Systematic Review and Meta-Analysis: Prevalence of Neurodevelopmental Disorders Among Indigenous Children

Objective To summarize epidemiological evidence on the prevalence of neurodevelopmental disorders (NDDs) among Indigenous children in Australia Canada, New Zealand, and the USA compared to that of non-Indigenous children. Method Comprehensive searches in five electronic databases were performed to identify studies evaluating the prevalence of NDDs among Indigenous and non-Indigenous children in Australia, Canada, New Zealand, and the USA. Pooled unadjusted odds ratios (pOR) with 95% confidence intervals (CI) were calculated in random-effects meta-analysis by outcome and Indigenous group. Results From 1,274 non-duplicate citations identified, 12 studies were included in the review. Overall, cohort, ecological, and cross-sectional studies had moderate-to-high RoB. Meta-analysis showed no differences in the prevalence of attention-deficit hyperactivity disorders (ADHD) between American Indian/Alaska Native (AI/AN) children and White children (pOR: 1·02, 95% CI: 0·79, 1·33); there were no differences in the prevalence of autism spectrum disorders (ASD) between Australian Aboriginal children and non-Aboriginal children (pOR: 0·43; 95% CI: 0·11, 1·58). Non-Indigenous children were found to have higher ASD prevalence compared to Indigenous children in Canada. Some evidence suggests a greater burden of intellectual disabilities affecting Indigenous children in Australia, New Zealand, and the USA and specific learning disorders among AI/AN children in the USA. Conclusion Limited evidence suggests a difference in prevalence for specific NDD between Indigenous children and non-Indigenous children in countries with similar colonial histories. More epidemiological research adopting an Indigenous lens in the screening and assessment of NDD is required to better understand the burden of NDDs on Indigenous children.