Disparities in Vision Screening in Primary Care for Young Children With Autism Spectrum Disorder

Area of Science:

• Pediatric ophthalmology
• Developmental pediatrics
• Public health

Background:

• Vision screening is crucial for early detection of visual impairments in children.
• Autism spectrum disorder (ASD) may be associated with higher risks of certain vision problems.
• Disparities in healthcare access and utilization exist for children with developmental disorders.

Purpose of the Study:

• To compare vision screening rates in children with and without ASD.
• To evaluate the uptake of photoscreening versus visual acuity screening.
• To identify demographic factors influencing vision screening completion for children with ASD.

Main Methods:

• Analysis of well-child visit data from 63,829 children aged 3-5 years (2016-2019).
• Billing codes used as a proxy for vision screening completion.
• Statistical analyses included chi-squared tests and multivariate logistic regression.

Main Results:

• Children with ASD had significantly lower vision screening rates (36.5%) than those without ASD (59.9%).
• Screening rates were lowest at the 3-year visit and varied by race/ethnicity, with Black children with ASD having lower rates.
• Photoscreening use was higher in Hispanic children and in certain practice regions, correlating with increased overall screening.

Conclusions:

• Children with ASD are underserved regarding vision screening during well-child visits.
• Disparities are more pronounced in younger children and Black children with ASD.
• Photoscreening demonstrates potential as an effective tool to mitigate vision screening disparities in high-risk populations.