Witnessing Medical Bias Forever Changed Me and Helped Me Build My Practice as a School Psych

Story time! ​A few years ago, I had worked with this family for a very long time and they finally trusted me enough to see a psychiatrist to get formally diagnosed with Autism.

The student's entire educational team confidently believed that this student showed signs of Autism Spectrum Disorder (ASD). Over several months, we designed tailored supports and interventions suited to his behaviors. Then came time for his annual review and we discussed changing his classification to Autism. Everything was in order until we got the report back from the psychiatrist. The student's mother said, "I just came from the doctor's office, and he believes he doesn't have Autism at all, just ODD."

A stunned silence filled the room. Even the principal appeared bewildered. All I could think was, "What just happened?"

Without missing a beat, the CSE administrator turned to me, asking, "Dr. Toussaint, do you agree with the psychiatrist's assessment?" I confidently responded, "I unequivocally disagree!" Prepared to defend our educational assessments, I felt the gravity of my responsibility.

Questions erupted from the team, particularly from his speech therapist and physical therapist. They struggled to understand how autism could have been overlooked, especially given the detailed progress documentation about his school behaviors that I had shared with the mother to give to the psychiatrist office. It was bewildering to see the insights of our team, grounded in months of observations, dismissed in light of one brief medical evaluation.

As I navigated this unexpected turn, I sensed that this was not an isolated incident but a reflection of a systemic issue. Research shows that Black children are often diagnosed with conditions like autism years later than their white peers—by as much as 4 to 5 years. Such disparities can severely impact educational and social outcomes.

Engaged students in a supportive learning environment

It felt like a gut punch, realizing that our months of building trust and understanding had been overshadowed by a 20-minute conversation. The swift dismissal of our collective insights reinforced damaging stereotypes, placing this Black student in a sad category of being labeled as just oppositional.

This experience was just the beginning. In my ongoing practice, I continued to observe instances where Black children, teens, and even adults receive diagnoses significantly later than their peers. This reality reinforced my belief in the critical role we play as school psychologists, educators, and therapists.

We are uniquely positioned to offer insights based on our direct relationships with students and their families. Often, we are on the front lines, advocating for the necessary supports and interventions. For instance, in one case, a Black student was misdiagnosed and subsequently placed in an inappropriate educational setting, missing critical support that could have been provided had early and accurate diagnosis occurred.

During discussions with a psychiatrist, I learned that many medical providers, particularly those outside the school system, often lack specialized training in Autism. This was surprising, given that parents frequently seek evaluations from these professionals, believing they hold crucial insights into their child's needs.

We, as educators, possess unique observations that should not be overlooked due to the limitations of a brief medical consultation. It became painfully clear that biases, insufficient training, and systemic barriers lead to real consequences for children attempting to navigate their educational journeys.

Bridging the Gap: Steps Forward

How can we make progress? First, we need to focus on raising awareness among parents and guardians. Families must understand they have the right to advocate for their children's needs and that collaboration between school professionals and medical practitioners is vital.

Additionally, educational institutions should initiate training sessions for healthcare professionals about the importance of recognizing diversity in diagnosis and assessment practices. For example, a comprehensive training program addressing cultural competence could contribute to minimizing biases.

Furthermore, we need to challenge existing norms about who gets diagnosed and when. Advocating for anti-bias training, improving communication between educators and healthcare providers, and emphasizing cultural competency are essential steps. Our role extends beyond just providing educational support; we have a duty to ensure equity in healthcare access so we can effectively advocate for our students.

Colorful markers and notes symbolize educational support and advocacy

Witnessing this instance of medical bias transformed my perception of the field and strengthened my resolve to fight for marginalized communities. Educators and healthcare practitioners must operate in tandem to ensure every child receives timely and accurate support.

We must not allow systemic bias to dictate our students' narratives. Instead, we should leverage our expertise and work alongside families and medical professionals to secure meaningful services that promote success for all children.

Networking Event: Want to learn more about how we can advocate as providers? Join me on April 26, 2025 for a networking event that I will be hosting with other Black providers as we work to bridge gaps in mental health care for Black families and community members! Message me below for more information!

Want to start a private practice or advocacy company? If you want to learn more about building your practice or a company that helps families advocate for themselves, send me a message for a "Brain Picking" session where we can discuss ways for you to advocate beyond the school. I'll be doing five Brain Picking/Consults in May. Lock down your spot!