Examining the Prevalence Rates of Autism Diagnosis by Race/Ethnicity for Medicaid-Eligible Children Enrolled in NYC Universal Pre-Kindergarten Programs

This study examines autism diagnosis prevalence within the New York City (NYC) Universal Pre-K for All (UPK) program expansion into racially, ethnically, and socioeconomically diverse NYC neighborhoods. Here, it is hypothesized that racial/ethnic differences in autism diagnoses may close as more children are referred for testing by UPK programs, which they have more thorough interactions with, instead of by public health clinics or other medical avenues. Using NYC Medicaid claim data from 2006 to 2016, descriptive analyses were conducted by estimating linear probability regression and generalized multiple logistic regression to examine whether the probabilities of being diagnosed with autism in comparison to two other disability types (as counterfactuals), learning disabilities (LD) and physical disabilities (PD), differ by race. Subsequently, a difference in difference (DID) strategy (with pre- and post-UPK expansion cohorts) was used to examine the effects of UPK on the probabilities of receiving disability diagnoses. Notably, Latinx and “Other” racially identified children have much higher odds than White children of being diagnosed with autism. By contrast, all non-White groups had much lower odds of being diagnosed with a LD. These findings offer important insight for future UPK and childhood program implementation.