Can cultural mistrust lead to autism misdiagnosis?

PostedNovember 18, 2025

UpdatedNovember 18, 2025

ByMy Patient Advice

Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Autism misdiagnosis can occur for many reasons, and one contributing factor is cultural mistrust. When families are hesitant to engage fully with healthcare providers, they may share incomplete information or avoid assessments altogether. This can result in a diagnostic error, either overlooking autism entirely or mistaking it for another developmental or behavioural condition.

Such mistrust may stem from past negative experiences, systemic discrimination, or differences in communication styles between families and clinicians. These barriers can affect how questions are interpreted and how behaviours are described, which in turn shapes the conclusions drawn by professionals. Without accurate, culturally informed exchanges, the risk of autism misdiagnosis increases.

How Mistrust Can Affect Autism Assessments

Below are some common ways that a lack of trust between families and healthcare providers can influence the accuracy of an assessment.

Limited sharing of behaviours

Families may withhold observations for fear of judgement, stigma, or misunderstanding.

Misinterpretation of cultural behaviours

Actions typical in one community may be seen as autistic traits by an assessor unfamiliar with that culture.

Reluctance to pursue further evaluation

Even after an initial assessment, mistrust may discourage follow-up appointments or additional testing.

Encouraging culturally sensitive practices, offering community-based support, and building trust can help reduce the likelihood of autism misdiagnosis and improve outcomes for children and families.

For tailored advice and support, visit providers like Autism Detect for personal consultations.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to cultural and gender barriers in diagnosis.

Beatrice Holloway, MSc

Author

Beatrice Holloway is a clinical psychologist with a Master’s in Clinical Psychology and a BS in Applied Psychology. She specialises in CBT, psychological testing, and applied behaviour therapy, working with children with autism spectrum disorder (ASD), developmental delays, and learning disabilities, as well as adults with bipolar disorder, schizophrenia, anxiety, OCD, and substance use disorders. Holloway creates personalised treatment plans to support emotional regulation, social skills, and academic progress in children, and delivers evidence-based therapy to improve mental health and well-being across all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.