Jennifer Russell Baker, a Licensed Professional Counselor (LPC), National Certified Counselor (NCC), and Certified Trauma and Anxiety Specialist, uses her expertise to help children and adolescents navigate the challenges of trauma and anxiety.
Autism spectrum disorder (ASD) is a developmental disability that affects how people communicate and interact with the world. While autism can affect anyone, it is more commonly diagnosed in boys. However, recent research suggests that autism may be underdiagnosed in girls and BIPOC (Black, Indigenous, and People of Color) children due to various factors. This can lead to delays in diagnosis and treatment, significantly impacting a child's development.
Underdiagnosis in girls
One reason autism may be missed in girls is that they often present with different symptoms than boys. Girls may be better at masking their autistic traits by mimicking social behaviors, making it harder for parents and professionals to recognize the signs of autism. Additionally, some diagnostic tools used to assess autism were developed based on research primarily focused on boys, which may not accurately capture the experiences of girls.
The impact of cultural bias
Cultural bias can also contribute to the underdiagnosis of autism in BIPOC children. Some healthcare providers may have preconceived notions about how children from certain racial or ethnic groups should behave, leading them to overlook signs of autism. Additionally, cultural differences in communication styles may be misinterpreted as symptoms of autism.
Signs and symptoms to look for in girls
Girls with autism may be more likely to:
Be quiet and withdrawn: They might seem shy or disinterested in social interaction, but their inner world could be very rich. One parent described how their daughter was always considered well-behaved in school. Initially, they thought she was just quiet but later realized she was struggling to connect with other children.
Have intense, specific interests: While special interests are common in autism, girls might focus on topics considered more "typical" for girls, such as animals or fictional characters, which can mask the intensity of their focus.
Mask their autistic traits: They might mimic neurotypical behaviors to fit in, which can be exhausting. A young woman with autism shared that she learned to laugh when everyone else laughed, even if she didn’t understand the joke, explaining that it felt like acting all the time.
Experience more internalizing symptoms: Anxiety and depression are common in autistic girls due to the pressure of masking and the challenges of navigating a neurotypical world.
Signs and symptoms to look for in BIPOC children
BIPOC children with autism may be more likely to:
Have their behaviors misinterpreted: Cultural differences in communication styles or play might be seen as defiance or a lack of social skills rather than a sign of autism.
Face diagnostic overshadowing: Existing diagnoses, such as ADHD or behavioral problems, may overshadow the signs of autism. One parent recounted how their son was labeled a "troublemaker" for years. Autism wasn't considered until they specifically pushed for it, despite the signs being present.
Experience language delays that are dismissed: In some cultures, later language development might be considered normal, leading to a delay in recognizing potential autism.
Have sensory-seeking behaviors misinterpreted: A child's need for movement or specific sensory input might be seen as disruptive rather than a need for self-regulation.
Common misdiagnoses
Common misdiagnoses for girls with autism include:
Anxiety disorders
Depression
ADHD
Social anxiety
Common misdiagnoses for BIPOC children with autism include:
ADHD
Oppositional Defiant Disorder (ODD)
Conduct Disorder
Intellectual Disability (sometimes due to a lack of culturally sensitive assessment tools)
From professional experience, I know how devastating misdiagnosis can be for families.
The third-grade Black boy whose parents are called every day to be told he is violent and disruptive.
The ninth-grade Black girl who has chronic absences because she becomes overstimulated at school and can’t cope with being there, whose mother is told to give her tough love because she "just doesn’t like school."
The seventh-grade Hispanic girl who has difficulty making friends because she doesn’t understand social cues and cries in her room because she’s lonely, whose parents are told, "She’ll grow out of it. All middle schoolers are awkward."
As a parent with a misdiagnosed child, it can feel as if nothing you do is working and that you don’t have the tools to help your child. Due to the misdiagnosis, you aren’t given the right tools, and it’s not your fault. The strategies being provided are for the (mis)diagnosed disorder and may not be effective for your neurodiverse child.
How parents can advocate for their children
If you are concerned that your child may have autism, it is important to seek out an evaluation from a qualified professional. Here are some tips for advocating for your child:
Document your concerns: Keep a record of your child's development and any concerns you have. Include specific examples of behaviors.
Seek out a specialist: Look for a developmental pediatrician, psychologist, or psychiatrist who has experience diagnosing autism in girls and BIPOC children. Ask about their experience with diverse populations.
Be persistent: If you feel that your concerns are not being taken seriously, don't give up. Seek out a second opinion if necessary.
Connect with other families: There are many support groups and organizations for families of children with autism. Connecting with other families can provide you with valuable information and support. Look for groups specifically for parents of girls or BIPOC children with autism.
Additional resources:
Read more from Jennifer Russell Baker
Jennifer Russell Baker, Licensed Professional Counselor
Jennifer Russell Baker is a Licensed Professional Counselor specializing in children, teens, and diverse populations. After sixteen years working in socio-economically disadvantaged schools, she saw the need for more accessible mental health options for children and marginalized communities. Driven by a mission to empower all communities, Russell Baker offers accessible mental health care through Untold Story Counseling Services, her online practice. She empowers clients to overcome trauma, anxiety, depression, and identity challenges. Combining expertise in trauma and anxiety with research-based interventions, she creates a safe space for clients to build coping skills and achieve their mental wellness goals.
