Bias in Diagnosis
Which racial group tends to receive later diagnosis on average?
a) Black
b) Asian
c) Hispanic/Latino(a)
d) White
e) a and c
f) a and b
e) a and c
True or False: Early screening and evaluation before age 2 can improve long-term language and adaptive outcomes for children with autism
True
**Early screening can lead to better treatment, language, and quality-of-life outcomes
Why can the ADOS-2 and ADI-R lead to biased autism diagnoses in culturally diverse children?
A. They rely on parent reports only.
B. They use standardized criteria based on Western norms.
C. They are administered differently by clinicians.
D. They are designed for adults, not children.
B. They use standardized criteria based on Western norms.
What is the average age of autism diagnosis?
a) 2;0
b) 3;0
c) 3;5
d) 4;4
d) 4;4
True or False: Provider bias and limited cultural competence can contribute to misdiagnosis or delayed referrals for ASD.
True
What is a common challenge when using standardized assessments for ASD with non-English speaking families?
A. The assessments are too short
B. Translating the assessment can change the meaning of questions
C. Non-English speaking families do not participate in assessments
D. The assessments do not require parental involvement
B. Translating the assessment can change the meaning of questions
Which factor most directly reflects how institutional bias can affect autism service delivery for families of color?
a) A parent not recognizing early ASD symptoms
b) A clinician using an outdated assessment tool
c) A clinic requiring U.S. citizenship for service eligibility
d) A teacher misunderstanding a child’s social cues
c) A clinic requiring U.S. citizenship for service eligibility
This reflects institutional bias because it's a system-level policy that disproportionately excludes immigrant families and communities of color from accessing autism services, regardless of clinical need
Cultural humility can be “achieved” after completing formal training in cultural competence.
False
A clinician assumes that a bilingual child’s language delay is “normal for second-language learners” and delays referral for autism testing. This is an example of:
a) Acculturation bias
b) Confirmation bias
c) Cultural humility
d) Over-referral bias
b) Confirmation bias
The clinician is using a prior belief ("language delays are normal for bilingual learners") to explain away new evidence (possible autism symptoms)
The prevalence of psychiatric comorbidities—such as anxiety and depression—in individuals with Autism Spectrum Disorder (ASD) is significantly higher than in the general population?
True: estimated prevalence in ASD is 40-50% for anxiety, 20-30% for depression
**Anxiety and depression are 2–4 times more common in individuals with ASD than in the general population.
What is one reason Spanish-speaking families may score lower on RRB items in the ADI-R (parent report)?
-under-reporting of symptoms due to stigma/lack of awareness
-Cultural differences may impact how repetitive behaviors are described or interpreted by parents, affecting assessment accuracy.
-misalignment between questions and cultural norms
Use of interpreters in autism assessments does not affect diagnostic accuracy if the clinician is skilled.
False
Interpreter use without proper training and pre-briefing can introduce bias, misinterpretation, and affect diagnostic outcomes.