As we observe Autism Acceptance Month, our collective efforts to embrace and support the autism community continue to grow stronger. Yet, the journey towards true acceptance must also include an ongoing commitment to raising awareness, particularly within underrepresented groups such as the BIPOC (Black, Indigenous, People of Color) communities. Despite progress, disparities in autism diagnosis and treatment persist, underscoring the crucial need for focused awareness and action to address these inequalities.

The State of Autism Diagnosis in BIPOC Communities

The Diagnosis Disparity

As autism awareness and diagnosis rates rise across the United States, with current figures from the CDC indicating that 1 in 36 children are diagnosed as Autistic, stark disparities persist in how these diagnoses are distributed across racial lines. Despite socioeconomic status, Black, Latino/Hispanic, and Indigenous children are consistently less likely to receive an autism diagnosis compared to their white counterparts. This discrepancy extends to the age of diagnosis and the consistency of medical support provided post-diagnosis.

Autism and BIPOC Diagnosis Disparity

In the U.S., white children are approximately 19% more likely to be diagnosed with autism than Black children and 65% more likely than Hispanic children, according to Furfaro (2017).

Black American Children: A Closer Examination

Research by Mandell et al. (2006) found that Black American children were 2.6 times less likely than white children to receive an autism diagnosis on their first specialty care visit, requiring more visits on average to obtain a diagnosis.
Further studies by Mandell et al. (2007) showed Black children were 5.1 times more likely to be misdiagnosed with conduct or adjustment disorders before being correctly diagnosed with ADHD or autism.
Post-diagnosis, Black Autistic children often receive less regular medical and diagnostic support compared to their white peers.
A study by Mandell et al. (2002) highlighted that Black children were typically diagnosed with autism 1.4 years later than white children, spent more months in mental health treatment before diagnosis, and needed three times the number of visits before receiving a diagnosis.

Hispanic/Latino Children: Delays and Misdiagnoses

Latino children are diagnosed with autism 2.5 years later than white non-Latino children and are often missed in diagnoses despite meeting the criteria (Zuckerman et al., 2014).
At the time of diagnosis, Latino children are more likely to exhibit “severe” autistic traits than white non-Latino children.
Factors contributing to these disparities include language barriers, cultural differences, and lack of autism awareness within the Latino community (Gatalica, 2020).

Indigenous Children: The Lowest Diagnosis Rates

Indigenous children have the lowest autism diagnosis rates among all racial groups in the U.S. One study found indigenous children were 13% less likely to be identified as Autistic (Bennett et al., 2021).

Asian American Children: A Mixed Picture

Research on Asian American children is mixed, with some studies indicating higher rates of misdiagnosis and others suggesting this is not the case (Foley, 2019).
Asian American children with disabilities, including autism, are underrepresented in research and often receive lower quality support and treatment.

Beyond Statistics: The Importance of Stories

While statistics offer a clear view of the disparities in autism diagnosis and treatment across racial groups, personal narratives and stories provide deep, invaluable insights into the lived experiences of families navigating these challenges. One such story is that of Dana Young-Askew and her son Drayden, whose journey to an autism diagnosis is both illuminating and deeply moving. Dana shares their story on the podcast "Terrible, Thanks for Asking" and has written a compelling book on their experiences, Come Meet Drayden.

Another fantastic story teller is Tiffy Hammond offers insightful reflections on her Substack and Instagram as well as in her book A Day Without Words. She educates on the intersection of race, autism and support needs. Sandra Coral is another powerful storyteller with a Substack, instagram, a podcast, and a recent book that delve into intersectional issues in the classroom.

Final Thoughts

The disparities in autism diagnosis and treatment across racial groups highlight a significant need for increased awareness, cultural competency, and accessibility in autism services. As we strive for equity in healthcare, the stories of those affected by these disparities remind us of the urgency and importance of this work. For clinicians, educators, and advocates, understanding these disparities is the first step toward bridging the gap and ensuring all children have equal access to the support and services they need.

Citations

Bennett, A., Ray, M., Zucker, E., & Chuo, J. (2021). Increasing Diagnostic Services for Autism Spectrum Disorder in the Native American Community: A Pilot Collaborative Telecare Model.

Drexler, Olivia. (2018). Colonization in Autism: Understanding the Role that Colonialism Plays in the Disparity in Native American Autism Rates Cultural Differences. 10.13140/RG.2.2.19773.36325.

Gourdine, R. M., Baffour, T. D., & Teasley, M. (2011). Autism and the African American community. Social work in public health, 26(4), 454-470.

Foley, D. R. (2019). Asian children with autism in US schools: Potential drivers of unexpected disproportionality. International Journal of Technology and Inclusive Education, 8(2).

Mandell, D. S., Listerrud, J., Levy, S. E., & Pinto-Martin, J. A. (2002). Race differences in the age at diagnosis among Medicaid-eligible child with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 41(12), 1447–1454.

Mandell, D. S., Ittenbach, R. F., Levy, S. E., & Pinto-Martin, J. A. (2007). Disparities in diagnoses received prior to a diagnosis of autism spectrum disorder. Journal of autism and developmental disorders, 37(9), 1795–1802. https://doi.org/10.1007/s10803-006-0314-8

Furfaro, H. (2017). Race, class contribute to disparities in autism diagnoses. Spectrum News. Retrieved at: https://www.spectrumnews.org/news/race-class-contribute-disparities-autism-diagnoses/

Zuckerman, K. E., Sinche, B., Cobian, M., Cervantes, M., Mejia, A., Becker, T., & Nicolaidis, C. (2014). Conceptualization of autism in the Latino community and its relationship with early diagnosis. Journal of developmental and behavioral pediatrics : JDBP, 35(8), 522–532. https://doi.org/10.1097/DBP.0000000000000091

Autism Awareness Special Edition: BIPoC and Autism