Identification of autistic Māori in Aotearoa New Zealand: A national cross-sectional study

This study examines disparities in autism identification rates and support needs between Māori and non-Māori populations in Aotearoa New Zealand. The research was conducted through a collaborative approach with autistic Māori. Population-level administrative data were analysed for all individuals aged 0-24 years (N = 1,565,505) as of 30 June 2018. Autism identification was determined through health service records from July 2010 to June 2018. Comparative analyses examined autism rates, intellectual disability (ID) co-occurrence, and Ongoing Resourcing Scheme (ORS; high-need education funding support) allocation between Māori and non-Māori populations. Autism identification rates were lower among Māori (70.9/10,000) compared to non-Māori (78.3/10,000). Autistic Māori had higher rates of ID diagnosis (OR = 1.12; 95% CI = 1.02, 1.24) and ORS funding allocation (OR = 1.35; 95% CI = 1.22, 1.48). The observed disparities in autism identification rates and diagnostic patterns suggest potential systemic barriers to autism identification among Māori, particularly for those with lower formal support needs. Future Kaupapa Māori, autistic-led research is warranted to better understand these disparities and inform culturally responsive diagnostic and support services.Lay AbstractIn this study, autistic Māori collaborated with researchers to analyse autism identification in Aotearoa New Zealand using population-level administrative data. The research examined all children and young people (0-24 years) in the Aotearoa New Zealand population as of 30 June 2018, identifying autism through health service records between July 2010 and June 2018. The findings showed lower autism identification rates among Māori (70.9 per 10,000) compared to non-Māori (78.3 per 10,000). This difference in rates is likely to reflect ongoing inequities and systemic racism, not true prevalence differences. Autistic Māori were also more frequently diagnosed with intellectual disability (ID) and more likely to receive high-need education funding support than autistic non-Māori. While these patterns might suggest higher formal support needs among autistic Māori, it's crucial to recognise that support requirements are highly individual and context-dependent, making them difficult to measure using broad indicators. The lower overall autism identification rate among Māori, combined with these findings, suggests that autistic Māori with lower formal support needs may be missing opportunities for diagnosis and not accessing the supports and services they are entitled to. Future Kaupapa Māori, autistic-led research is needed to gain a more nuanced understanding of autism identification and support needs among Māori.