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. 2025 Sep;55(9):3364-3377.
doi: 10.1007/s10803-024-06403-5. Epub 2024 Jun 28.

Racial Differences in the Prevalence of Autism Spectrum Disorder: A Systematic Review

Zachary Gallin  1 , Ana M Kolevzon  2 , Abraham Reichenberg  3   4   5 , Sidney H Hankerson  4   6 , Alexander Kolevzon  7   8   9
Affiliations

Racial Differences in the Prevalence of Autism Spectrum Disorder: A Systematic Review

Zachary Gallin et al. J Autism Dev Disord. 2025 Sep.

Abstract

Purpose: Racial differences in prevalence rates of autism spectrum disorder (ASD) have shifted in the United States (US) since the 1990s. This review addresses the nature and context of this shift and discusses potential contributing factors and areas for future research.

Methods: Seventeen population-based epidemiological birth cohort studies on ASD prevalence in the US that included race as a variable are included in the review. Studies were identified via a keyword search on PubMed. To be included, studies were required to include race or ethnicity as a variable in the prevalence estimates, include at least 1000 cases with autism, and be published in English by June 3rd, 2023.

Results: Results suggest that in nearly all birth cohorts prior to 2010, ASD prevalence rates were highest among White children. ASD prevalence rates among Black, Hispanic, and Asian/Pacific Islander (API) children (22.3, 22.5, and 22.2 per 1000, respectively) surpassed prevalence rates among White children (21.2 per 1000) in the 2010 birth cohort and continued to increase in the 2012 birth cohorts.

Conclusions: There are persistent racial differences in ASD prevalence in the US, and these differences were inverted after 2010, when ASD prevalence among Black, Hispanic, & API children surpassed ASD prevalence among White children. Possible drivers of this racial repatterning of ASD prevalence include changes in ASD screening and diagnosis, changes to health insurance policy, changes to immigration policy, and increased education attainment by minority groups.

Keywords: Autism spectrum disorder; Epidemiology; Ethnicity; Pervasive developmental disorder; Prevalence; Racial disparities.

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Conflict of interest statement

Declarations. Conflict of Interest: AK is on the Advisory Board for the Klingenstein Third Generation Foundation, Ovid Therapeutics, David Lynch Foundation, ADNP Kids Research Foundation, and Ritrova Therapeutics and consults to Acadia, Alkermes, Jaguar Therapeutics, GW Pharmaceuticals, Neuren Pharmaceuticals, Clinilabs Drug Development Corporation, Scioto Biosciences, and Biogen. The remaining authors have no potential conflict of interests related to this publication.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only. Adapted from Page et al.,
Fig. 2
Fig. 2
ADDM Data on Time Trends in ASD Prevalence by Race Group 1992–2012. *Error bars represent 95% confidence intervals (CIs). All data and CIs were originally reported in the ADDM reports except for the 1992 birth cohort, in which prevalence was calculated as a proportion using data from Rice (2007), with CIs derived from the binomial calculation
See this image and copyright information in PMC

References

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