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Originally described by Leo Kanner (1943) and recognized as a special education eligibility category by the U.S. Department of Education in 1990 (Individuals with Disabilities Education Act [IDEA], 1990), autism spectrum disorders (ASD) are characterized by deficits in reciprocal social interactions, communication, and interests and behaviors (American Psychiatric Association [APA], 2000; World Health Organization, 1993). Even though individual prevalence rates vary by state (Centers for Disease Control and Prevention [CDC], 2007a, 2007b), published prevalence rate estimates are approximately one out of 150 children (CDC, 2007b), making ASD the most common development disability diagnosed in children.
Demographic Variations in Children with ASD
According to the APA (2000), individuals with ASD are found in all cultures, ethnicities, and across socioeconomic levels. Studies in gender differences indicate that ASD is more common in males than females, with an average ratio of 4.3:1 (Fombonne, 2005). Cross state comparisons list male-to-female ratios from 3.4:1 to 6.5:1 (CDC, 2007b). Little attention has been paid, however, to the ethnic breakdown of children within this disability category (Dyches, Wilder, Sudweeks, Obiakor, & Algozzine, 2004). Most investigations of ethnicity within ASD focus on the family's immigration status as a means to determine national origin (Fombonne, 2005). These studies have been inconclusive in documenting the prevalence of ASD across ethnic groups.
Yeargin-Allsopp, Rice, Karapurkar, Doernberg, Boyle, and Murphy (2003) found that in one metropolitan area rates of autistic disorder were similar between White and Black 3-10 year olds when ethnic background was analyzed in eligibility determination. In this study, both ethnic groups had a prevalence rate of 3.4 per 1,000, and children from other ethnic groups had a prevalence rate of 2.9 per 1,000, a non-significant difference.
Using data from the U.S. Department of Education, Office of Special Education Programs (OSEP, 2001, 2002), Dyches, Wilder, Sudweeks, Obiakor, and Algozzine (2004) found that children from African American and Asian/Pacific Island backgrounds received special education services under an Autism eligibility at approximately two times the rate of students from American Indian, Native Alaskan, or Hispanic backgrounds.
These findings contradict previous data on disproportionate representation which indicate that ethnically diverse students are not overrepresented in specific low incidence eligibility categories such as autism (Parrish, 2002).
More recent multistate data (i.e., Alabama, Arizona, Arkansas, Colorado, Georgia, Maryland, Missouri, New Jersey, North Carolina, Pennsylvania, South Carolina, Utah, West Virginia, and Wisconsin) on the ethnic breakdown of children with ASD (CDC, 2007b) indicates that prevalence is higher among Caucasian children than African American children in 10 of 14 sites under investigation. These rates were significantly different between ethnic groups in five of the 14 states.
Hispanic children had significantly lower prevalence rates than Caucasian students in approximately 43% of the sites, and significantly lower rates than African American children in approximately 93% of the sites. Although prevalence rates of ASD are reported to be equal across all ethnic backgrounds (APA, 2000), one site (New Jersey) reported higher prevalence rates among Hispanic children (9.7 per 1,000) as compared to African American children (7.7 per 1,000).
Cultural Variations in Parental Views Regarding Identification and Treatment of ASD
The issue of ethnic disproportionality in children with ASD has important implications for diagnosis and provision of intervention since prognosis for children with ASD improves with early identification (McGee, Morrier, & Daly, 2001; National Research Council [NRC], 2001). However, previous investigations of ethnicity and ASD have indicated that parents from different cultures have varying points of view regarding ASD symptomology, often leading to a later diagnosis.
In interviews with 95 families of children with autism in India, Daley (2004) found that families noticed social deficits before they noticed language deficits in their children. These findings differ from those regarding identification of ASD symptoms by Caucasian parents in the United States, who notice language deficits before they identify social deficits (Coonrod & Stone, 2004; Filipek, Accardo, Ashwal, Baranek, Cook, & Dawson, 2000; Filipek, Accardo, Baranek, Cook, Dawson, & Gordon, 1999).
Differences in parental views have also been reported in the Navajo society (Connors & Donnellan, 1993). In the Navajo culture children with disabilities, including children with ASD, are viewed as children first and a disability second. Members of this culture tend to describe children by the unique characteristics they display, rather than describing unusual characteristics as an incompetence factor. Due to this view, in Navajo society a "cure" is not sought for children with disabilities (Connors & Donnellan).
Implications of Ethnicity for Special Education Placements
According to Chinn and Hughes (1987), disproportionate representation occurs when children from a specific ethnic group within a disability category are identified at a rate plus or minus 10% as compared to their representation in the general population. Research on disproportionate representation of ethnically diverse students indicates that ethnicity plays a role in the restrictiveness of settings in which children eligible for special education are placed.
Thus, children from ethnically diverse backgrounds tend to be placed in more segregated special education classrooms over placement in the general education classroom (Fierros & Conroy, 2002). This phenomena continues to be found as it relates to the placement of students under a mild mental retardation, specific learning disability, or emotional/behavioral disorder special education eligibilities (de Valensuela, Copeland, Qi, & Park, 2006; Hosp & Reschly, 2001; Skiba, Poloni-Staudinger, Gallini, Simmons, & Feggins-Azziz, 2006).
One of the few studies investigating ethnicity as a factor in diagnosing ASD (Dyches et al., 2003) did not examine educational placement as a variable, although data from OSEP (2005) indicate that children with ASD are placed in more restrictive settings as they advance through the educational system, implying that age is also an important factor in determining placement for this population.
Cultural mismatch between a school system's students and teachers has been found to be one indicator of disproportionate representation. Investigations of referral rates for children with emotional/ behavior disorders report that when greater percentages of teachers and administrators from ethnically diverse backgrounds are employed in a school system, children from ethnically diverse backgrounds are referred to special education at reduced rates (Serwatka, Deering, & Grants, 1995).
Neal, McCray, Webb-Johnson, and Bridgest (2003) demonstrated that a significant interaction occurred when the ethnicity of teacher and a student's walking style (e.g., standard v. stroll) were considered for special education referrals. This research found that a cultural match between a school's teachers and students can reduce special education referrals, and as such has an …