Is Parent Education a Factor in Identifying Autism/Takiwatanga in an Ethnic Cohort of Pacific Children in Aotearoa, New Zealand? A National Cross-Sectional Study Using Linked Administrative Data

Studies have found early detection of autism is protective for an individual and their family. Fewer Pacific children are diagnosed with autism compared with non-Pacific children, and those who have significantly higher needs, suggesting an undercount of those diagnosed. The purpose of this study was to explore any association between parental education and autism in Pacific children living in Aotearoa, New Zealand. This was a national cross-sectional study using data from New Zealand's Integrated Data Infrastructure, including Pacific and non-Maori non-Pacific children in the 2013 Census. A novel method was employed to capture autism, while years of parents' education was estimated from their highest attained qualification level. Apposite regression models were used to analyse the relationship between parental education and autism. We found that autism was identified in 1.1% of Pacific children compared with 1.6% of non-Maori, non-Pacific children. A year of education among parents of Pacific children was associated with increased identification of autism (odds ratio = 1.10; 95% confidence interval = 1.06-1.15). The findings show education plays a positive role in receiving a diagnosis for Pacific autistic children but suggest a systemic failure to support Pacific parents to navigate existing health systems for themselves or their children.