ASD. Multivariable logistic regression accounting for age, gender, Diagnostic and Statistical Manual of Mental Disorders (4th Edition - Text Revision), diagnosis (Autistic Disorder, PDD-NOS, Asperger's Disorder), and parents' education did not show any racial or ethnic differences in behavioral challenges, conduct problems, or sleep disturbances for any of the groups, but Black children had lower odds of Total Problem Behaviors and Asian children had lower odds of Hyperactivity compared to White children. As a group, children from racial and ethnic minorities had lower odds of Total Problem Behaviors and Conduct Problems compared to White children. Hispanic children had lower odds of medication use for Behavioral Challenges, Total Problem Behaviors, Hyperactivity, and Conduct Problems. Asian children had lower odds of medication use for Behavioral Challenges, Total Problem Behaviors, and Hyperactivity; and had close to lower odds in medication use for Conduct Problems. Black children had lower odds for medication use for Total Problem Behaviors only. As a group, children from racial and ethnic minorities had lower odds for medication use for Behavioral Challenges, Total Problem Behaviors, Hyperactivity, and Conduct problems, but not for Sleep Disturbances. While these results are consistent with previous studies showing that White children are significantly more likely to receive psychotropic medication compared to children from racial and ethnic minority groups, we found no such differences for sleep challenges, suggesting that they are more consistently identified and equitably treated than other behavioral problems associated with ASD. We draw upon Andersen's (1995) Behavioral Model of Healthcare Use to suggest predisposing, enabling, and needs factors that may contribute to this pattern of racial and ethnic differences in the use of medications among children ASD.

中文翻译：

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自闭症谱系障碍儿童行为问题和药物使用的种族和民族差异。


我们研究了自闭症谱系障碍 (ASD) 儿童中通过儿童行为检查表 (CBCL) 衡量的行为问题发生率、通过儿童睡眠习惯问卷 (CSHQ) 衡量的睡眠障碍以及药物使用情况的种族和民族差异。我们分析了自闭症治疗网络 (ATN) 数据集中 2,576 名 6 至 18 岁被诊断患有自闭症谱系障碍 (ASD) 儿童的数据。考虑年龄、性别、精神障碍诊断和统计手册（第四版 - 文本修订版）、诊断（自闭症、PDD-NOS、阿斯伯格症）和父母教育的多变量逻辑回归没有显示出任何种族或民族差异任何群体的行为挑战、行为问题或睡眠障碍，但与白人儿童相比，黑人儿童出现总体问题行为的几率较低，亚洲儿童出现多动症的几率较低。作为一个群体，与白人儿童相比，少数种族和族裔儿童出现总体问题行为和品行问题的几率较低。西班牙裔儿童因行为挑战、总体问题行为、多动症和品行问题而使用药物的几率较低。亚洲儿童因行为挑战、总体问题行为和多动症而使用药物的几率较低；因行为问题而使用药物的几率也接近较低。黑人儿童仅因总体问题行为而使用药物的几率较低。作为一个群体，少数种族和族裔儿童因行为挑战、总体问题行为、多动症和行为问题而使用药物的几率较低，但因睡眠障碍而用药的几率较低。 虽然这些结果与之前的研究一致，即与少数族裔儿童相比，白人儿童接受精神药物治疗的可能性明显更大，但我们发现睡眠挑战没有这种差异，这表明他们比其他种族和族裔儿童更容易被识别和公平对待。与 ASD 相关的其他行为问题。我们利用 Andersen (1995) 的医疗保健使用行为模型来提出可能导致自闭症谱系障碍儿童药物使用中种族和民族差异模式的诱发因素、促成因素和需求因素。