The Somali Autism Rate in Minneapolis: What does it mean?

The Minnesota Health Department reported Tuesday that "young Somali children [in Minnesota] appeared to have higher than usual rates of autism," according to today's New York Times:

Dr. Sanne Magnan, the state health commissioner, said the finding was “consistent with the observations by parents,” who have been saying for more than a year that alarming numbers of Somali children born in this country have severe autism. Somalis began immigrating into the area in the 1990s, fleeing civil war in their homeland. The report made no attempt to explain why the children had autism. Its authors did not examine children or their medical records. They accepted the diagnoses — some by doctors, some by school evaluators — that admitted children to special education classes, and they calculated rates for different races.

They counted only 3- to 4-year-olds, only children in Minneapolis public schools, and only children born in Minnesota. They drew no comparisons with Somalis in other cities.

The last couple of sentences are more telling than they might appear to be. In Minnesota, children do not need a medical diagnosis of autism to qualify for special education programs. Criteria for an autism diagnosis by a school evaluator can vary; school districts might give a child an autism diagnosis with a view to ensuring the child gets sufficient educational and other services.  Also, the population for the study is quite restricted, being limited in terms of age (3- to 4- year olds) and location (children in Minneapolis public schools who are of Somali descent and born in Minnesota).

In other words, the report from the Minnesota Health Department pretty much tells us what was first reported about rates of autism in the children of Somali immigrants in Minneapolis back in July of 2008. Today's Star-Tribune reports more specifically:

The investigation found that, among 3- and 4-year-olds in Minneapolis, Somali children were two to seven times likelier than others to be in special classes for autism, a brain disorder linked to behavior problems.

The report estimated that 0.9 to 1.5 percent of Somali children in that age group were in autism-related classes, compared with 0.2 to 0.7 percent of non-Somalis, between 2005 and 2008. The gap between the two groups narrowed, however, over the three years studied.

Minnesota does not have a formal system to track autism.

The New York Times article quotes Dr. Magnan as saying that the study found "'strikingly low' numbers of Asian and Native American children in the same special education classes"; Dr. Magnan noted that "parents might not be enrolling their children in those classes, or might be sending them to private schools." Here I have to add a piece of anecdotal information. My own son was diagnosed with autism in Minneapolis as we were living in St. Paul at the time (1999-2000). It happened that Charlie's case manager from the St. Paul Public School District was Hmong. One day she mentioned that her son had PDD-NOS---she said that very definitely, rather than saying autism. She also noted that her son (he was about 6 at the time) was non-verbal and did not seem to be responding to any teaching or therapies. And---when we asked where he was going to school----it was noted that he was being educated at home.

The Star-Tribunearticle points out that "medical experts told the Health Department that a fourth or more of the children placed in autism programs at school turned out to have some other disorder." If this is indeed the case, it seems more than likely that claims of there actually being more Somali children medically diagnosed with autism may be over-rated, or at least require a second, and third, and much closer look.