Disparities exist in the recognition of autism spectrum disorder (ASD) and intellectual disability (ID) in racial/ethnic minorities in the United States. This study examined whether rurality, race/ethnicity, and low resource availability are associated with disparities in primary educational classifications of ASD and ID in North Carolina (NC). Descriptive maps were created. Multilevel logistic regression models examined two separate outcomes (mild ID vs. ASD; moderate/severe ID vs. ASD). For the interaction term included in the model (race/ethnicity and residence), predicted probabilities were estimated and plotted. The effects of other covariates were also estimated. Rural counties had fewer students with ASD and a greater number of students with ID compared to urban counties. The majority of students with ASD were non‐Hispanic Whites, while the majority of students with ID were non‐Hispanic Blacks. Compared to non‐Hispanic White students, non‐Hispanic Black students were overrepresented in the ID classification and underrepresented in the ASD classification across urban and rural areas. Indicators of low resource availability were also associated with higher probabilities of ID vs. ASD classification. Differences in primary educational classification based on urban–rural divide, race/ethnicity, and resource availability are important to understand as they may point to disparities that could have significant policy and service implications. Because disparities manifest through complex interactions between environmental, socioeconomic and system‐level factors, reduction in these disparities will require broader approaches that address structural determinants. Future research should utilize disparity frameworks to understand differences in primary educational classifications of ASD and ID in the context of race/ethnicity and rurality.

中文翻译：

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北卡罗来纳州学龄儿童自闭症谱系障碍和智力障碍的教育分类：与种族、农村和资源可用性的关联

在美国，对自闭症谱系障碍 (ASD) 和智力残疾 (ID) 的识别存在差异。本研究调查了北卡罗来纳 (NC) 农村地区、种族/族裔和低资源可用性是否与 ASD 和 ID 初级教育分类的差异有关。创建了描述性地图。多级逻辑回归模型检查了两个独立的结果（轻度 ID 与 ASD；中度/重度 ID 与 ASD）。对于模型中包含的交互项（种族/民族和居住地），估计并绘制了预测概率。还估计了其他协变量的影响。与城市县相比，农村县患 ASD 的学生较少，而有智力障碍的学生则较多。大多数 ASD 学生是非西班牙裔白人，而大多数有 ID 的学生是非西班牙裔黑人。与非西班牙裔白人学生相比，非西班牙裔黑人学生在城市和农村地区的 ID 分类中所占比例过高，而在 ASD 分类中所占比例不足。资源可用性低的指标也与 ID 与 ASD 分类的更高概率相关。基于城乡差距、种族/族裔和资源可用性的初级教育分类差异很重要，因为它们可能指向可能具有重大政策和服务影响的差异。由于差异通过环境、社会经济和系统层面因素之间复杂的相互作用表现出来，缩小这些差异需要更广泛的方法来解决结构性决定因素。