Age of Parental Concern, Diagnosis, and Service Initiation Among Children With Autism Spectrum Disorder.
Benjamin Zablotsky, Lisa J Colpe, Beverly A Pringle and 3 others
PMID 28095057WHAT IT FOUND
Parents who first noticed verbal communication problems reported concerns earlier, their children received an ASD diagnosis earlier, and services started earlier.
Nonverbal communication and unusual gestures were linked to earlier diagnosis. Behavioral concerns were reported later. The survey cannot show cause.
Key findings
01Children whose parents first reported verbal communication concerns had earlier parental concern, ASD diagnosis, and first services.
02Concerns about nonverbal communication or unusual gestures and movements were associated with earlier ASD diagnosis.
03Younger children had earlier reported parental concern, ASD diagnosis, and first services than older children.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The overall response rate was 16%, so selection bias may remain even with survey weights. The survey was cross-sectional and relied on parent recall over many years, so ages at concern, diagnosis, and services were not clinically validated. Older children had longer reference periods and more time to experience the outcomes, which may bias comparisons between age groups. The analytic sample came from households with higher education than a national comparison group, so results may not apply to less educated families. Only children already diagnosed with ASD were included, so children who qualify but remain undiagnosed were missed.
Declared interests
The study was funded by the National Institute of Mental Health and conducted by the National Center for Health Statistics. The article does not report author conflicts of interest.
The easy way to misread this
Do not conclude that children whose parents first noticed behavioral problems receive services later. The study found later reported concerns for behavioral problems, but it did not show that services were delayed, and the survey cannot prove cause.