Time is of the essence: Age at autism diagnosis, sex assigned at birth, and psychopathology.
Jessica V Smith, Goldie A McQuaid, Gregory L Wallace and 9 others
PMID 38725306WHAT IT FOUND
In autistic youth, later diagnosis was associated with more caregiver-reported anxiety and depression in both samples.
In the clinic sample, people assigned female at birth were diagnosed later, and later diagnosis was linked to their symptoms.
Key findings
01Later age at autism diagnosis predicted higher caregiver-reported anxious and depressive symptoms in both the clinic-based and research-based samples.
02In the clinic-based sample, people assigned female at birth were diagnosed later, and later diagnosis mediated the relationship between sex and both anxious and depressive symptoms.
03Sex did not predict anxious symptoms in either sample, but in the research-based sample people assigned female at birth showed higher caregiver-endorsed depressive symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot show that later diagnosis caused anxiety or depression. In the clinic sample, anxiety and depression were measured at the time of diagnostic evaluation, a stressful moment that may have affected caregiver ratings. In the research sample, age at diagnosis and symptom ratings were not concurrent, and the average age at diagnosis was 6.55 years before research participation. The research sample was small and had low power to detect indirect effects, 18-23%. Psychopathology came from caregiver report on measures developed for non-autistic populations. The study analysed sex assigned at birth only and lacked systematic gender identity data. Ethnoracial differences between samples could not be examined because the samples asked about identity differently.
Declared interests
No funding or conflict-of-interest declaration is included in the supplied text. The publication types list NIH extramural and non-U.S. government support.
The easy way to misread this
Do not read the association as proof that late diagnosis causes anxiety or depression. The study is cross-sectional, and it could not test whether later diagnosis came before symptoms.