Based on Kanner’s observations of the children he worked with, autism was once thought to be a disorder that disproportionately affected families of higher socioeconomic status (Kanner, 1943). He noted that the parents of the children he described in his seminal work were highly educated, upper middle class, and of European-American descent. Subsequent studies failed to corroborate Kanner’s belief. The likely reason for Kanner’s finding was a result of bias caused by a greater access to diagnostic and treatment options for families with financial means.
In the 70 years since Kanner’s report we now know that autism clearly affects children from diverse racial and socioeconomic backgrounds yet disparity continues to exist in services. Nowhere is this more evident than in the prevalence work that the Centers for Disease Control are currently conducting (Autism and Developmental Disabilities Monitoring Network Surveillance Year 2010 Principal Investigators, 2014). This autism prevalence monitoring program has found that White children were 30% more likely to be identified with autism than Black children and 50% more likely to be identified than Hispanic children underscoring a significant disparity in the identification and diagnosis of autism as a function of racial/ethnic background.
In November 2013 there were 10,910 children ages 3-21 receiving special education services under the autism category in Washington State (2013 OSPI). The racial/ethnic background of these children are listed below. Compared to census data on Washington State these numbers suggest statistically speaking, in WA state we have an over-representation of White, Black, and Asian kids in special education and an under-representation of Hispanic, Hawaiian/Islander, and multi-racial kids.
|# of STUDENTS||%||RACE|
|110||1%||American Indian/Alaska Native|
|1317||12%||Hispanic or Latino|
|49||<1%||Native Hawaiian/Other Pacific Islander|
While more research is needed to more fully understand the implications of racial and socioeconomic differences, Dr. Raphael Bernier, shares with us his 2010 study on this important issue.
The real take home of this paper is that we first need to increase our awareness of autism in the broader community. The CDC studies, and several other studies focused on race, culture, and autism, have already paved the way for this awareness. Second, we need to improve our knowledge base of how cultural differences may influence clinician perspective when evaluating a child for an autism diagnosis, of how cultural differences may influence family perspective and experience of autism, and of how cultural differences may influence treatment options and intervention approaches. Thirdly, we need to develop and enhance our skills at applying this knowledge in clinics so that autism is appropriately identified, information and resources are made available in a culturally relevant manner, and treatment options are appropriately considered. The only way to tackle steps two and three are through collaborations between families, clinicians, and scientists.
Read more: “Psychopathology, Families, and Culture: Autism” by Bernier et al 2010.