Autism is becoming more widely recognized in the Black community, but challenges still remain when it comes to getting a proper and timely diagnosis. According to a CDC report, about 3% of Black, Hispanic, and Asian children in the U.S. are being diagnosed on the spectrum, compared to about 2% of white children. This is a big shift from 2010, when white children were 30% more likely to be diagnosed than Black children. Experts say this change is mostly because of better screening, improved services, and more awareness and advocacy in communities of color.
Even though more Black children are being diagnosed now, many still face delays in diagnosis and barriers to getting help. On average, Black children are diagnosed later than white children, and they’re more likely to be misdiagnosed with other conditions before doctors recognize they are on the autism spectrum. These delays make it harder for families to get early support, which can impact long-term learning and development.
Studies show that Black parents often notice something different about their child, although they may not always describe the classic signs of being on the autism spectrum. For example, white families are more likely to talk about repetitive behaviors (a key sign of autism). In contrast, Black families are more likely to mention general concerns like speech delays, problems with motor skills, or trouble sleeping. This can lead doctors to miss the subtle signs of autism, especially if the child doesn’t show more obvious symptoms or if the child happens to be a girl.
Autism is often underdiagnosed in Black girls. Even though more children are being identified with it today than in the past, Black girls still face significant barriers in diagnosis, support, and inclusion when it comes to research. This underdiagnosis is caused by several overlapping factors, including racial bias, gender bias, and a lack of culturally appropriate screening and services.
For every girl diagnosed with autism, over four boys are diagnosed. However, many experts believe that this gap does not reflect the actual number of girls with autism. Instead, it shows that the signs of it in girls are often missed.
For example, if a young girl’s language is very advanced for her age, it could be a sign that she is on the spectrum. Many confuse this with being an extremely gifted and intelligent girl. “Girls with autism typically show language skills that may appear advanced for their age, which ironically can lead parents and teachers to overlook potential developmental concerns,” Ralph Moller, director of operations at Above & Beyond Therapy, observes.
Black children in general tend to be diagnosed later than white children, but the delay is often even longer for Black girls. Many are only diagnosed if they also have an intellectual disability, which means Black girls who are considered “high functioning” or who have more subtle signs of autism are often overlooked. These delays can prevent them from getting early intervention and support that could help them thrive.
Another issue is that many Black girls mask or hide their struggles to fit in. They may follow social rules, do well in school, or stay quiet, making it harder for adults to see that they are struggling. Even after receiving a diagnosis, Black girls often have more trouble getting services like therapy and school support.
Black children with autism are more likely to also be diagnosed with intellectual disability (ID) (about 50%), compared to 32% of white children. This suggests that Black children who don’t have intellectual disabilities, and may have milder symptoms of autism, are sometimes overlooked. An article in the journal Pediatrics explores how symptoms that impact diagnosis are worth noting.
Behind all of this are deep issues like racism, bias, and unfair systems. Many Black families face challenges such as not having enough doctors in their area, not feeling heard by healthcare workers, or struggling to get referrals to autism specialists. Some of these problems happen because of structural racism—systems that give white families easier access to care, while making it harder for Black families.
While progress has been made in diagnosing autism in the Black community, racial disparities still persist. More work is needed to make sure all children, regardless of race or income, get the support they need early on. According to Dr. Erin Vinoski Thomas, a disability health Research Associate Professor, the reasons behind these disparities are complex but deeply connected. She notes that bias in healthcare providers is a significant issue.“Healthcare providers are really not trained to provide culturally relevant care to people with disabilities, and that includes autistic people,” she says. “It has numerous interrelated factors, all sort of underscored by systemic racism and systemic ableism working together.”
“Dr. Thomas and her team are working to change that by embedding disability and autism training in medical and nursing school curricula, alongside offering continuing education for providers.
“Even if you’ve been practicing medicine for 30 years, you can still benefit from the training available today to shape how you care for patients with disabilities,” Dr. Vinoski Thomas points out.
This is exemplified through the Georgia Statewide Disability and Health Program:
It offers healthcare provider training to improve access to care for adults with intellectual and developmental disabilities (including autism). The Center for Leadership in Disability at Georgia State University also runs programs like IDEAL.
This inclusive postsecondary education initiative supports students with intellectual disabilities and college students with ASD. This will help them succeed with tailored services and support. You can learn more about these programs here:
Georgia Statewide Disability & Health Program
IDEAL (Inclusive Postsecondary Education Program)
Center for Leadership in Disability
Additional Resources:
CDC Archives
JAMA Network Racial and Ethnic Disparities in Geographic Access to Autism Resources Across the US
Pediatrics: Timing of the Diagnosis of Autism in African American Children
