Autism Diagnosis Delayed in Minority Children

Eileen Bailey Health Guide March 06, 2012
  • Autism can be diagnosed as early as 14 months of age and should be screened beginning at 18 months according to the American Academy of Pediatrics. Even so, in the United States the average age for a diagnosis is 4.5 years old. But for minority children, diagnosis is often delayed by another year and a half.

     

    Experts believe there are a number of factors that contribute to the delayed diagnosis:

    • Black children may be more likely to get misdiagnosed during their initial visit with a medical specialist. Merva Jackson, executive director of African Caribbean Parents of Children with Disabilities, in an article on AutismToday.com, stated that she "believes that many African-American children with autism=spectrum disorders are misdiagnosed as having disorders involving defiant, oppositional or behavioral problems." A study completed by David Mandel in 2002 showed the same results.
    • Cultural disparities in the level and quality of health care between Caucasians and minorities. Even when economic factors and insurance availability are taken into account, minorities do not receive the same level of quality medical care.
    • A lack of education about autism within minority communities. Doctors rely on parents' descriptions of symptoms to aid in making a diagnosis. If a parent emphasizes behavioral concerns, the child may be diagnosed with ADHD or a defiance disorder. On the other hand, if the parent comes in with descriptions such as "not making eye contact" or "flapping his hands and arms" the doctor will lean more toward autism. Education about early warning signs of autism may be lacking within minority communities.
    • Cultural differences such as relying on extended family for information; in some ethnic communities, mothers will more naturally listen to grandparents or other elders, who may dismiss symptoms as nothing to worry about. Rather than talking to a pediatrician or doctor, the mother takes advice from elders in her family and community.

    Economic factors in some communities can also play a role. Routine doctor's visits, to the same doctor help in early diagnosis because the doctor is able to watch the development of the child and can more easily see if there are developmental delays. For those without insurance or access to medical care, this may not happen as often. And without insurance, it is more difficult to visit a specialist. However, while minorities living in low-income neighborhoods and communities may face this problem, delayed diagnosis of minority children was seen in low-, middle- and high-income communities.

     

    Besides the delayed diagnosis, according to the research study, minority children diagnosed with autism had more severe developmental delays. Researchers at the Kennedy Krieger Institute indicated that minority children have "more delayed language, communication and gross motor skills than Caucasian children with the disorder." [1] They believe that "subtle developmental delays may be going unaddressed in minority toddlers until more severe symptoms develop."

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    Early detection of autism is considered to be integral to receiving early treatment in language and other skills and the study seems to back this up. Dr. Rebecca Landa, director of the Center for Autism and Related Disorders at the Kennedy Krieger Institute and author of the study believes the results suggest that many children in need of early detection and intervention are not getting it. But, she also indicates that the study may show a difference in how the disease presents itself in different ethnic groups. She plans on continuing her research to gain more information into the reason there are disparities in the level of symptoms across ethnic groups. Her next study will look at how and why minorities first noticed developmental delays and will hopefully further answer questions as to whether the severity of the symptoms in minority children can be attributed to delayed diagnosis alone or if ethniticity plays a role.

     

    References:

    "New Study Shows Minority Toddlers with Autism are More Delayed than Affected Caucasian Peers," 2012, Feb 21, Kennedy Krieger Institute

     

    "Parents, Advocates Seek More Prompt Diagnoses of Minority Children," Date Unknown, Kathleen Megan, AutismToday.com