Social Communication Profiles of Toddlers with and without Autism Spectrum Disorder from Three Racial/Ethnic Groups

Racial and ethnic diversity is growing rapidly in the United States (US), leading to heightened concerns about racial/ethnic disparities in the provision of services for young toddlers with autism spectrum disorder (ASD). This investigation of the FIRST WORDS® Project studied a sample of 364 toddlers between the ages of 18 and 36 months who had a diagnosis of ASD confirmed (n = 195) or ruled out (n = 169) from three racial/ethnic categories: non-Hispanic White (n = 226), non-Hispanic Black (n = 74), and Hispanic White (n = 64). Differences across the groups were examined using scores from an observational measure of social communication, the Communication and Symbolic Behavior Scales (CSBS; Wetherby & Prizant, 2002) Behavior Sample, and a parent-report measure of autism red flags, the Early Screening for Autism and Communication Disorders (ESAC; Wetherby, Woods, & Lord, 2007). After controlling for maternal education, findings revealed that, compared to children without ASD, children with ASD scored lower on the CSBS, indicating poorer social communication and scored higher on the ESAC, indicating more red flags of ASD. Racial/ethnic groups did not differ on six of the seven clusters of the CSBS, but Non-Hispanic White toddlers were observed to score significantly higher than non-Hispanic Black and Hispanic White toddlers on the understanding cluster. There were no significant interactions between diagnostic classification and race/ethnicity on either the CSBS or ESAC. These findings indicate good agreement between observed social communication and parent report of autism red flags in a diverse sample of toddlers. Results from this study suggest that the CSBS and ESAC could be instrumental in identifying young toddlers with ASD from these racial/ethnic categories and may contribute to improving early detection and access to early intervention for toddlers with ASD.