This post is part of a series of guest posts on GPS by the graduate students in my Psychopathology course. As part of their work for the course, each student had to demonstrate mastery of the skill of “Educating the Public about Mental Health.” To that end, each student has to prepare two 1,000ish word posts on a particular class of mental disorders.
Autism: It’s about more than vaccines and white kids by Dustin Belden
In my previous post, Improved Autism Detection Methods Came with a Hefty Price Tag, I discussed how improved autism detection measures have led to more than what we bargained for – a false correlation in some people’s mind with vaccines. Hopefully, everyone that reads blogs containing treasure troves of scientifically accepted facts knows that correlation doesn’t equal causation. Unfortunately, as my previous post also pointed out, the two decade long vaccine debacle has strained researchers who need to be pouring through mountains of other data related to autism. Also unfortunately, the majority of people that believe that vaccines cause autism are middle- to upper- class white people, and middle to upper class white people tend to form societal trends. They also tend to be most supported by society.
According to Dr. Tina Dykes and colleagues, different cultures deal with autism in different ways. Asian Americans and Navajo Indians are more likely to blame God or have spiritual reasons for the existence of Autism. Caucasians and African Americans are more likely to assign blame to physical things, though they differ greatly on what those things are. Caucasians are more likely to believe that autism is caused by vaccines. African Americans are more likely to blame poor diets and environmental toxins. This is especially intriguing, since the diagnoses of autism in African Americans come much later in life than in Caucasians. While the diagnosis with Caucasians now comes around the age of vaccinations, the diagnosis in many minorities comes around the age that children begin to make their own food choices. When you don’t follow the science, people tend to believe in conspiracy theories, especially when something external can be blamed. But why is there such a discrepancy in detection?
In 2002, Caucasian parents received an autism diagnosis for their autistic children at 6.3 years of age, and African American parents at 7.9 years of age. A 2009 US study found that the Autism detection age was reduced to 5.7 years of age, but race was not separated. Presently, even though Autism can be reliably detected within the first 24 months of life, children are still not being diagnosed, on average, until after the age of 4 years old. The data is being skewed though with study after study showing that minorities are receiving much later diagnoses. Late diagnoses also mean late treatment, and early treatment is essential, in order for a child to learn competitive and norm-abiding behaviors.
A major factor involved with the presentation of autism is social economic status (SES). The simple fact that autism is only diagnosed by presentation, and not by a technological innovation, such as simple cholesterol monitoring devices, means that people need to first be concerned, and second consult a qualified specialist. Herein lies a major problem. Low SES areas of the country tend to have lower quality schools, fewer healthcare options, and less qualified doctors and specialists that can accurately and quickly identify disorders such as autism. According to Dr. Rebecca Landa, minority parents such as African American, Asian, and Hispanic parents are considerably less likely to receive an early diagnosis of autism than Caucasian parents. A considerable amount of research supports Dr. Landa. A University of Penn research study concluded that not only do black children spend more time in treatment with a physician before a diagnosis, that when they are diagnosed, they are considerably more likely to be given a misdiagnosis of a conduct or adjustment disorder, instead of autism. They were actually 2.6 times less likely than Caucasians to receive the proper diagnosis of autism. According to a study in Atlanta, from 2000 to 2006, out of the proper diagnoses given to African American children for autism, it was far less likely that more mild forms in the autism spectrum would be given, meaning that only the most severe forms of autism would be diagnosed in African Americans. Several studies claiming that minorities only present the most severe autism symptoms have been reviewed only to find this detection gap of milder forms of the disorder, especially studies only done in low SES areas. Autism has a high comorbidity rate with other developmental disorders, and for some reason, it takes the most severe symptoms presented in African American children, in order for them to be diagnosed with Autism. Language developmental problems are commonly associated with their diagnoses. But happens to all of those that aren’t diagnosed with milder forms of autism?
According to the Treatment Advocacy Center, approximately one-third of the homeless population has untreated psychiatric illnesses. People with untreated serious brain disorders make up approximately 16% of the U.S. prison population. There are also thousands of homicides, enormous amounts of suicide, and other huge societal costs that go along with untreated psychiatric disorders. People with untreated forms of autism are less likely to follow societal rules, less likely to conform to group norms, and more likely to live independently within and from the groups. Without the treatment of evidence based methods, untreated mental illnesses are likely to show up in these undesirable locations. Without groups like the Seattle Foundation, whose goal is to provide equal access to quality medical care for minority families, these unfortunate outcomes may continue. We need to look at autism and how it affects everyone, not just middle to high income Caucasian families. We need to have a multicultural view on how everyone approaches diagnosis, treatment, and life with autism. Autism affects everyone, and it’s about much more than just vaccines and whites.