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Multiple Barriers Contribute to Late Autism Diagnosis in Minority Children


Although autism has no cure, experts agree that early intervention gives the child the best chance for a positive developmental outcome. However, some minority groups, especially African-Americans, are being diagnosed later in childhood which can ultimately lead to longer and more intensive treatment needs.

The rate of autism is no different among the different racial groups. About one in 110 children will be diagnosed with a disorder on the spectrum. However, multiple barriers such as lack of access to quality care and social stigma, delay diagnosis in some children.

Martell Teasley, an associate professor at Florida State University’s College of Social Work, has conducted a comprehensive review of the currently available literature on autism in African-American children. Co-writers for the article published in the journal Social Work in Public Health include Ruby Gourdine from Howard University and Tiffany Baffour from Winston-Salem (NC) State University.

Dr. Teasley examined autism spectrum disorder (ASD) diagnosis and treatment strategies, and their effect on African American families. He notes that, because brain scans are the only appropriate diagnostic tool and that not every family has access to this kind of evaluation, patients are diagnosed later in childhood thus having a “poorer developmental outcome that can have a lasting impact on the child’s and family’s quality of life.”

There is also a concern about lack of accessibility to the appropriate resources. Teasley notes that although African-Americans live in all types of settings, the majority live in urban areas which have seen a decline in the number of mental-health care agencies since the 1980’s.

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Other reasons for the delay in diagnosis for autism are mistrust of healthcare providers, lack of communication, or social stigmas. African-Americans may not readily accept a diagnosis or treatment plan because of a mistrust of mainstream health care providers due to past discrimination.

There may also be a cultural divide which leads to miscommunication. “There are not enough health care professionals who understand the cultural norms and attributes of the African-American community,” Teasley said. For example, families may have a differing opinion on what constitutes typical versus atypical development in young children.

A separate study, conducted by researchers at the Kennedy Krieger Institute notes that delay in diagnosis for autism in toddlers leads to more severe symptoms, such as delayed language and gross motor skills. This second study notes that not only are African-Americans at risk, but also at risk are other ethnic and racial minorities, such as Hispanics and Asian-Americans.

Dr. Rebecca Landa, the director of the Center for Autism and Related Disorders at KKI, examined the development of 84 toddlers with ASD with an average age of 26 to 28 months. Three standardized instruments were used including the Communication and Symbolic Behavior Scales Developmental Caregiver Questionnaire (CSBS-DP CQ) and the Mullen Scales of Early Learning and the Autism Diagnostic Observation Schedule-Generic (ADOS).

“We found the toddlers in the minority group were significantly further behind than the non-minority group in development of language and motor skills and showed more severe autism symptoms in their communication abilities,” says Dr. Landa.

Intervention for any autistic child needs to start around age 3, so we can get the child to begin to learn how to eat right and develop normal, healthy routines, which will result in a better developmental outcome,” Teasley said. “Later intervention will result in a poorer developmental outcome that can have a lasting impact on the child’s and family’s quality of life.”

“Autism and the African-American Community,” published in a special issue of the journal Social Work in Public Health (Vol. 26, Issue 4, 2011)
Kennedy Krieger Institute. "Minority Toddlers With Autism May Be More Delayed Than Affected Caucasian Peers." Medical News Today. Retrieved 2012, February 23 from Medical News Today.