Parental relationship status and age at autism spectrum disorder diagnosis of their child.
Luther G Kalb, Calliope Holingue, Danika Pfeiffer and 5 others
PMID 34010065WHAT IT FOUND
Children whose biological parents were not together received an autism diagnosis 1.4 years later on average than children whose parents were together.
This delay persisted after adjusting for income, race, insurance, and symptom severity. Families with separated parents may need extra navigation support.
Key findings
01Children of parents who were together were diagnosed 1.4 years (16.6 months) earlier than children of parents who were not together.
02After adjusting for demographic and clinical covariates, parents not together was associated with a delay of 1 year and 4 months in age at diagnosis.
03Children of parents who were not together had higher CBCL internalizing and externalizing scores and lower parental education, but the diagnostic delay remained after adjustment.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used a cross-sectional design from a single site, limiting generalisability. The timing of divorce or separation and the quality of the parents' relationship were not measured, so it is unclear if the delay is caused by the separation itself or pre-existing conflict. The measure for parenting stress changed during the study period (from PSI-SF to APSI), requiring statistical combination of scores. The study cannot determine causality; the association between parental status and later diagnosis may be influenced by unmeasured factors. The sample was drawn from a specialty clinic, which may not represent children diagnosed in primary care settings.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institute of Mental Health (NIMH).
The easy way to misread this
Do not assume that parental separation directly causes later diagnosis. The study is observational and cannot prove causation; the delay may be driven by unmeasured factors such as family conflict, logistical barriers, or lower symptom severity that were not fully captured.