In The Politics of Autism, I write about the experiences of different economic, ethnic and racial groups.
I am a child and adolescent psychiatrist. I am also a South Asian woman and a mother. For years, I worked with families navigating complex childhood diagnoses at institutions like Johns Hopkins, Kennedy Krieger, and Kaiser Permanente. The pattern I saw in the clinic is the same one the research now confirms: South Asian children are diagnosed with developmental disabilities later than white peers. (On average, minority children are diagnosed roughly a year to a year and a half later than their white peers.) Their families access fewer services. And the primary barrier is not language, insurance, or geography. It is stigma.
In South Asian households, a child’s disability triggers a specific kind of family crisis that most American clinicians are not trained to recognize. The concept of izzat, or family honor, means a diagnosis does not stay with the child. It attaches to the entire family. Grandparents deny it. Aunties suggest prayers or herbal remedies instead of therapy. The question that should be simple (“How do we get our child the right help?”) becomes a painful negotiation with shame.
Then there is the karma narrative. In many South Asian spiritual frameworks, disability is framed as punishment for past wrongdoing and is internalized as personal moral failure. Mothers carry the blame: her diet during pregnancy, her stress, her genetics, and her parenting. Research on South Asian and broader Asian caregivers documents the result: emotional exhaustion that does not respond to rest, chronic physical symptoms, and a shrinking social world as families withdraw to avoid judgment.
