Autism, Race and Economics: Who Gets the Diagnosis?

According to an article in Newsday.com, wealthier children on Long Island are more likely than poorer children to receive early autism diagnosis.

Affluent school districts such as Half Hollow Hills, Manhasset and Roslyn classify more than five times as many of their students with autism as districts at the opposite end of the economic spectrum, including Brentwood, Copiague, Freeport and Hempstead, a Newsday survey confirms.

The reason: A push to expand special-education help for students with autism has largely bypassed Long Island's poorest communities, creating what family advocates view as damaging gaps in services for minority youngsters and those speaking limited English.

The survey, based on state figures, compares the proportion of students with autism in all Island school systems that have enrollments of more than 500.

Advocates who have compiled similar data voice concern that many poor, minority youngsters might not be getting the same extensive, state-mandated services available to those identified as autistic. Such services include parent training, along with home therapy for children.

Medical experts blame the problem not so much on schools as on a lack of quality health care in low-income neighborhoods. Research shows toddlers in poor families who aren't taken on regular visits to pediatricians are less likely to have their autism diagnosed when it first appears - usually, before age 3.

This situation is typical. Across the board, wealthier whiter Americans receive better health care than anyone else. It is, of course, an issue of money and race. But it's also an issue of culture and perspective. As Newsday goes on to say:

Educators say the problem appears to be compounded by differences in racial perspectives. Many white parents actively seek special-education classifications for their children, educators add, for advantages such as extended testing time. Black and Hispanic parents tend to be warier of special-education programs that, historically, placed many minority children in classes beneath their ability levels.

It is interesting to note that the vast majority of autism advocates (including adults on the autism spectrum) are white. Authors writing about autism, celebrities speaking about autism, and fundraisers pounding the pavements for autism are also largely white. And even while a few major voices from the African American community - including Oprah Winfrey, Bill Cosby and Toni Braxton - are speaking out about autism, there are good reasons for parents to avoid that "special" diagnosis if they can.

I'm not at all sure there's an easy answer to this issue. Research seems to suggest that autism is equally prevalent among all races and economic levels ... and certainly early intervention and treatment is beneficial to every child on the spectrum. But given the present state of American health care and education, there seems to be no good reason for the service gap to narrow anytime soon.