Clinical Profiles of Black and White Children Referred for Autism Diagnosis.

Researchers compared autism symptoms in Black and White children referred for diagnosis. Both groups showed similar autism symptoms overall, though Black children scored slightly lower on thinking skills and communication tests. Since the symptoms were mostly similar, the reason Black children are typically diagnosed later may not be due to different presentations, but other factors in the healthcare system.

This cross-sectional study compared clinical profiles of 245 Black and 488 White children (mean age 4.2 years, 82.8% male) referred for autism diagnosis. Despite known delays in autism diagnosis for Black children, both groups showed similar overall autistic symptom levels. Black children scored slightly lower on cognitive tests and communication assessments but were comparable on behavioral problems. The findings suggest that differences in clinical presentation at referral may not be the primary driver of racial disparities in autism diagnosis timing and service access, pointing to potential systemic factors affecting diagnostic pathways.

Similar clinical presentations between racial groups suggest diagnostic delays for Black children stem from systemic barriers rather than symptom differences. Clinicians should be aware that delayed diagnosis does not indicate milder symptoms and should examine referral pathways and assessment practices for potential bias.

Cross-sectional design limits causal inferences. Sample limited to referred children only, which may not represent broader population differences. Potential selection bias as study only included children who reached referral stage.

Black children with autism are diagnosed at an older age. Whether or not late detection is paralleled by differing clinical presentation is not known. We evaluated symptom profiles of 245 Black and 488 sex- and age-matched White non-Hispanic participants (82.8% male; mean age: 4.2 years) referred for ASD diagnosis. Both groups showed similar overall levels of autistic symptoms.

Black children had significantly but slightly lower scores on cognitive tests and on the Vineland communication domain than White children. Groups were comparable on internalizing and externalizing co-occurring problems. Given the largely similar clinical profiles, clinical differences in initial presentation may not be a primary reason for Black/White disparities in diagnostic and services use. Limitations of a cross-sectional referred sample are acknowledged.