Agreement between concern about autism spectrum disorder at the time of referral and diagnosis, and factors associated with agreement

Lo, Bee Hong; Klopper, Felicity; Barnes, Elizabeth H; Williams, Katrina

doi:10.1111/jpc.13511

Cited by 14 publications

(8 citation statements)

References 26 publications

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“…The remaining 20 children all met our inclusion criterion of either a formal diagnosis of autism ( n 14) or an ongoing formal diagnostic assessment ( n 6), which has an average duration for this age range of 3.5 years (Crane, Chester, Goddard, Henry, & Hill, ). In one large‐scale study, 70% of children referred for an autism diagnosis went on to receive a diagnosis, and for children without any co‐occurring conditions (as was the case for the present sample) this figure rose to 89% (Lo, Klopper, Barnes, & Williams, ). Importantly, all parents completed the Gilliam Autism Rating Scale (GARS) with all 20 children in the ASD group receiving GARS‐AI scores ≥71 (i.e., severity level 2 or 3).…”

Section: Methodsmentioning

confidence: 48%

Atypicalities in sleep and semantic consolidation in autism

Fletcher

Knowland

Walker

et al. 2019

Developmental Science

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Sleep is known to support the neocortical consolidation of declarative memory, including the acquisition of new language. Autism spectrum disorder (ASD) is often characterized by both sleep and language learning difficulties, but few studies have explored a potential connection between the two. Here, 54 children with and without ASD (matched on age, nonverbal ability and vocabulary) were taught nine rare animal names (e.g., pipa). Memory was assessed via definitions, naming and speeded semantic decision tasks immediately after learning (pre‐sleep), the next day (post‐sleep, with a night of polysomnography between pre‐ and post‐sleep tests) and roughly 1 month later (follow‐up). Both groups showed comparable performance at pre‐test and similar levels of overnight change on all tasks; but at follow‐up children with ASD showed significantly greater forgetting of the unique features of the new animals (e.g., pipa is a flat frog). Children with ASD had significantly lower central non‐rapid eye movement (NREM) sigma power. Associations between spindle properties and overnight changes in speeded semantic decisions differed by group. For the TD group, spindle duration predicted overnight changes in responses to novel animals but not familiar animals, reinforcing a role for sleep in the stabilization of new semantic knowledge. For the ASD group, sigma power and spindle duration were associated with improvements in responses to novel and particularly familiar animals, perhaps reflecting more general sleep‐associated improvements in task performance. Plausibly, microstructural sleep atypicalities in children with ASD and differences in how information is prioritized for consolidation may lead to cumulative consolidation difficulties, compromising the quality of newly formed semantic representations in long‐term memory.

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Section: Methodsmentioning

confidence: 48%

Atypicalities in sleep and semantic consolidation in autism

Fletcher

Knowland

Walker

et al. 2019

Developmental Science

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“…We included 56 studies that reported the mean and/or median age at ASD diagnosis, of which 46 reported an overall ASD mean age at diagnosis between 30.9 and 574.4 months (Becerra-Culqui et al, 2018; Begeer et al, 2013; Bello-Mojeed et al, 2017; Bent et al, 2015; Berg et al, 2018; Bravo Oro et al, 2012; Brett et al, 2016; Carias & Wevrick, 2019; Cawthorpe, 2018; Crane et al, 2016; Daniels et al, 2017; Darcy-Mahoney et al, 2016; Emerson et al, 2016; Garrido et al, 2018; Goodwin et al, 2017; Hagberg & Jick, 2017; Hall-Lande et al, 2018; Hausman-Kedem et al, 2018; Höfer et al, 2019; Hrdlicka et al, 2016; Jo et al, 2015; Kentrou et al, 2019; Kurasawa et al, 2018; Lagunju et al, 2014; Larsen, 2015; Lo et al, 2017; Magaña et al, 2013; Manohar et al, 2019; Martinez et al, 2018; Masri et al, 2013; May et al, 2017; Mazurek et al, 2014; Miodovnik et al, 2015; Mishaal et al, 2014; Mpaka et al, 2016; Ribeiro et al, 2017; Rutherford et al, 2016; Salomone et al, 2016; Sheldrick et al, 2017; Shrestha et al, 2019; Sicherman et al, 2017; Talero-Gutiérrez et al, 2012; Ververi et al, 2012; Wei et al, 2018; Zablotsky et al, 2018). Of the 56 studies, 24 reported an overall ASD median age at diagnosis (only or combined with mean age at diagnosis score) between 28 and 96 months (Baio et al, 2018; Becerra-Culqui et al, 2018; Bent et al, 2015;…”

Section: Resultsmentioning

confidence: 99%

“…Factors associated with age at ASD diagnosis. Of the 56 studies, 10 did not report any influencing factors on age at diagnosis (Cawthorpe, 2018;Garrido et al, 2018;Hausman-Kedem et al, 2018;Lo et al, 2017;Martinez et al, 2018;Masri et al, 2013;May et al, 2017;Mpaka et al, 2016;Nadeem et al, 2019;Ribeiro et al, 2017). However, 46 studies reported many possible influencing factors on age at ASD diagnosis, including type of ASD diagnosis, additional diagnoses and gender among the most frequently reported (Supplemental Material 2).…”

