I worry about how many missed social cues are listed as defiant behavior. I wonder how often poor eye contact and silence due to speech difficulties are perceived as disinterest in therapy sessions or disability hearings. I think about how my clients’ use of seemingly misplaced statements are marked or described as inappropriate and/or threatening in their individualized education plans (IEPs) and school records. They are not seen, and being invisible and/or misrepresented is not a neutral state of being.
To be clear, I am in no way attempting to diagnose Elijah McClain, who died on August 24, 2019. I do not have knowledge of his medical records, and his family has not made that information public. Maybe he did not have a diagnosis and maybe he is not on the autism spectrum at all, but there are many Black and brown men and boys who share behavioral characteristics with Elijah who do have diagnoses, and who are punished for them.
I have appeared before judges who were not able to appropriately recognize autistic symptoms in my clients. I have seen autistic clients’ medical records and therapy notes that are replete with misdiagnoses and misrepresentations of their mental and behavioral health symptoms. Many of my autistic clients were diagnosed at later-than-average ages, although they held many of the common symptoms.
Also, it is not lost on me that white children are about 19% more likely than Black children and 65% more likely than Hispanic children to be diagnosed with autism, although they have similar prevalence rates.
We can partially attribute the difference in rate of diagnoses to the lack of access to diagnostic services for Black, Indigenous, People of Color (BIPOC) children. We also know that if and when a BIPOC child is diagnosed, it occurs later in their life and results in them requiring longer and more intensive intervention. This means that there are some Black and brown men and boys who do not have diagnosis due to institutional racism.
We couldn’t save Elijah McClain. However, we can save many self-described “different” Black and brown men and boys, who are in need of our collective help. I call on teachers to better educate themselves on autism and other mental/behavioral health disorders, especially regarding Black and brown boys with perceived behavioral issues. I ask that therapists and psychiatrists educate themselves on how racial biases can impact a diagnosis, and continue to progress in identifying autism earlier in Black and brown children.
I call on judges in disability hearings to analyze their own biases, that may be connected to intersectional racial and gender stereotypes, in their assessment of SSI claimants. And I challenge you to educate yourself on the impact that racism has on behavioral and mental health misdiagnosis, late diagnosis, and treatment.
Lastly, I challenge all of us to see, and I mean really understand and appreciate, the uniqueness and individual qualities of different Black and brown boys. The more we see them, the more we create a world that affords them the ability to stay alive.