Age of First Walking and Associations with Symptom Severity in Children with Suspected or Diagnosed Autism Spectrum Disorder

Abstract

Background: In Mali, the national health facility-based prevalence of autism spectrum disorders (ASD) was 4.5% (105/2,343) and the age of rst medical visit for autistic children was around 7 years old in 2018. Parental recognition of developmental abnormalities initiates the early autism detection and diagnosis. Our aim was to investigate if parental concerns were associated with early rst medical visits and subsequent ASD diagnostic in Mali. Methods: We conducted a pilot study from November 2017 to July 2019. We surveyed parents of 57 out of 60 available autistic children aged 3-14 years old. Results: Parents were concerned over verbal communication in 54.1% and reciprocal social interaction in 43.8%. Children with ASD had their rst medical visit after 18 months old in 66.7%, ≥ two medical visits in 87.7%, and were identi ed after 36 months old in 76.8%. Conclusion: Parental concerns were not signi cantly associated with early rst medical visit and ASD identi cation. Our results will guide future full scale studies on parental concerns in ASD in Mali. Background Autism spectrum disorders (ASD) affect 1 in 59 children aged 8 years old in the United States of America (U.S.A.) [1]. ASD are recognized as an emerging global public health concern due to the increasing worldwide prevalence and awareness along the need for early diagnostic and lifelong care [2,3]. Almost everything we know about ASD still comes from the World Bank high-income countries mainly. In sub-Sahara Africa, the stigma and unmet needs of parents and children with ASD are considerable while the prevalence of ASD is still unknown [4-6]. In Mali, the health facility-based prevalence of ASD was 4.5% (105/2,343) in 2018 [7]. Early ASD diagnosis is very important because it helps to ensure appropriate services are offered and because this may improve prognosis [8,9]. Early intervention in ASD requires early detection, which depends on early screening. Various early autism screening tools have been developed in the U.S. to promote early autism risk detection [10]. In developed countries, the online version of the Modi ed checklist for autism in toddlers-Revised/follow up (M-CHAT-R/F) and the social communication questionnaire (SCQ) are available to parents who suspect their children at risk of ASD [11]. In Mali, we have validated the M-CHAT-R and SCQ in 2017-2018 to screen ASD in toddlers aged 18-24 months old and people aged 4-20 years old suspected with ASD, respectively [12]. Timely ASD diagnostic requires early detection, which greatly depends on parental recognition of developmental abnormalities [13]. In the U.S.A, parental concerns of childhood developmental abnormalities have been associated with early or late ASD screening and diagnostic as well as the overall well-being of autistic children [14,15]. In general, initial concerns about the autistic child's development come rst from their parents in up to 80% [16]. Developmental motor delays during early childhood may represent an important predictor for ASD diagnostic [17,18]. In high risk child...

Multimodal imaging improves brain age prediction and reveals distinct abnormalities in patients with psychiatric and neurological disorders

“…Diagnostic conclusions were best-estimate clinical diagnoses derived from tests, interview results and observations. All diagnoses were based on the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) (Reindal et al, 2019).…”

“…Diagnostic conclusions were best-estimate clinical diagnoses derived from tests, interview results and observations. All diagnoses were based on the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) (Reindal et al, 2019). HC in STROKEMRI were recruited through local newspapers and social media, were required to be at least 18 years old and reported no history of stroke, dementia, or other neurological and psychiatric disorders, alcohol and substance abuse or intake of medications significantly affecting the nervous system.…”

Autism Spectrum Disorders in Mali: Parental concerns about child developmental milestones and late diagnostic age

“…This may have many plausible explanations. First, even with higher ASD prevalence in both sexes, core ASD symptomology are easily presentable in males, and females are too good in camou aging their symptoms, which may result in sex differences in parental concerns after age 5 years [45][46][47][48][49][50]. Second, females experienced less unusual stereotyped and repetitive behaviors than males due to genetic (Y chromosome) and hormonal factors (fetal testosterone) and they have an increased prevalence of internalizing problems [47,51].…”

Autism Spectrum Disorders in Mali: Parental concerns about child developmental milestones and late diagnostic age

“…This may have many plausible explanations. First, even with higher ASD prevalence in both sexes, core ASD symptomology are easily presentable in males, and females are too good in camouflaging their symptoms, which may result in sex differences in parental concerns after age 5 years [38][39][40][41][42][43]. Second, females experienced less unusual stereotyped and repetitive behaviors than males due to genetic (Y chromosome) and hormonal factors (fetal testosterone) and they have an increased prevalence of internalizing problems [40,44].…”