Seen but not heard: School-based professionals’ oversight of autism in children from ethnic minority groups Delia A. Burke *, Hans M. Koot, Sander Begeer VU University, Amsterdam, The Netherlands 1. Introduction An autism spectrum disorder (ASD) is a complex lifelong neuro-developmental condition with detrimental effects on one’s social functioning. An ASD is characterised by deficits in social interaction and communication as well as unusually narrow interests and activities (American Psychological Association (APA), 2013). The early identification – and diagnosis of ASDs is vital for implementing early interventions which are essential for the well-being of individuals with an ASD (American Academy of Pediatrics (AAP), 2001; Bryson, Rogers, & Fombonne, 2003; Rogers & Vismara, 2008). However, various factors may hamper the detection of ASD symptoms. For example, female gender (Begeer et al., 2013) and low- income (Mandell & Palmer, 2005) are associated with delayed identification. Ethnic background may also complicate the detection of autism. It has, specifically, been shown to delay the detection of autistic features in paediatricians (Begeer, El Bouk, Boussaid, Meerum-Terwogt, & Koot, 2009). However, like most deviant behaviour, autism is often first detected by adults in the child’s environment who subsequently consult a paediatrician for evaluation (Verhulst & Koot, 1995). Besides parents, school-based professionals are likely to play a role in the detection of psychological problems in children. However, research to date has not investigated school-based professionals’ ability to evaluate symptoms of autism in young children. The aim of the current study was firstly, to establish the extent to which school-based professionals contribute towards the Research in Autism Spectrum Disorders 9 (2015) 112–120 ARTICLE INFO Article history: Received 25 August 2014 Received in revised form 14 October 2014 Accepted 17 October 2014 Keywords: Evaluation Diagnostic error Ethnic minority School ABSTRACT Previous studies have shown that ethnic background hinders clinician detection of autistic features in children from non-western minority groups. The use of a structured instrument during evaluation of these children can reduce the risk of hindered detection. The aims of the current studies were to establish the extent of school-based professionals’ involvement in detecting autism and to replicate earlier findings of autism detection amongst school mentors. Results showed that school-based professionals were reported to be the first to suspect autistic features in 20% of children later diagnosed with autism. Additionally, school-based professionals refer to autism more often when judging children from majority than children from minority groups. However, using a structured instrument did not eliminate this bias. Providing these professionals with culture- sensitive education may help maximise their involvement in detecting autism amongst children from all ethnic backgrounds. ß 2014 Published by Elsevier Ltd. * Corresponding author at: VU University, Department of Developmental Psychology, van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. Tel.: +31 020 598 3168. E-mail address: d.a.burke@vu.nl (D.A. Burke). Contents lists available at ScienceDirect Research in Autism Spectrum Disorders Journal homepage: http://ees.elsevier.com/RASD/default.asp http://dx.doi.org/10.1016/j.rasd.2014.10.013 1750-9467/ß 2014 Published by Elsevier Ltd.