Black Children Tend to be Diagnosed with Autism Later than White Children
The rate of diagnosis for autism spectrum disorders (ASD) is the same among all racial groups - one in 110, according to current estimates. However, a study by a Florida State University researcher has found that African-American children tend to be diagnosed later than white children, which results in a longer and more intensive intervention.
The reasons for later diagnoses include a lack of access to quality, affordable, culturally competent health care, according to Martell Teasley, an associate professor in Florida State’s College of Social Work who has conducted a comprehensive review of researchliterature on autism and African-American children. In addition, the stigmaattached to mental health conditions within the black community contribute to misdiagnoses of autism, and underuse of available treatment services.
“There are no subjective criteria for diagnosing autism. Only brain scans can truly provide appropriate diagnoses, because we are dealing with biological and chemical imbalances in the brain,” Teasley said. “Not every child is going to have access to this kind of medical evaluation, particularly those who are indigent and don’t have health care funding.”
Teasley examined ASD diagnosis and treatment strategies, and their effect on African-American families, in “Autism and the African-American Community,” a paper published in a special issue of the journal Social Work in Public Health (Vol. 26, Issue 4, 2011) that dealt with health-care policy issues in the black community related to the human genome. Teasley co-wrote the paper with Ruby Gourdine, a professor of social work at Howard University in Washington, D.C., and Tiffany Baffour, an associate professor of social work at Winston-Salem State University in North Carolina.
Because of the social stigma, Teasley says that some African-American families might be resistant to accept a diagnosis and treatment.
Autism is a complex lifelong neurodevelopmental disorder usually identified by age three. A child with autism will show different behaviors than typical developing children.
Parents become concerned that their child may lack eye contact, be deaf, is not yet talking, resists cuddling, appears aloof and avoids interacting with others.
These behaviors may begin shortly after birth or develop as a child grows older.
Symptoms will range from mild to severe. Mental retardation is commonly associated in autism. The Centers for Disease Control in Atlanta and others report black children have significantly higher rates of mild mental retardation than white children do and socioeconomic factors cannot explain the differences. Yeargin-Allsopp M, Drews CD, Decoufle P, Murphy CC Mild mental retardation in black and white children in metropolitan Atlanta: a case-control study. Am J Public Health. 1995 Mar;85(3):324–8. Drews CD, Yeargin-Allsopp M, Decoufle P, Murphy CC Variation in the influence of selected sociodemographic risk factors for mental retardation. Am J Public Health. 1995 Mar;85(3):329–34.
“Less discussion about autism among African-Americans or between African-Americans and health care providers leads to misdiagnoses, a lack of treatment and a lack of services,” Teasley said. “This will lead to greater challenges for families - more stress and anxiety, and poorer developmental outcomes.”
African-Americans also might resist a diagnosis and treatment because of a mistrust of mainstream health care providers over past discrimination.
Autism In Black Children
There are many myths about autism floating around out there, but one that specifically affects the African American Community is that autism is a “white disorder.” The truth of the matter is that autism affects every race, ethnic group, and socio-economic status. However, there are clear racial disparities in healthcare and special education, as studies have consistently reported negative biases toward minorities in the areas of diagnosis and treatment.
African American autistic children are diagnosed later, receive more misdiagnoses, and are more likely to be misdiagnosed as having organic psychoses, mental retardation, or selective mutism. A study by Dr. David Mandell in October 2005, reported that, on average, the diagnosis of Autism Spectrum Disorder (ASD) was delayed by almost two years among African American children – to 7.5 years old – as compared to their Caucasian counterparts, whose autism is diagnosed at an average 5.5 years old.
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By Karissa Lang
“African-Americans are well versed in going to a doctor who might have biases or discriminatory practices, so they may not readily accept what a doctor says,” Teasley said.
In addition, a cultural divide between African-Americans and mainstream health care providers can hinder a timely and correct diagnosis.
“There are not enough health care professionals who understand the cultural norms and attributes of the African-American community,” Teasley said.
African-Americans live in all types of settings, but the majority live in urban areas, which have seen a decline in the number of mental-health care agencies since the 1980s.
“This lack of accessibility causes a problem for some African-Americans,” Teasley said.
Once a child is diagnosed with ASD, Teasley says both the child and the members of his or her family needs to receive appropriate training and counseling.