Navigating Fragmented Systems: A Multilevel Analysis of Social Support Among Black Caregivers of Children with Autism

Black caregivers of children with autism spectrum disorder (ASD) navigate complex care systems shaped by racial inequities and limited access to culturally responsive supports. Although disparities in diagnosis and service utilization are well documented, less research has examined how Black caregivers experience social support across the diagnostic process. This study utilizes secondary qualitative data from semi-structured interviews with 23 Black caregivers. A narrative-centered analytic approach was applied using episode profiling, followed by analysis guided by Bronfenbrenner’s bioecological systems theory and an intersectionality framework. Social support experiences were examined across ecological systems and stages of the diagnostic process, with attention to both child-focused and caregiver-focused supports. Findings suggest that caregivers frequently relied on informal and community-based supports to compensate for barriers within formal service systems, including provider dismissal, long wait times, and limited access to culturally responsive care. Support experiences varied across ecological levels, with microsystem relationships shaping initial access to care and broader structural and cultural factors influencing service availability and engagement. Notably, coordinated support across systems was rarely described, suggesting that caregivers often assumed primary responsibility for navigating fragmented service systems. These findings highlight the importance of developing culturally responsive, multilevel strategies to improve care coordination and improve equity, support access for Black autistic children and their caregivers.   Keywords: autism, Black caregivers, community, social support