Patterns of Special Education Eligibility and Age of First Autism Spectrum Disorder (ASD) Identification Among US Children with ASD.
Amy N Esler, Jeannette Sample, Jennifer Hall-Lande and 5 others
PMID 35212866WHAT IT FOUND
Children identified only through school records were evaluated and diagnosed with autism over a year later than those seen in health settings.
School evaluations for developmental delay often missed specific autism traits like restricted interests, potentially delaying access to specialized services.
Key findings
01Children with records from education-only sources had a median age of first ASD identification of 69 months, compared to 44 months for health-only and 50 months for health and education sources.
02Evaluations resulting in developmental delay eligibility documented restricted and repetitive behaviors, such as fixated interests and unusual sensory responses, less frequently than those resulting in ASD eligibility.
03Black, Hispanic, and Asian children were more likely to have records from education-only sources compared to White, non-Hispanic children.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on existing records, so incomplete documentation could affect the accuracy of identification dates. Children in the education-only group might have been seen in health settings outside the surveillance area, which would misclassify them. The sites were not nationally representative, and only four of the eleven ADDM sites had full access to educational records. The study could not determine if parents refused ASD-specific evaluations in favor of DD eligibility.
Declared interests
The ADDM Network is funded by the Centers for Disease Control and Prevention (CDC). The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that a child with a school-based developmental delay eligibility does not have autism. The study found that school evaluations for developmental delay often missed specific autism traits like restricted interests and sensory differences. A child may meet criteria for ASD even if their school record only lists developmental delay.