Addressing Racial Disparity in Autism Treatment

By Dr John N Constantino | St Louis Post-Dispatch (MO), October 22, 2015 | Go to article overview

Addressing Racial Disparity in Autism Treatment


Dr John N Constantino, St Louis Post-Dispatch (MO)


The opening pages of the recently released Ferguson Commission report assert that vulnerability is a key to empathy, and that empathy is the key to understanding others from diverse backgrounds.

Few individuals in our society are more vulnerable than those with developmental disabilities, which affect one in six 6 U.S. citizens, largely irrespective of race. But because of disparities in access to quality care, the playing field becomes very uneven for minority children with developmental disabilities following the opening days of life. Effective intervention requires a tapestry of medical, developmental, educational and behavioral supports. Without it, disparities cruelly widen over time. Resolution of these inequities is central to the Ferguson Commission report's signature priorities of Youth at the Center, Opportunity to Thrive, and Racial Equity.

The statistics from two long-standing autism studies at Washington University highlight these issues. In the St. Louis region, on average, autism is diagnosed six months later in African- American families compared to Caucasian families. At a given level of symptom burden, African-American children are more likely to be misdiagnosed with less serious conditions, rendering them ineligible for intensive intervention. Parents of African-American children in our region report an average delay of almost four years between the time of their first concerns about their child's development and receiving an autism diagnosis.

The prevalence of autism does not vary by race. But until five years ago, there was only one African-American family represented in the national autism gene bank for every 20 Caucasian families, setting up the prospect that novel treatments from gene discovery might apply only to "Caucasian autism." This severe under- representation has been steadily corrected in a gene discovery program jointly led by Washington University and the University of California Los Angeles, supported by Autism Speaks and the U.S. National Institutes of Health. Our enrollment outreach for this effort continued on Oct. 10 at the annual Walk Now for Autism Speaks in Forest Park.

To counteract local disparities in special education for children with developmental disabilities, St. Louis County blazed a trail in 1957 by effectively consolidating each district's special education budget into a shared resource, the Special School District of St. …

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