The solution, according to Geschwind, is a change in how the system handles these children. Greater access to trained professionals is needed, and if a racial or cultural bias exists, it needs to be overcome, he said.
The report was published online Aug. 24 in the journal Pediatrics.
Dr. Sarabeth Broder-Fingert is an associate professor of pediatrics at Boston University School of Medicine, who co-authored an accompanying journal editorial. “We feel like there are multiple issues of systemic racism that are likely contributing to the delays,” she said.
Also, for parents whose insurance is through Medicaid, it can be difficult to find a doctor who takes that insurance because of its low reimbursement, Broder-Fingert noted.
The practical consequence of delayed diagnosis is missing out on treatment that might help preschool children.
“One could imagine that if you were getting 20 hours a week of treatment, the difference if you’re diagnosed even one year later, it’s 1,000 hours of treatment that you’re missing,” Broder-Fingert said.
“In this study, it was more like two to three years, that’s 2,000 to 3,000 hours’ worth of treatment that these kids are missing out on, and one can imagine how that could be extremely impactful on their lives,” she added.
Broder-Fingert believes that more providers qualified to diagnose autism are needed, especially those who see Black children.
“If you have concerns about your child’s development, unfortunately, right now, the system we have in place is not doing its job and detecting and supporting you and your family and getting a diagnosis as well as we would like,” she said.
“At the moment, parents are going to have to advocate for their children, especially parents from marginalized communities, as we continue to work to improve the system so that the burden is no longer on the family, but it’s actually on the system to provide the support families need to get the diagnosis,” Broder-Fingert said.