The objectives of our study were to (a) report how many children met an autism spectrum disorder (ASD) surveillance definition but had no clinical diagnosis of ASD in health or education records and (b) evaluate differences in demographic, individual, and service factors between children with and without a documented ASD diagnosis. ASD surveillance was conducted in selected areas of Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin. Children were defined as having ASD if sufficient social and behavioral deficits and/or an ASD diagnosis were noted in health and/or education records. Among 4,498 children, 1,135 (25%) had ASD indicators without having an ASD diagnosis. Of those 1,135 children without a documented ASD diagnosis, 628 (55%) were not known to receive ASD services in public school. Factors associated with not having a clinical diagnosis of ASD were non‐White race, no intellectual disability, older age at first developmental concern, older age at first developmental evaluation, special education eligibility other than ASD, and need for fewer supports. These results highlight the importance of reducing disparities in the diagnosis of children with ASD characteristics so that appropriate interventions can be promoted across communities. Autism Res 2020, 13: 464–473. © 2019 International Society for AutismResearch,Wiley Periodicals, Inc.

中文翻译：

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基于人口、个人和服务因素的自闭症谱系障碍记录诊断的差异。

我们研究的目的是 (a) 报告有多少儿童符合自闭症谱系障碍 (ASD) 监测定义，但在健康或教育记录中没有 ASD 临床诊断；(b) 评估人口、个人和服务因素的差异有和没有记录自闭症谱系障碍 (ASD) 诊断的儿童之间的差异。ASD 监测在亚利桑那州、阿肯色州、科罗拉多州、佐治亚州、马里兰州、明尼苏达州、密苏里州、新泽西州、北卡罗来纳州、田纳西州和威斯康星州的选定地区进行。如果健康和/或教育记录中记录了足够的社交和行为缺陷和/或自闭症谱系障碍诊断，则儿童被定义为患有自闭症谱系障碍。在 4,498 名儿童中，有 1,135 名（25%）有 ASD 指标，但没有被诊断为 ASD。在这 1,135 名没有 ASD 诊断记录的儿童中，有 628 名 (55%) 不知道在公立学校接受过 ASD 服务。与没有临床诊断自闭症谱系障碍相关的因素包括非白人、无智力障碍、首次发育问题的年龄较大、首次发育评估的年龄较大、除自闭症谱系障碍之外的特殊教育资格以及需要较少的支持。这些结果凸显了减少自闭症谱系障碍儿童诊断差异的重要性，以便在各个社区推广适当的干预措施。自闭症研究2020，13：464–473。© 2019 国际自闭症研究协会，Wiley periodicals, Inc.