Intersectionality highlights the complexities of a neurodivergent person’s lived experiences of marginalization, inequality, and power structures, going well beyond disability. Therapist Neurodiversity Collective recognizes the social injustice of structural racism and unconscious biases surrounding disabled and neurodivergent marginalized populations and affirms that working within the disability rights movement requires providers to advocate for, and join forces with all members of marginalized groups to persevere for justice for all. Therapist
Neurodiversity Collective recognizes that all forms of systemic oppression and structural violence, including but not limited to racism, sexism, homophobia, transphobia, ableism, classism, ageism, antisemitism, Islamophobia, anti-immigrant bias, and white supremacy personally impact and cause harm and trauma to members of neurodivergent communities, and acquired neurodivergence communities with intersectional backgrounds.
The Ohio State University’s Kirwan Institute for the Study of Race and Ethnicity defines implicit bias as “the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner.”
Research shows that providers’ biases may predict clinical decisions, including diagnostic decisions and therapy approaches, more than most therapists realize. Licensed, credentialed therapists can contribute to, be a part of, or participate in structural racism, even inadvertently. Therapist Neurodiversity Collective believes it is important to work diligently to educate ourselves about environmental and sociocultural influences that impact our practices, including implicit or unconscious clinician biases surrounding Black, Latinx, Asian, and Indigenous communities.
Interweaving intersectionality into practice framework is a continuing process of self-reflection and self-critique where providers not only own up to unearned privilege and acknowledge biases but actively work towards eliminating social and structural barriers for marginalized people while pledging to actively address the significant identified problem of under-identification of autistic and other neurodivergent diagnoses, and over-identification of diagnosis of disruptive behavior disorders in Black, Latinx, Asian, and Indigenous communities, all of which limit equitable access to therapy, and other supportive services.
The Therapist Neurodiversity Collective commits to peer education and public education and advocacy regarding structural racism and unconscious biases in private practice, medical and educational settings, undertaking to serve and advocate for all marginalized, autistic, and other neurodivergent and disabled clients, students, and patients to have the inherent rights of civil liberties, dignity, self-advocacy, self-determination, and equitable access.
Providers who have chosen to align with Therapist Neurodiversity Collective commit to championing the civil rights of marginalized groups, both as a cohesive group, and individually in respective accreditation organizations (ASHA, AOTA, APTA) with identified strategies as learned from people of the global majority. We will continue to address the glaring lack of representation from people of the global majority in our own accreditation organizations, and compel our accrediting agencies and universities to promote educational and financial equitable access for under-represented Black, Latinx, Asian, Native American, Hawaiian or Pacific Islander, and Multiracial students.
Sources suggested for further reading:
Intersectional Experiences of Stigma and Their Relation to Mental Health Outcomes Among Black and White Autistic Adults: “Non-autistic adults often harbor negative attitudes about autism and show a reluctance to interact with autistic people. Despite common misconceptions, many autistic adults express a strong desire for interaction, friendships, and romantic relationships but can struggle to achieve them. This gap between autistic social desires and actual social experiences can increase the risk for poor mental health outcomes for autistic adults. For those with multiple marginalized identities, the compounding effects of stigma based on both race and disability may further worsen mental health outcomes…”
Come as You Are: Examining Autistic Identity Development and the Neurodiversity Movement through an Intersectional Lens: “We reviewed literature about neurodiversity, intersectionality, discrimination, and the identity development of autistic people, racial/ethnic minorities, and gender and sexual minorities. We discuss minority stress and evidence that cultural traditions alleviate it. Autistic culture can reframe personal difficulties as a politicized struggle. While the stereotype of autism is one of withdrawal, the history of autistic people coming together for justice defies this notion. Intersectionality teaches us that we must understand differences within the autistic community if we wish to help all autistic people experience the dignity they deserve. Using an intersectional lens, we can become more flexible in our understanding of positive autistic identity development and strategies to promote it.”
An expert discussion on structural racism in autism research and practice: “Autism research has a race problem. Despite improvements in screening and diagnosis, autism continues to be underdiagnosed in Black and Hispanic children, 1 and those who obtain a diagnosis often have limited access to support services. Racial disparities persist during the transition to adulthood, with autistic adults from racial and ethnic minority groups experiencing a number of challenges, including lower rates of employment, social participation, and postsecondary education3 compared with White autistic adults.”
To address racial disparities in autism research, we must think globally, act locally: “A history of systemic racism has led to too few Black Americans working in the sciences. Autism research is not immune to this problem, and the dearth of Black scientists and clinicians likely has contributed to health disparities among Black autistic people…”
Understanding Racial Differences in Diagnosing ODD Versus ADHD Using Critical Race Theory: “While epidemiological literature suggests similar prevalence of ODD and ADHD across racial groups, a review of studies assessing “real-world” diagnostic practice suggests Black children may be over-diagnosed with ODD. Critical race theory (CRT) is applied to determine the etiology and sequelae of a racial effect in diagnostic practice to explain this disparity in findings.”
Unconscious Bias and the Diagnosis of Disruptive Behavior Disorders and ADHD in African American and Hispanic Youth: “There is a growing body of evidence indicating that when compared to non-Hispanic white youth, some ethnic and racial minority youth are more likely to receive a diagnosis of a disruptive behavior disorder and are less likely to receive a diagnosis of #ADHD. When controlling for confounding variables such as adverse childhood experiences, prior juvenile offenses, genetics, and sociodemographics, these diagnostic and treatment disparities remain.”
“Significant racial/ethnic disparities exist in the recognition of ASD. For some children in some racial/ethnic groups, the presence of intellectual disability may affect professionals’ further assessment of developmental delay. Our findings suggest the need for continued professional education related to the heterogeneity of the presentation of ASD.”
AUTISM’S RACE PROBLEM: (Warning – Ableist Language)
“For years, the medical community has studied and treated autism as a “white person’s” disease, and, today, research and therapy remain geared toward affluent, white people and families — leaving people of color in the lurch.”
Race, class contribute to disparities in autism diagnoses “The findings highlight persistent racial disparities in autism prevalence: White children are about 19 percent more likely than black children and 65 percent more likely than Hispanic children to be diagnosed with autism.”
CDC – Spotlight On: Racial and Ethnic Differences in Children Identified with Autism Spectrum Disorder (ASD) (Warning – Ableist Language) “ADDM reports have consistently noted that more white children are identified with ASD than black or Hispanic children. Previous studies have shown that stigma, lack of access to healthcare services due to non-citizenship or low-income, and non-English primary language are potential barriers to the identification of children with ASD, especially among Hispanic children. A difference in identifying black and Hispanic children with ASD relative to white children means these children may not be getting the services they need to reach their full potential.”