Examining factors related to the age of diagnosis of children with autism spectrum disorder from immigrant and non‐immigrant backgrounds in a diverse clinical sample

Abstract

A timely diagnosis of autism spectrum disorder (ASD) is important for children as that may help inform the best services and supports needed for optimal outcomes. However, disparities in the identification of ASD have been consistently documented for racial/ethnic minority and immigrant populations. The majority of studies of immigrant populations have focused on the qualitative experience of ASD, however, greater knowledge about the predictors of the age of initial ASD diagnosis is needed. This study examined the child, maternal, and family‐level factors that predicted the age of initial ASD diagnosis in a diverse clinical sample through a retrospective medical record review. Medical records of clinical evaluations conducted between 2004 and 2014 were reviewed for children with ASD born to immigrant and non‐immigrant mothers. Regression analyses found that for both groups of children with ASD, using verbal language to communicate and having another diagnosis (attention‐deficit/hyperactivity disorder or another condition) predicted an older age of initial ASD diagnosis. For children with ASD born to immigrant mothers, residing in a multilingual household was associated with a younger age of diagnosis. These results highlight the complexities of an ASD diagnosis among diverse children and families, particularly among immigrant communities. Lay Summary This research looked at predictors of when children received their first autism spectrum disorder diagnosis across children born to immigrant mothers and children born to U.S.‐born mothers. Living in a multilingual home was related to a younger age of diagnosis for children of immigrant mothers; being verbal and having another diagnosis was related to an older age of diagnosis for both groups of children. This highlights the need to improve diagnostic services for diverse children.

Delay of diagnosis in autism spectrum disorder and its influencing factors

“…Our ndings indicate that children with normal language abilities are a risk factor for longer diagnosis delays. Consistent with previous research, language scores were the strongest variable associated with the age of diagnosis, and using verbal language to communicate predicts an older age of initial ASD diagnosis (37,40). Furthermore, language di culties are frequently mentioned as the most common early parental concern, and a delay in language development is the most common reason for seeking professional consultation (44,45).…”

Autismespekterforstyrrelser hos barn i førskolealder i Sør-Trøndelag 2016–19

“…Barn av mødre med annen landbakgrunn enn Norge var overrepresentert hos førskolebarn med autismespekterforstyrrelser, noe som kan tyde på at migrasjon i denne aldersgruppen har etiologisk betydning. Ved en journalgjennomgang av barn som hadde få en autismespekterdiagnose i et geografisk område i USA i årene 2004-14 (27), fant man at barn med verbalt språk og komorbiditet i form av for eksempel ADHD var eldre ved diagnosetidspunktet. I samme studie fant man også at barn av mødre med migrasjonsbakgrunn i flerspråklige hjem var yngre på diagnosetidspunktet enn barn av mødre uten migrasjonsbakgrunn.…”