Autism presentation in female and Black populations: Examining the roles of identity, theory, and systemic inequalities.
Update your screening tools and intake questions so both race and gender stop hiding autism.
01Research in Context
What this study did
Diemer et al. (2022) wrote a narrative review. They looked at past work on autism in girls and Black children.
The team asked how race and gender shape who gets missed. They used intersectional theory to connect the dots.
What they found
The review shows girls and Black kids are diagnosed later. Old checklists and white, male norms hide their traits.
Systemic bias plus clinic tools create a double filter. The paper calls for new screens that see both race and gender.
How this fits with other research
Klein et al. (2024) extends the same story. A survey of 400 Black and multiracial families found provider dismissal is real. Parents said doctors ignored concerns and used one-size-fits-all screens.
Diemer et al. (2023) and Lineberry et al. (2023) add girl voices. Parents and women report the same barrier: tools built for boys miss quiet girls who mask.
Dyches et al. (2004) is a predecessor. That early review flagged multicultural gaps; Diemer et al. (2022) adds the sex-gender layer and names it intersectional.
Why it matters
You can act today. Add girl-friendly items to your intake form: ask about social exhaustion, mimicry, and intense small-group interests. For Black families, start with listening, use culturally normed examples, and schedule longer first visits. These small edits catch kids who used to slip through.
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02At a glance
03Original abstract
Although the prevalence of autism has been rising in recent years, disparities in diagnosis still remain. Female and Black populations in the United States are diagnosed later, are more likely to have an intellectual disability, and are excluded from research as well as services designed for autistic individuals. Autistic Black girls are effectively invisible in the current scientific literature. Intersectional theory, which looks at a person as a whole, examines models that are inclusive toward diverse gender, ability, and racial/ethnic backgrounds. This theory may be a useful approach to clinical and research work with autism so that practitioners may be most effective for the whole population of autistic people. The authors recommend research focusing on inclusion of autistic populations with intellectual disability and research studies that include evaluations as part of the procedure. Clinically, the authors recommend a focus on screening all young children for autism and improving provider knowledge in working with diverse autistic populations.
Autism : the international journal of research and practice, 2022 · doi:10.1177/13623613221113501