Factors That Influene Age of Diagnosis of Autism Spectrum Disorder

Background/Purpose: Currently, one in 59 children are diagnosed with autism spectrum disorder (ASD) in the United States (Centers for Disease Control and Prevention, 2018). ASD is a pervasive developmental disorder that affects children’s growth and development across all areas of socialization, communication, and behavior. Early diagnosis and treatment of ASD are known to lead to a better long-term prognosis. For example, researchers have found that children with ASD that received early intervention had significant gains in the areas of cognition, communication, and social behavior.

Considering the effectiveness of early intervention, it is important to understand what predicts children’s diagnosis. This study thus investigated which variables predict the age a child receives an ASD diagnosis utilizing the Behavioral Model of Health Services Use for children aged 6 to 17 (Andersen, 1995). According to Andersen’s Behavioral Model of Health Services, predisposing characteristics, enabling resources and perceived need are required in order for individuals to utilize health services. Applying this model, the study examined whether a child’s gender and race, and parent’s and doctor’s perceived need would predict the age that a child receives an initial diagnosis of ASD while controlling for a child’s ethnicity, parental education level, household income, and type of health insurance.

Methods:

Sample: The study utilized data collected by the National Center for Health Statistics (NCHS). The sample in the original dataset consisted of 6,090 children with special healthcare needs identified as having ASD, developmental disability, or intellectual disability. The sample of the study focused on children with ASD diagnosis, resulting in the final sample of 1,647 children that had received an ASD diagnosis prior to the survey.

Measures: NCHS collected data on child age of diagnosis, race, ethnicity and gender, parental education level, whether or not the child has an ASD diagnosis, and parent’s and doctor’s perception on the child’s behaviors and needs for further assessment. A composite score of 20 questions related to the parent’s concerns about their child’s growth, development, and behaviors was used to measure parental perceived need. Doctor’s perceived need was measured by creating a composite score of nine questions that assessed the doctor’s perception on the parent’s concerns.

Results: The results of a hierarchical linear regression analysis showed that parents’ and doctors’ perceived need were the only statistically significant predictors for the age of ASD diagnosis in the final model. Specifically, the findings indicated that higher parent’s and doctor’s perceived need would lead to a child’s earlier diagnosis of ASD.

Conclusions and Implications: The findings of the study show the importance of parent and doctor perception in a child’s early ASD diagnosis. Further research should look at what impacts a parent’s and doctor’s perceived need. Additionally, programs and interventions will be needed to improve parent’s and doctor’s understanding of ASD symptoms and the importance of early identification in order to support the early diagnosis of ASD.