Black Caregiver Perspectives During a Developmental Diagnostic Interview.
Thin evaluations, not race, keep Black children with clear autism traits from school autism services.
01Research in Context
What this study did
The team talked with Black caregivers after their child’s autism interview.
They asked what parts of the evaluation felt helpful or missing.
All children already showed clear autism traits, so every child should qualify for school autism services.
What they found
Only 7 out of the kids actually had autism listed on their school plan.
Kids who got more parts tested—ADOS, language test, full report—were far more likely to win eligibility.
Race alone did not block services; thin evaluations did.
How this fits with other research
Klein et al. (2024) asked 400 Black and multiracial families the same big question and found the same barrier: short or dismissive visits.
McKenzie et al. (2015) showed families sometimes wait because they distrust white-coat culture; Lillian adds that even when families show up, the test itself may still be too skinny.
Jashar et al. (2019) saw most parents feel “okay” about the process, but their sample was mostly white; Lillian’s Black caregivers reveal that “okay” can still leave kids shut out of services.
Why it matters
You can’t fix racial disparity by telling teams to “be nice.” You must script the evaluation. Make sure every autism referral walks out with ADOS scores, language numbers, and a written report. If any piece is missing, pause the meeting and re-schedule. One complete test is the fastest equity move you can make this week.
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02At a glance
03Original abstract
Though there is evidence autism identification has been inequitable for populations who are culturally and linguistically minoritized, there is limited research that explains the issue of disproportionality and factors contributing to its occurrence, especially within an educational setting. To explore contributors to racial/ethnic disparities in autism special education eligibility, the current investigation evaluated child and evaluation characteristics as they relate to the absence of autism eligibility. Data were obtained from the Autism and Developmental Disabilities Monitoring (ADDM) Network Study and included children with behavioral characteristics consistent with autism and educational evaluation records. Despite documented characteristics consistent with autism, only 72% of the sample received educational services under autism eligibility. To characterize children without autism eligibility, hierarchical logistic regression was used to evaluate factors documented in evaluation records predicting the absence of autism eligibility. Factors influencing autism eligibility included behavioral characteristics documented, evaluation components completed, intellectual ability, and clinical diagnoses present. There was no unique contribution of race/ethnicity in predicting the absence of autism eligibility when accounting for these previous predictors, but many of these predictors differed by racial/ethnic group. Disproportionality in autism may be the manifestation of inequitable evaluation experiences, including experiencing less comprehensive evaluations, and not receiving an autism specific assessment. Though race/ethnicity did not uniquely contribute to the absence of autism eligibility above and beyond those combined factors, it is important to evaluate and reduce inequities experienced within the autism identification process for populations who are culturally and linguistically minoritized.
Journal of autism and developmental disorders, 2026 · doi:10.1542/peds.2013-0383