The Importance of Language Delays as an Early Indicator of Subsequent ASD Diagnosis in Public Healthcare Settings

Nitzan, Tanya; Koller, Judah; Ilan, Michal; Faroy, Michal; Michaelovski, Analya; Menashe, Idan; Meiri, Gal; Dinstein, Ilan

doi:10.1007/s10803-022-05757-y

Cited by 9 publications

(8 citation statements)

References 53 publications

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“…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).…”

Section: Discussionsupporting

confidence: 82%

Delay of diagnosis in autism spectrum disorder and its influencing factors

Zhu,

Ji,

Wang

et al. 2023

Preprint

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Background Although experienced clinicians are capable of diagnosing autism spectrum disorders (ASD) in children before they reach the age of 2, the average age of diagnosis reported internationally is between 4 and 5 years, indicating a significant delay in diagnosis. The objective of this study was to determine the factors influencing the diagnosis delay time (DDT) in children with ASD and to shorten the diagnosis period. Methods We employed the Cox proportional hazard model to examine the effects of individual, family, sociodemographic, and healthcare system indicators on DDT in a retrospective survey involving ASD children and their families. Results This study included a total of 560 subjects. The findings revealed that the median DDT in children with ASD was 8.16 (15.99) months, and the mean DDT was 13.68 (17.11) months. Language development level of children (RR = 0.521, 95%CI 0.400 ~ 0.680, P < 0.001), enrollment in school (RR = 1.950, 95%CI 1.552 ~ 2.450, P = < 0.001), experience of previous misdiagnosis (RR = 1.637, 95%CI 1.249 ~ 2.146, P < 0.001), degree of caregiver's concern about initial symptoms (RR = 0.781, 95%CI 0.635 ~ 0.960, P = 0.019), and whether the initial symptom is a core defect of ASD (RR = 1.758, 95%CI 1.210 ~ 2.553, P = 0.003) were identified as independent risk factors for delayed diagnosis of ASD in children under the age of six. Conclusions In China, there is a significant delay in the diagnosis of ASD among children. Children at risk of delayed ASD diagnosis include those with normal language abilities and early-onset non-autistic core difficulties, whose parents neglect their children’s atypical symptoms, those who have already started school, and those with a history of misdiagnosis. We urge parents, educators, and healthcare providers to closely monitor atypical child development during early childhood, enhance growth monitoring for preschool and school-aged children, and be attentive to children with normal language skills.

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Section: Discussionsupporting

confidence: 82%

Delay of diagnosis in autism spectrum disorder and its influencing factors

Zhu,

Ji,

Wang

et al. 2023

Preprint

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“…Considering the studies showing that there is a relationship between the language-cognitive levels of children with ASD and the severity and prognosis of the disease [ 56 , 57 ]; we expected that serum YKL-40 and serum CD163 levels, which we found to be correlated with ASD severity, would also be correlated with delays in children’s language cognitive levels. However, in our study, no significant relationship was found between the PLS-4 data showing the language development level and the ADSI data showing the cognitive development level in the ASD group, and serum YKL-40 and CD163 levels.…”

Section: Discussionmentioning

confidence: 94%

Investigating the Relationship of Serum CD163, YKL40 and VILIP-1 Levels with Autism Severity and Language-cognitive Development in Preschool Children with Autism

Demirci,

Barun,

Özaslan

et al. 2024

Clin Psychopharmacol Neurosci

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Objective This study aimed to compare serum levels of CD163, YKL-40, and VILIP-1 between children with autism spectrum disorder (ASD) and healthy controls, while also investigating their association with the severity of ASD and language development. Methods The study included 40 ASD-diagnosed patients (aged 18−72 months) and 40 age-matched healthy controls. Childhood Autism Rating Scale, Preschool Language Scale-4, and Ankara Development Screening Inventory were administered to children in the ASD group. Serum CD163, YKL-40 and VILIP-1 levels were measured with an enzyme-linked immunosorbent assay kit. Results In the ASD group compared to the control group, serum VILIP-1 levels were significantly higher ( p = 0.046). No significant differences were observed in mean serum CD163 and YKL-40 levels between patients and controls ( p = 0.613, p = 0.769). Interestingly, a positive correlation was observed between CD163 and YKL-40 levels and ASD severity ( p < 0.001 for both). Additionally, CD163 and YKL-40 levels showed significant predictive value for ASD severity. While no significant associations were found between CD163 and YKL-40 levels and language development, a negative correlation was observed between VILIP-1 levels and language development ( p < 0.001). Conclusion Our findings highlight that the levels of CD163 and YKL-40 significantly predicted ASD severity, indicating a potential role of neuroinflammation in the development of ASD.

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“…Moreover, the production of first words and sentences occurs earlier in ASD F than in ASD M [16]. Indeed, S/G differences in language delay may contribute to the delayed ASD diagnosis in some F compared to M [17,18], since earlier ASD diagnoses are associated with parent-reported expressive language delays [19]. According to this view, findings from a retrospective investigation reported that ASD F who received a diagnosis of autism after the age of 5 years displayed more advanced social communication skills, including vocabulary [20].…”

Section: Introductionmentioning

confidence: 99%

Sex/gender Differences in the Language Profiles of Italian Children with Autism Spectrum Disorder

Barsotti¹,

Mangani²,

Nencioli³

et al. 2023

Preprint

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Sex/gender (S/G) differences in ASD language profiles have been poorly investigated. The present study aims to explore whether male (M) and female (F) children with ASD and with normal non-verbal cognitive abilities differ in their linguistic profiles. A sample of 76 Italian children with ASD (range: 4.9 – 8 years), including 50 M and 26 F, was retrospectively recruited. Language profiles were analyzed using standardized tests for the evaluation of receptive and expressive vocabulary as well as grammar. Grammatical comprehension was the most impaired domain compared to the other language measures in both M and F children. Comparing language profiles between S/G, F showed significantly better scores than M in grammatical production (p=.002), and M showed better active negative sentences comprehension (p=.035). Moreover, comparing the language profiles between M and F with receptive disorder, F had significantly worse grammatical comprehension and better grammatical production than M. Even among children without receptive disorder, F had significantly higher grammatical production scores. The S/G differences in language profile, particularly better expressive language in F than M, can partially contribute to the delayed ASD diagnosis or underdiagnosis of F without intellectual disability. Finally, our results document the importance of accurately investigating both expressive and receptive abilities in children with ASD.

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The Importance of Language Delays as an Early Indicator of Subsequent ASD Diagnosis in Public Healthcare Settings

Cited by 9 publications

References 53 publications

Delay of diagnosis in autism spectrum disorder and its influencing factors

Delay of diagnosis in autism spectrum disorder and its influencing factors

Investigating the Relationship of Serum CD163, YKL40 and VILIP-1 Levels with Autism Severity and Language-cognitive Development in Preschool Children with Autism

Sex/gender Differences in the Language Profiles of Italian Children with Autism Spectrum Disorder

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