Age of Diagnosis Among Medicaid-Enrolled Children With Autism, 2001–2004

Abstract

Objective-This study examined child-and county-level factors associated with age of diagnosis of autism among Medicaid-enrolled children and the change in age of diagnosis over time.Methods-National Medicaid claims from 2002 to 2004 were used to identify age of diagnosis and characteristics of children younger than ten years old with a diagnosis of autism (ICD-9 codes 299, 299.0x, or 299.8x). These data were linked to county-level education and health care variables. Linear regression with random effects for state and county was used to examine associations between these variables and age of diagnosis.Results-A total of 28,722 Medicaid-enrolled children newly diagnosed with an autism spectrum disorder were identified. Their average age of diagnosis was 64.9 months. Adjusted average age of diagnosis dropped 5.0 months for autistic disorder and 1.8 months for other spectrum disorders during the study period. Asian children were diagnosed earlier than children in other racial or ethnic groups, although these differences were much more pronounced for other spectrum disorders than for autistic disorder. Children eligible for Medicaid through the poverty category were diagnosed earlier, on average, than children who were eligible through disability, foster care, or other reasons, although this difference decreased over time. Children in large urban or rural counties were diagnosed later than children in small urban or suburban counties.Conclusions-Findings showed that diagnosis of autism occurs much later than it should among Medicaid-enrolled children, although timeliness is improving over time. Analyses suggest that most Preliminary findings of this study were presented at

Age at First Autism Spectrum Disorder Diagnosis

“…The average age of diagnosis (5.3 yr) across the entire sample was markedly similar to previous reports 8 ; yet in the current AS-ATN sample, children from the most recent birth cohorts were diagnosed at much earlier ages. The availability of a large and well-defined sample of children and adolescents with ASD participating in the Autism Speaks Autism Treatment Network (AS-ATN) provided an opportunity to examine this issue within a geographically, socioeconomically, and phenotypically diverse sample.…”

Utility of the Social Communication Questionnaire-Current and Social Responsiveness Scale as Teacher-Report Screening Tools for Autism Spectrum Disorders

“…Results from one large, internet-based survey in which parents were queried about the ages at which their children received first ASD diagnoses found that children with autism were diagnosed at an average age of 3.4 years, those with PDD-NOS at 4.2 years, and those with Asperger's syndrome at 7.5 years (Goin-Kochel et al 2006). Other literature suggests that if and when a child is diagnosed with an ASD is, in part, dependent on a child's race, with factors such as socioeconomic status and degree of cognitive and language impairment also influencing identification and age at diagnosis (Mandell et al 2007(Mandell et al , 2010.…”

Clinical and psychosocial characteristics in adults with pervasive development disorders: a survey in Japan

“…These results, together with the results of the present study, indicated that adolescents and adults with ASD are a highly and increasingly medicated population. Concerning children with PDD, Mandell et al [18] examined Medicaid claims in 2001 from all 50 states and Washington, DC, for a total of 60,641 children with PDD. They reported that 56 % of subjects used at least one psychoactive medication and 20 % were prescribed more than three kinds of medications concurrently.…”