In the earliest days of the pandemic, it was obvious that some communities felt the impact at an entirely different level than others. While we have only begun to recognize and document disparities in the autism community, we know they also occur based on gender, race and socioeconomic standing.
Autism can be difficult to diagnose, especially since clinicians must engage with very young children. Boys are four times as likely to be diagnosed with autism as girls, but a growing body of research indicates that new methods may be needed to successfully diagnose girls.
A recent study by Children’s Hospital of Philadelphia and supported by the Autism Science Foundation found that autistic girls use different, more cognitive language to describe their experiences, which can lead to clinicians ruling against an autism diagnosis. Other studies show girls appear to be more adept at masking autism symptoms, and are more likely to be misdiagnosed with depression or anxiety instead. We know that early diagnosis leads to better outcomes. These and other studies promise to change the way we understand and diagnose autism in girls.
With appropriate developmental surveillance and screening, a child with autism may be diagnosed and treated younger than two years of age; however, the national average age of diagnosis in the United States remains between four- and five-years-old. That average is delayed even further for children of color.
According to a 2015 article in the Journal of Developmental Disorders, diagnosis for African American children occurs an average of 1.6 years later than white children, and Black children are also 2.6 times more likely to be misdiagnosed — they are 5.1 times more likely to receive a misdiagnosis of adjustment disorder and 2.4 times more likely to receive a conduct disorder misdiagnosis.
The American Academy of Pediatrics published a study in 2020 noting that Black children with ASD were diagnosed an average of three years after their parents expressed concerns about their development. For children in families where English is not the primary language, there is yet another barrier. Both Black and Latinx children often experience stigma and lack of access to healthcare services due to lack of income or citizenship.
Sometimes it takes a cataclysmic event to draw attention to obvious truths. The pandemic cast a harsh light on the disparities of healthcare that initially allowed COVID-19 to claim more lives in communities of color than in white communities.
Surely, that is a lesson for all of us. We have identified the challenge. We can and must do better. Our children’s future depends on it.
Kanika Littleton is the director of Michigan Alliance for Families in Lansing.
Originally posted by The Lansing State Journal.