Section: Additional Analysesmentioning

confidence: 99%

Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019

Hof

Tisseur²,

Berckelear-Onnes

et al. 2020

Autism

256

109

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Between 1990 and 2012, the global mean age at diagnosis of autism spectrum disorder ranged from 38 to 120 months. Measures have since been introduced to reduce the age at autism spectrum disorder diagnosis, but the current global mean age is unknown. This review and meta-analysis report the average age at diagnosis from studies published between 2012 and 2019. We initially identified 1150 articles, including 56 studies that reported the mean or median age at diagnosis across 40 countries (n = 120,540 individuals with autism spectrum disorder). Meta-analysis results (on 35 studies, including 55 cohorts from 35 countries, n = 66,966 individuals with autism spectrum disorder) found a current mean age at diagnosis of 60.48 months (range: 30.90–234.57 months). The subgroup analysis for studies that only included children aged ⩽10 years (nine studies, including 26 cohorts from 23 countries, n = 18,134 children with autism spectrum disorder) showed a mean age at diagnosis of 43.18 months (range: 30.90–74.70 months). Numerous factors may influence age at diagnosis and were reported by 46 studies, often with conflicting or inconclusive findings. Our study is the first to ascertain the global average age at autism spectrum disorder diagnosis from a meta-analysis. Continued efforts to lower the average age at autism spectrum disorder diagnosis are needed. Lay abstract We currently assume that the global mean age at diagnosis of autism spectrum disorder ranges from 38 to 120 months. However, this range is based on studies from 1991 to 2012 and measures have since been introduced to reduce the age at autism spectrum disorder diagnosis. We performed a systematic review and meta-analysis (statistical analysis that combines the results of multiple scientific studies) for studies published between 2012 and 2019 to evaluate the current age at autism spectrum disorder diagnosis. We included 56 studies that reported the age at diagnosis for 40 countries (containing 120,540 individuals with autism spectrum disorder). Results showed the current mean age at diagnosis to be 60.48 months (range: 30.90–234.57 months) and 43.18 months (range: 30.90–74.70 months) for studies that only included children aged ⩽10 years. Numerous factors that may influence age at diagnosis (e.g. type of autism spectrum disorder diagnosis, additional diagnoses and gender) were reported by 46 studies, often with conflicting or inconclusive results. Our study is the first to determine the global average age at autism spectrum disorder diagnosis from a meta-analysis. Although progress is being made in the earlier detection of autism spectrum disorder, it requires our constant attention.

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“…The dissociation between parental opinion about child’s problems and objective status is common in ASD [ 33 ]. Parental collaboration in the diagnostic evaluation is rated by Bulgarian physicians as moderate—3, 2–3, 4 in a 1 to 5 scale [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

The Route to Autism Spectrum Diagnosis in Pediatric Practice in Bulgaria

et al. 2021

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Diagnosis of autism spectrum disorder (ASD) before the age of three years is a challenge. Analyzing the present practice may help reaching that goal. Aim: To investigate developmental abnormalities and diagnostic pathway of ASD patients in pediatric practice. Methods: Retrospective cross-sectional study of 192 children aged 13 months to 17 years 11 months (average 4 years 9 months), investigated in an outpatient and hospital setting from January 2015 to June 2018 by a semi-structured history and clinical examination, and diagnosed with ASD by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Results: Behavioral peculiarities were detected in the history of the first two years of life in 74.8% of the subjects. The first developmental abnormalities were noticed by the parents at ages from 8 to 36 months (mean 15.6 months) and were predominantly in speech (in 94.6%) and non-verbal communication (11.3%). Developmental regression was reported in 42.1% of the patients occurring between the ages of 6 and 50 months (mean 17.9 months), affecting most commonly speech (88.4% of cases), non-verbal communication (29.2%), and behavior (12.8%). By history, the first manifestations of ASD were noticed at ages from 8 months to 84 months (mean 18.5 months), and were disorders of expressive speech (in 66.7% of cases), receptive speech (in 45.8%), non-verbal communication (35.4%), behavior (27.6%), play (8.9%), socialization (5.7%), and joint attention (2.1%). The most common motive for specialized consultation was delay in language development—in 84.6% of children. The age of ASD diagnosis varied between 12 and 132 months (mean 39.7 months), and the time period between first ASD manifestations and diagnosis was in the range of 0 to 79 months (mean 23.3 months). Many symptoms of abnormal social communication, unnoticed by parents, were detected objectively in more than 95% of the cases—absent or rare spontaneous or reciprocal smile; lack of sharing of interest or affect; abnormal eye contact; lack of finger pointing; lack of gaze to a pointed object; poor facial expressions; lack of imaginary play, etc. Conclusions: Almost two years are needed for diagnosing abnormal development in other domains besides speech in ASD patients. Diagnosis before the age of three years can be achieved by focusing parents’ and pediatricians’ attention on social communication and behavior in patients with speech delay or developmental regression.

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Agreement between concern about autism spectrum disorder at the time of referral and diagnosis, and factors associated with agreement

Cited by 14 publications

References 26 publications

Atypicalities in sleep and semantic consolidation in autism

Atypicalities in sleep and semantic consolidation in autism

Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019

The Route to Autism Spectrum Diagnosis in Pediatric Practice in Bulgaria

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