2/12 Race, Ethnicity, and Inequity in Autism Identification

Join Duke Neurodiversity Advocates (DNA) for a discussion-based meeting that uses two papers to unpack a core question: why autism is recognized earlier for some groups and later, differently, or not at all for others. We will focus on what the research says about racial, ethnic, and sociodemographic disparities in autism diagnosis, and what those patterns mean for students, families, and communities.

Readings for the meeting (2 papers)

• Aylward, B. S., Gal-Szabo, D. E., & Taraman, S. (2021). Racial, ethnic, and sociodemographic disparities in diagnosis of children with autism spectrum disorder. Journal of Developmental & Behavioral Pediatrics, 42(8), 682-689. https://doi.org/10.1097/DBP.0000000000000996 

• Pham, H. H., Sandberg, N., Trinkl, J., & Thayer, J. (2022). Racial and ethnic differences in rates and age of diagnosis of autism spectrum disorder. JAMA Network Open, 5(10), e2239604. https://doi.org/10.1001/jamanetworkopen.2022.39604 

  
  

What we will cover

• What the disparities look like: Differences in age of diagnosis, likelihood of diagnosis, and diagnostic pathways across groups.

• Why disparities happen: Bias and stereotypes, unequal access to specialists, insurance and cost barriers, school referral patterns, language and cultural mismatch, and how screening tools are used in real life.

• Misdiagnosis and missed diagnosis: How autism can be mislabeled as behavior problems, anxiety, ADHD, ODD, or “social issues,” and how masking and “being high-achieving” can hide needs.

• What changes the system: Practical, evidence-consistent ideas like improving culturally responsive screening and referral, reducing gatekeeping, and shifting how we define “clinically noticeable.”