by Kalliope Bessler
Autism Spectrum Disorders (ASD) are broadly defined by the American Psychological Association Dictionary as “any one of a group of disorders with an onset typically occurring during the preschool years and characterized by varying but often marked difficulties in communication and social interaction.” (Autism Spectrum Disorder).
The Centers for Disease Control and Prevention have found through their research that rates of autism are near identical across racial and ethnic groups (Arnold). However, when it comes to the actual diagnosis of and consequential support for those with Autism Spectrum Disorders, there is an evident disparity, as noted in the results of a 2008 study titled “Racial/Ethnic Disparities in the Identification of Children with ASD.” Researchers Mandell et al. noted that “significant racial/ethnic disparities exist in recognition of ASD” (Mandell et al. 493).
Non-white children, especially Hispanic or black children, tend to be diagnosed with Autism Spectrum Disorder later in life. When studying Medicaid claims data from 1993-1999, Mandell and other researchers found that “Black children were identified as having ASD later and were more likely to be diagnosed with conduct disorder or adjustment disorder than were white children” (Mandell et al. 493). According to CDC data from 2014, white children are 30 percent more likely to receive an autism diagnosis than black [children], and 50 percent more likely than Hispanic [children]” (Arnold). Researchers suggest that unconscious biases contribute to black children being diagnosed with ASD later in life and the higher likelihood that they are diagnosed with conduct disorder or adjustment disorder compared to white children (Fadus et al.).
Additionally, black communities have historically had less access to healthcare and been discriminated against by white healthcare professionals. As Mandell et al. state in their 2008 research, the aforementioned “pattern of delayed and missed ASD diagnosis may be exacerbated among medically underserved ethnic and racial [groups]” (Mandell et al. 493). Black patients are more likely to receive “lower-quality health services” (Frakt). As a result of missed or late ASD diagnoses, black people with Autism Spectrum Disorders miss out on the crucial support they need to thrive and reach their fullest potential academically, socially, and professionally.
As the myriad research on the missed/late diagnoses of ASD in black children suggests, there is a great deal of work that remains for the medical community in how it shows up for and serves black people, especially in America. Black children with ASD do not deserve to be put at a disadvantage because they are missing out on a diagnosis and the necessary consequential support that comes with growing up and navigating life with ASD.
Sources:
Arnold, Carrie. “Autism's Race Problem.” Pacific Standard, Grist, 25 May 2016,
psmag.com/news/autisms-race-problem.
“Autism Spectrum Disorder.” APA Dictionary of Psychology, American Psychological Association,
dictionary.apa.org/autism-spectrum-disorder.
Fadus, M.C., Ginsburg, K.R., Sobowale, K. et al. Unconscious Bias and the Diagnosis of Disruptive
Behavior Disorders and ADHD in African American and Hispanic Youth. Acad
Psychiatry 44, 95–102 (2020). https://doi.org/10.1007/s40596-019-01127-6
Frakt, Austin. “Race and Medicine: The Harm That Comes From Mistrust.” The New York Times,
The New York Times, 13 Jan. 2020, www.nytimes.com/2020/01/13/upshot/race-and-
medicine-the-harm-that-comes-from-mistrust.html.
Gourdine, Ruby M, et al. “Autism and the African American Community.” Soc Work Public
Health, vol. 26, no. 4, 2011, pp. 454–470. PubMed.gov,
doi:10.1080/19371918.2011.579499.
Mandell, David S, et al. “Racial/Ethnic Disparities in the Identification of Children with Autism
Spectrum Disorders.” American Journal of Public Health, vol. 99, no. 3, Mar. 2009, pp.
493–498. American Journal of Public Health, doi:https://doi.org/10.2105/AJPH.2007.131243.