Parents' Concerns as They Relate to Their Child's Development and Later Diagnosis of Autism Spectrum Disorder.
Megan Richards, Jana Mossey, Diana L Robins
PMID 27541581WHAT IT FOUND
The total number of concerns was similar in toddlers later diagnosed with ASD and toddlers not diagnosed with ASD.
Parents of children with ASD reported more speech, repetitive behavior and social concerns. Concerns were associated with therapies and specialists children received before diagnosis.
Key findings
01The average number of concern categories was 2.2 for children later diagnosed with ASD and 2.02 for children without ASD, and this difference was not statistically significant.
02Parents of children with ASD were significantly more likely than parents of non-ASD children to report speech/communication, restricted and repetitive behaviors, and social concerns.
03Therapies received and specialists seen were associated with parents' specific concerns: speech concerns with speech therapy, motor concerns with physical therapy, and medical/regulatory concerns with occupational therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The history questionnaire was completed at the time of evaluation, so parents may have forgotten earlier concerns or focused on recent ones. The screening call may have made parents more aware of possible developmental delays, even though autism was not mentioned. Parents attending the evaluation may have been more focused on their child and reported more concerns than they otherwise would. Speech concerns were counted as an autism concern, but speech delay is not specific to autism. The sample was limited to toddlers who screened positive and completed evaluation, so it may not represent all children with developmental concerns. Only 62.2% of children who screened positive completed the diagnostic evaluation, and some children were referred for reasons other than a positive screen. The questionnaire did not capture quality, frequency, or details of therapies and specialists, so service use cannot be read as treatment dose or effectiveness. The study shows associations, not causation. It cannot show that a concern caused a referral or that therapy improved outcomes.
Declared interests
Diana Robins is a co-owner of M-CHAT, LLC, which receives royalties from companies that incorporate the M-CHAT(-R) into commercial products. The study used the freely available version of the M-CHAT(-R).
The easy way to misread this
Do not read parent concerns as a standalone ASD screen. The total number of concerns was similar in children later diagnosed with ASD and children not diagnosed with ASD, and speech concerns were not specific to ASD.