Racial Disparity Seen in ASD Prevalence Among Preschoolers in Swedish Immigrant Population

June 29, 2020

90% of Children Had a Mother Born in Africa or Asia

The Journal of Autism and Developmental Disorders recently published a new study out of Sweden which examines the prevalence of autism spectrum disorder (ASD) in preschool children among the country’s migrant population. Estimated ASD prevalence for this cohort was, at a minimum, 3.5 times more than the non-immigrant Swedish population.

The study took place in Gothenburg, the second largest and most ethnically diverse city in Sweden. Within Gothenburg, the researchers selected one district to be the study’s focus due to the residents’ foreign background (89.6% of population) and low socioeconomic level. Since Sweden ensures universal health care, 99% of the district’s children ages 0-6 years were included in the study. The target population consisted of children born from January 1, 2013 to December 31, 2016 that were registered at the Gothenburg CHC by December 31, 2018. In total, the study included 902 participants, 454 males and 448 females.

Sweden’s complementary health care provides a developmental surveillance program through community Child Health Centers (CHC). All 30-month-old children are screened for ASD at their local CHC. Children identified at risk for ASD and other neurodevelopmental disorders were referred to a multidisciplinary team made up of a pediatrician/child psychiatrist, a developmental psychologist, a special education teacher, a speech language pathologist, a child specialist nurse and a social worker for further assessments and interventions. In the end, 33 children (24 males and 9 females) were diagnosed with ASD, making the autism prevalence of this research cohort 3.66%. Although, the team noted that additional children in the group were diagnosed with ASD after December 31, 2018. The researchers believe the actual ASD prevalence of this cohort to be more than 4.32% while the non-immigrant Swedish prevalence in Gothenburg is 1.03%. The average age of diagnosis for these children was 36.3 months.

The reasons for the increased ASD prevalence among immigrants remained unclear to the research team. However, multiple risk factors were observed which included maternal stress from recent migration, reduced level of prenatal care, clustering of pregnancy and birth complications, maternal vitamin D deficiency, socioeconomic disadvantages, family history and genetic factors. The study also reported that children of African heritage showed higher heritability rates of ASD than other racial cohorts. When looking at Gothenburg’s immigrant group as a whole, the researchers noted that 90% of the children had a mother born in either the African or Asian continents and 64.5% of these children had an additional diagnosis of intellectual disability.

A similar trend was recently observed in the United States. A SafeMinds Shares article from March reported that University of Colorado Boulder researcher Cynthia Nevison, PhD, and Duke University microbiology researcher William Parker, PhD, found autism rates escalating in socioeconomically disadvantaged portions of the African American and Hispanic populations while decreasing wealthier Caucasian population. Just like the Swedish research team, Nevison and Parker were uncertain about the reasons for higher ASD rates in these two populations. Parker noted in a CU Boulder Today article that environmental factors like toxins, unhealthy food and emotional stress have been associated with autism. He suggested that lower income and families of color may have a harder time accessing or affording healthier lifestyle options.

The Swedish research team ended their study with a call for change to assist immigrant families. The conclusion states, “The result highlights the importance of coordinated systems in health care to meet the many and individual needs of young children with ASD and their families. Costless and general care is not enough to reach all immigrant families. Thus, it is of importance that new models be developed so as to increase accessibility to services for children with ASD and other developmental disorders in immigrant communities. Health care professionals need knowledge of neurodevelopmental disorders and how cultural values influence different views of children’s development in general, as well as neurodevelopmental disorders.”


Petra Linnsand, Christopher Gillberg, Asa Nilses, Bibbi Hagberg, Gudrun Nygren. A High Prevalence of Autism Spectrum Disorder in Preschool Children in an Immigrant, Multiethnic Population in Sweden: Challenges for Health Care. Journal of Autism and Developmental Disorders. July 2020

SafeMinds. Socioeconomic & Racial Divide in Autism Numbers. SafeMinds Shares. March 23, 2020.

Lisa Marshall. Autism Rates Declining Among Wealthy Whites, Escalating Among Poor. CU Boulder Today. March 19, 2020.

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