Many children are diagnosed with autism spectrum disorder (ASD) every year. In 2018, for example, 1 child in 44 was diagnosed with autism. But diagnosis rates vary widely from state to state. And many experts believe some children are diagnosed too late or not at all.
These discrepancies matter. Children diagnosed late have more mental and social difficulties than peers diagnosed early.
Two main sets of myths lead to diagnosis discrepancies: gender and race. Let’s dig into them now, so you can understand how to help.
Four Gender-Based Autism Myths
ASD is a developmental disorder that could impact a person of any gender. But the way autism has been studied, diagnosed, and discussed could twist your assumptions. These are four myths we commonly hear.
1. Autism Only Happens to Boys
Boys are four to five times more likely to be diagnosed with autism, when compared to girls. The wording of this sentence matters. Boys get the diagnosis, but girls may struggle in silence.
Strip away the sexism and bias, and some researchers say the ratio of boys/girls with autism would be two to one. More boys would be diagnosed with autism than girls, but far more girls would get the help they deserve.
2. Boys Get Autism Earlier Than Girls
When compared to males, females wait longer for mental health services referrals, and they’re older when diagnosed. This fact is often misinterpreted. While males are diagnosed earlier, this indicates that females are often misdiagnosed in their appointments, or they’re not given a diagnosis at all.
Some girls with autism are adept at masking their difficulties. They may have significant problems while at home or near people they trust. But they may work hard to stay still and quiet around strangers and in official settings (like schools). A girl’s silence can be interpreted as obedience or exceptional behavior—not fear of being reprimanded. A girl like this doesn’t get help.
3. Symptoms of Autism in Boys and Girls are the Same
Doctors use observations and behavior reports to diagnose autism. The disorder hallmarks they look for were developed by scientists studying boys with autism. Issues unique to girls just don’t show up as warning signs.
Girls with autism have fewer symptoms related to restricted interests. They may not fixate on dinosaurs or Disney films. Without that symptom, they may not qualify for an autism diagnosis from some doctors. They do have lower IQs than males with autism, and they tend to display more extreme behavior issues, especially at home.
Looking for these gender-specific signs could help doctors close the autism gap. But few doctors do so.
4. People with Autism Are Asexual
People assume that a child with autism will grow up isolated, preferring alone time to romantic relationships. This myth can stifle a natural source of joy for both boys and girls with autism.
While some people with autism prefer time alone, many others enjoy a full romantic life. And some explore a different form of romance.
In one study of people with autism, 5% were cisgender, and 24% were gender diverse. People like this are also five times as likely to suspect they have undiagnosed autism as their cisgendered peers.
People with autism are just as unique and capable of love as people who don’t have autism. Respecting that fact leads to more compassionate treatment throughout the lifespan.
Four Myths About Race and Ethnicity
The color of your child’s skin or the language your child speaks doesn’t determine autism risks. But those same factors could keep your child from a quick, accurate autism diagnosis.
These are four race-based myths about autism we often hear.
1. Autism Risks Are Significantly Higher in White Children
White children are 1.1 times more likely than Black children and 1.2 times more likely than Hispanic children to have autism. But those gaps are closing yearly. As they narrow, it suggests autism isn’t tied to skin color.
Instead, children of color are not diagnosed like their white peers. To some doctors and assessors, they don’t fit the playbook of autism.
2. Only White Parents Recognize Autism Symptoms
Black parents report fewer social and repetitive behavior concerns than their white counterparts. Doctors looking for an exclusive set of symptoms may believe that Black children don’t qualify for an autism diagnosis as they don’t have classic symptoms.
Most early autism research was conducted on white children. Symptoms doctors look for stem from that research. Nuances in presentation in children of color may not appear on these coded lists, which could keep children from getting the proper diagnosis.
3. Parents of Color Don’t Seek Help for Their Children
It’s easy to place the blame for delayed diagnosis at the feet of parents. But this tactic denies the challenges parents face when they ask for help for their children.
Black children with autism wait three years for an autism diagnosis—measured from the moment their parents notice concerning symptoms. About 36% of parents like this wait for a long time to see a professional, and 42% see more than one before getting answers.
Parents like this want the best for their children. But they’re working within a system that doesn’t support them.
4. Racial Disparities Can Be Explained By Income
Structural racism forces some families of color into low-income neighborhoods. Poverty can keep children from getting accurate autism help. But plenty of families of color struggle to get their children an autism diagnosis—and the issues persist regardless of income.
In a study of families using Medicaid, economic disparities disappear. White children were diagnosed at age 6.3 years, but Black children were age 7.9 years. Research like this demonstrates how the color of a child’s skin, not the money in a parent’s bank account, can keep children behind.
We Can Do Better
At Elemy, we keep a close eye on statistics like this. We believe that all families touched by ASD deserve help, and we know that early interventions can mean the world for children in need. We must all—as a community that cares about children—recognize bias and fight it.
Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years: Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. (December 2021). Centers for Disease Control and Prevention.
Mental Health and Social Difficulties of Late-Diagnosed Autistic Children Across Childhood and Adolescence. (February 2022). The Association for Child and Adolescent Mental Health.
U.S. Autism Rates Up 10 Percent in New CDC Report. (March 2020). Johns Hopkins Bloomberg School of Public Health.
Autism: It’s Different in Girls. (March 2016). Scientific American.
Largest Study to Date Confirms Overlap Between Autism and Gender Diversity. (September 2020). Spectrum.
Spotlight on Racial and Ethnic Differences in Children Identified with Autism Spectrum Disorder. (August 2019). Centers for Disease Control and Prevention.
Race Influences Parent Report of Concerns About Symptoms of Autism Spectrum Disorder. (November 2017). Autism.
Study: Black Children’s Autism Diagnosis Typically Delayed 3 Years. (August 2020). American Academy of Pediatrics.
Race Differences in the Age at Diagnosis Among Medicaid-Eligible Children with Autism. (December 2002). Journal of the American Academy of Child and Adolescent Psychiatry.