Date of Conferral

8-4-2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Shanna Barnett

Abstract

As autism spectrum disorder (autism/ASD) diagnoses rise, understanding the influence of socioecological factors on the age of diagnosis among children in the United States is critical for timely intervention and improved quality of life. The purpose of this study was to examine how socioecological factors influence the age at which children are diagnosed with autism/ASD. The quantitative causal-comparative design, which was informed by Bronfenbrenner’s socioecological model, involved analysis of secondary data from the 2021 National Survey of Children’s Health (N=1416). Ordinal logistic regression analysis revealed that race and ethnicity moderated the relationship between socioeconomic status (caregiver educational and employment status showed significance) and adequacy of current health insurance on the age of autism/ASD diagnosis, highlighting disparities in early identification. The findings underscore the need for equitable access to autism/ASD screening and early intervention services. Field-based products developed from this study provide tools that public health practitioners and policymakers can potentially use to address delays in diagnosis through culturally competent care, improved health education, and expanded health insurance coverage. By identifying barriers and proposing actionable strategies, this study supports efforts to promote health equity and positive social change for children with autism/ASD and their families.

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