Race influences parent report of concerns about symptoms of autism spectrum disorder

Oct 15, 2026

Racial differences in how parents report concerns about their child’s development to healthcare providers may contribute to delayed autism spectrum disorder diagnoses for Black children. This study tested whether, compared with White parents, Black parents of children with ASD reported fewer autism-related symptom concerns and more concerns about disruptive behaviors. In a sample of 174 toddlers (18–40 months), parents provided free-response concerns prior to diagnostic evaluation. Black parents reported fewer autism and autism-related social and restricted/repetitive concerns, but not fewer non-autism concerns; race also did not affect reports of disruptive behavior concerns.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Keywords

Introduction

Diagnostic disparity in Black children with ASD

Parent concerns about child development

Original Article Race influences parent report of concerns about symptoms of autism spectrum disorder Meghan Rose Donohue 1, Amber W Childs2, Megan Richards3,4 and Diana L Robins 1,3 Autism 2019, Vol. 23(1) 100–111 © The Author(s) 2017 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/1362361317722030](DOI: 10.1177/1362361317722030)[ ](DOI: 10.1177/1362361317722030)[journals.sagepub.com/home/aut](journals.sagepub.com/home/aut) Abstract Racial differences in parent report of concerns about their child’s development to healthcare providers may contribute to delayed autism spectrum disorder diagnoses in Black children. We tested the hypotheses that compared to White parents, Black parents of children with autism spectrum disorder would report fewer concerns about autism symptoms and would be more likely to report concerns about disruptive behaviors. A sample of 18-to 40-month-old toddlers (N = 174) with autism spectrum disorder and their parent participated. After screening positive for autism spectrum disorder risk, but prior to a diagnostic evaluation, parents completed free-response questions soliciting concerns about their child’s development. Parent responses were coded for the presence or the absence of 10 possible concerns, which were grouped into autism concerns ([e.g. social](e.g. social) and restricted and repetitive behavior concerns) or non-autism concerns (e.g. general developmental and disruptive behavior concerns). Compared to White parents, Black parents reported significantly fewer autism concerns and fewer social and restricted and repetitive behavior concerns. However, Black parents did not report significantly fewer non-autism concerns. Race did not influence parent report of disruptive behavior concerns. Lower reporting of autism concerns by Black parents may impact providers’ abilities to identify children who need further screening or evaluation. Keywords autism, autism spectrum disorder, child development, diagnostic disparities, parent concerns, race and ethnicity Introduction Although the majority of parents of children with autism spectrum disorder (ASD) report concerns about their child’s development during the first 2 years of the child’s life (Herlihy et al., 2013; Richards et al., 2016; Zuckerman et al., 2015), the median age of diagnosis is after the child’s fourth birthday (CDC, 2016). Early detection of ASD facilitates early intervention, which is associated with better outcomes (Anderson et al., 2014; Linstead et al., 2016; MacDonald et al., 2014; Orinstein et al., 2014; Smith et al., 2015; Vivanti et al., 2016). Despite progress in using standardized screening to identify children at risk for ASD (Pierce et al., 2011; Robins et al., 2014), Black children are diagnosed with ASD at older ages than White children and children of other races (Mandell et al., 2007, 2002, 2009; Valicenti-McDermottet al., 2012) . To date, little research has been devoted to elucidating potential reasons for such diagnostic disparity. The purpose of this study is to offer insight into delayed ASD diagnosis for Black children by examining whether concerns that parents communicated to healthcare providers about their child’s development prior to diagnosis differed as a function of race. Diagnostic disparity in Black children with ASDIn light of the implications of delayed or missed diagnosis, it is crucial to address ASD diagnostic disparity in Black children. Although the ASD phenotype is not thought to 1 Georgia State University, USA 2Yale University, USA 3Drexel University, USA 4Indiana University, USA Corresponding author: Meghan Rose Donohue, Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA 30302-5010, USA. [Email: mdonohue1@student.gsu.edu](Email: mdonohue1@student.gsu.edu) differ by race, studies have found that Black children hada lower incidence of

FAQs

What question does the study address about race and autism diagnosis?

It examines whether the concerns parents communicate to healthcare providers before diagnosis differ by race, potentially contributing to delayed ASD diagnoses in Black children.

What did the researchers find about autism-specific concerns reported by Black versus White parents?

Compared with White parents, Black parents reported significantly fewer autism-related concerns, including fewer concerns about social and restricted and repetitive behaviors.

Did race affect parents’ reporting of disruptive behavior concerns?

No. Race did not significantly influence parent reports of disruptive behavior concerns.

Oct 15, 2026

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