Prior Diagnoses and Age of Diagnosis in Children Later Diagnosed with Autism.
Maire C Diemer, Emily Gerstein
PMID 39585536WHAT IT FOUND
Black children were diagnosed with autism about six months earlier than White children.
White children had higher rates of prior diagnoses like ADHD and anxiety. More prior diagnoses predicted later autism diagnosis. These findings contradict expected disparities in access to care.
Key findings
01Black children were diagnosed with autism at a younger average age (6.55 years) compared to White children (7.05 years).
02White children were significantly more likely to have received prior diagnoses of ADHD, conduct disorder, adjustment disorder, anxiety, and mood disorder before their autism diagnosis.
03Having a higher number of prior diagnoses was associated with an older age of autism diagnosis.
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 only included White and Black participants, excluding other racial and ethnic groups. Medicaid claims data cannot distinguish between accurate co-occurring diagnoses and misdiagnoses that were later better explained by autism. The sample was restricted to low-income families on Medicaid, limiting generalizability to higher socioeconomic groups. Geographic status was dichotomized into rural and urban, collapsing variability within these categories. The study found small effect sizes despite high power, suggesting many other factors influence age of diagnosis and prior diagnostic patterns. Black children and girls were underrepresented in the sample compared to the general Medicaid population, which may bias the findings regarding these groups.
Declared interests
No specific funding source or conflicts of interest are reported in the provided text.
The easy way to misread this
Do not interpret the earlier diagnosis of Black children as evidence of equitable access to care. The authors suggest this may be due to under-representation of Black children with subtle presentations in the sample, meaning those who did get diagnosed may have had more obvious symptoms or different pathways to care.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →