The worldwide prevalence of autism spectrum disorder (ASD) is 1-2%; however, its association with race/ethnicity and social disadvantage is not known. The objective of this study is to determine the differences in ASD prevalence estimates in racial/ethnic minority groups.

This case-control prevalence cohort study included a total data of 7,074,238 pupils. Age and sex were the prior confounders in the study. ASD status was assessed according to race/ethnicity, social disadvantage, and the first language spoken. The primary endpoint of the study was

The findings suggested that among the included participants, 119,821 pupils had ASD, and 21,660 had ASD with learning disabilities. Standard ASD prevalence was 1.76%, with males being at a higher risk (2.81%) than females (0.65%). Standardized prevalence was the highest in black pupils (2.11%) and lowest in Irish/Roma travelers (0.65%). It was also found that pupils with ASD were more likely to face a social disadvantage and speak English as an additional language. The social disadvantage was the main factor mediating the effect of race/ethnicity on ASD, with black pupils facing the largest effect.

The research confirmed that ASD prevalence was associated with racial/ethnic groups and was mainly mediated by social disadvantage.