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Are Black Girls Overlooked For Autism Diagnoses?

April 2, 2022

April 2, 2022

“One in 27 boys is diagnosed with autism compared to one in 116 girls, and boys are four times as likely to be diagnosed than girls.”

Autism Awareness in Black Girls

Source: NHS

In Young Children

  • not responding to their name
  • avoiding eye contact
  • not smiling when you smile at them
  • getting very upset if they do not like a particular taste, smell, or sound
  • repetitive movements, such as flapping their hands, flicking their fingers, or rocking their body
  • not talking as much as other children
  • repeating the same phrases

In Older Children

  • inappropriate responses in social situations
  • mimicking behavior to fit in
  • obsessive focus on one interest
  • not seeming to understand what others are thinking or feeling
  • finding it hard to say how they feel
  • liking a strict daily routine and getting very upset if it changes
  • having a very keen interest in certain subjects or activities
  • getting very upset if you ask them to do something
  • finding it hard to make friends or prefer to be on their own
  • taking things very literally — for example, they may not understand phrases like “break a leg”

Autism can sometimes be different in girls and boys. For example, autistic girls may be quieter, hide their feelings, and appear to cope better with social situations. For these reasons, autism can be harder to spot in girls.

Support For Parents

Autism in Black

Autism in Black aims to support Black parents, who have an autistic child, through education and advocacy services. They also have a podcast.

Black Autistic Moms (B.A.M.)

A safe space for Black moms with children on the autism spectrum to come together to celebrate, encourage, and sometimes vent about their journeys.

Black Parents of Children with Autism and other Disabilities 

In this nonjudgemental supportive place, we can ask questions, voice our concerns and frustrations, celebrate our children’s accomplishments, and most importantly, support each other.

The Color of Autism Foundation

Connecting families to culturally competent support.

You might be familiar with the inappropriate term, “boys will be boys,” well, when it comes to autism, many doctors overlook girls because of the belief that “girls will be girls.” Activities that are red flags in boys but explained away in girls are part of why they are often underdiagnosed. Dr. Anna Kroncke, PH.D., NCSP, a recognized expert on autism, ADHD, anxiety, and depression, said, “…girls have more typical special interests than boys do. Girls may be interested in horses, dolls, or zoo animals. These are also common interests in neurotypical children.” Meaning that when boys become obsessed with these things, society pays attention and views it as something more, and oftentimes it is. “Also, autism is…diagnosed much later in girls because symptoms are commonly more subtle,” said Kroncke.

According to AutismSpeaks.com, one in 27 boys is diagnosed with autism compared to one in 116 girls, and boys are four times more likely to be diagnosed than girls. Add to this equation that Black children are less likely than white children to be diagnosed at all, and when Black children are found to have autism, it’s often realized later in life. Because it is difficult to determine autism in Black boys, Black girls really slip through the cracks when it comes to Autism diagnoses. “For females and children with average or above-average intelligence, autism can be difficult to identify and is often first diagnosed in later elementary, middle school, high school, or even adulthood. To be clear, autism is present prior to diagnosis but is not recognized or diagnosed, ” said Jessica Myszak, Ph.D., a licensed psychologist and the Director of The Help and Healing Center.

“Because it is difficult to determine autism for Black boys, Black girls often slip through the cracks when it comes to Autism diagnoses.”

Disguising symptoms of autism is a common thing for girls. “Females…hide their autistic characteristics by playing a role, attempting to blend in, or copying things they see in others, ” said Myszak. Unfortunately, “…most of our education and assessment tools are likely skewed towards recognizing autism in males,” said Myszak. Cecelia McCarton, M.D., is among the world’s leading experts in diagnosing and treating children with developmental disorders. She said, “Girls are naturally more able to mimic social interactions.” Not only are girls able to copy the interactions of others, but it takes a closer look to see that their response doesn’t always fit the action that is happening around them. “More careful observation may reveal a girl’s social responses are not spontaneous, appropriately timed, or genuine. For example, a young girl with autism may laugh with her friends, but she may consistently be the last one in her group to laugh, or her laugh may be forced,” said McCarton.

One big problem is the minimal research available on Black children with autism. Often, Black families don’t want to participate in studies, which is part of the generational trauma from studies that we call the “Tuskegee Experiment Effect.” The Black community has trust issues with scientists and government health organizations and often will not answer surveys and are hesitant to enroll their children in studies. In addition, young children with autism, especially boys, are assumed to have behavior problems due to their socio-economic status. Teachers and other adults will see them as misbehaving or ‘bad’ because of unconscious biases that skew their perception and prevent a proper diagnosis at a young age. When a child is younger, they can receive the appropriate therapy and social support while their brain develops to reach their optimal performance level. “It also allows for more practice and support in social settings before social relationships get harder in adolescence…,” said Kroncke.

Experts agree that the younger your child receives support for autism, the better. “Research shows us that those diagnosed later with autism tend to have more anxiety and depression than children diagnosed and supported at a young age,” said Kroncke. And girls are especially vulnerable because they are often described as the “invisible child,” said McCarton. “But as adolescence sets in, they are no longer able to share the same interests with their classmates. The adolescent girl with autism is less likely to be able to engage with peers on personal subjects of feelings and experiences. Girls may withdraw and experience a tremendous amount of anxiety trying to hide their challenges.”

If you suspect that your daughter has autism, resources are available to you. You are not alone. This article has a listing of some autism groups to help you start building your support system.


How Do Children Get Autism?

No one knows why some children are autistic. Scientists do know that “many of the genes identified as causal to autism reside on the X chromosome,” said Maria I. Kontaridis, Ph.D., Director of Research at the Masonic Medical Research Institute in Utica, New York. The location of the gene is always on the X chromosome but that doesn’t mean it comes from the mother. Dad’s X chromosome contribution to his daughter may also be a carrier, whether he shows signs of autism or not.

GIRLS AND CHROMOSOMES

High school biology class taught us that females have two X chromosomes and males have one X and one Y chromosome (see chart). Because boys only have one X chromosome from their mothers, moms “who are carriers for a mutation on an X chromosome have a 50:50 chance of having sons with autism,” said Kontardis. When the daughter receives her two X chromosomes, if only one has the mutation, the other will likely mask it, and the daughter will probably have zero to mild symptoms of autism.

BOYS AND CHROMOSOMES

“Since boys only receive one X chromosome from the mother (the other being a Y chromosome inherited from the father), a mutation on this X chromosome would manifest in a clearer diagnosis of autism,” said Kontardis.

April is National Autism Awareness Month and April 2nd is World Autism Awareness Day.

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