Racial and Socioeconomic Disparities in Autism Providers' ACEs Inquiries

Autistic individuals experience Adverse Childhood Experiences (ACEs), including neglect, abuse, and financial stress, at above-average rates. However, little is known regarding the factors influencing whether autism community-based providers conduct ACEs inquiries in their practice. Racial, ethnic, and socioeconomic status (SES) group disparities persist in healthcare and may exist in providers' ACEs inquiries. Whether autism community-based providers inquire about ACEs differently between racial, ethnic, and SES groups has not been studied. Understanding potential variations in inquiry rates is crucial, as inquiring can lead to the identification of ACEs and service provision. To investigate whether community providers' ACEs inquiries differ, we surveyed providers (N = 567) serving autistic individuals ages 7-22 years. Logistic regression using generalized estimating equations estimated the association between racial, ethnic, and SES groups providers reported serving and frequency of ACEs inquiries. Considering overall inquiries (i.e., if providers ever inquired) obscured significant specific inquiry discrepancies (i.e., variation in eight ACEs inquiries by groups served). Specific inquiries models revealed that providers serving Black, Native American, high, and low SES individuals reported higher odds of inquiring about various ACEs. In contrast, providers serving Asian individuals reported inquiring less about particular ACEs. The specific characteristics of the population served by providers may influence their ACEs inquiries. Further investigations are needed to reveal factors underlying gaps in ACEs inquiries across groups and narrow such disparities.