Age of Autism Spectrum Disorder diagnosis and associated factors

Total views: 431 | Open access Open Access

Authors

https://doi.org/10.33700/jhrs.2.1.66

Keywords:

Autism Spectrum Disorder, diagnosis, age, severity, parents

Abstract

Introduction The mean age of autism spectrum disorder (ASD) diagnosis varies globally and the factors affecting it are inconsistent across populations and studies.

Aim Quantitative research was undertaken to investigate the age ASD was diagnosed and some possibly related factors, in a sample from Macedonia.

Methods A web-based survey was conducted among 103 parents of 103 individuals with ASD, from December 2021 to May 2022. Socio-demographic characteristics of parents/families and demographic and medical characteristics of individuals with ASD were reported through an anonymous questionnaire. Descriptive statistics and non-parametric inferential statistical tests were used to analyse data.

Results The median age of the ASD sample was 10 years and most individuals (47.57%) had moderately severe ASD. In 39.81% ASD was diagnosed by a psychiatrist/neuropsychiatrist, in 37.86% by several professionals, while paediatricians/developmental paediatricians were the source of diagnosis in only 2.91%. Over half of the individuals with ASD (51.46%) received the diagnosis before the age of 4, while around 17% received the diagnosis after the age of 6. The level of education of the parents, family living location, gender, current age and severity of ASD were not found to be associated with the age of diagnosis.

Conclusion Nearly 1/5 of the sample was diagnosed comparatively late ‒ at school age. However, characteristics pertaining to parents/families and to individuals with ASD, did not significantly affect the age of diagnosis. Possible influence of other, external factors (e.g., awareness and vigilance among professionals, availability of early screening programs) is acknowledged and will be included in further research.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Bonney, E., Abbo, C., Ogara, C., Villalobos, M. E., & Elison, J. T. (2022). Sex differences in age of diagnosis of autism spectrum disorder: Preliminary evidence from Uganda. Autism research: official journal of the International Society for Autism Research, 15(1), 183–191. https://doi.org/10.1002/aur.2645

Bujas Petkovic, Z., Marsanic, V. B., Divcic, B., & Ercegovic, N. (2015). Late diagnosis of Asperger syndrome in Croatia - a low-income country. Psychiatria Danubina, 27(4), 426–428.

Celebic, E., & Memisevic, H. (2023). Exploring the Parental Experiences in the Media: A Qualitative Analysis of Articles Written by Parents of Children with Autism in Bosnia and Herzegovina. Journal of Health and Rehabilitation Sciences, 2(1), 1-9. https://doi.org/10.33700/jhrs.2.1.62

Clark, M. L. E., Vinen, S., Barbaro, J., & Dissanayake, C. (2018). School Age Outcomes of Children Diagnosed Early and Later with Autism Spectrum Disorder. Journal of autism and developmental disorders, 48(1), 92–102. https://doi.org/10.1007/s10803-017-3279-x

Daniels, A. M., Como, A., Hergüner, S., Kostadinova, K., Stosic, J., & Shih, A. (2017). Autism in Southeast Europe: A Survey of Caregivers of Children with Autism Spectrum Disorders. Journal of autism and developmental disorders, 47(8), 2314–2325. https://doi.org/10.1007/s10803-017-3145-x

Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., Donaldson, A., & Varley, J. (2010). Randomised, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17–e23. https://doi.org/10.1542/peds.2009-0958

Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-Term Outcomes of Early Intervention in 6-Year-Old Children with Autism Spectrum Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54(7), 580–587. https://doi.org/10.1016/j.jaac.2015.04.005

Gabbay-Dizdar, N., Ilan, M., Meiri, G., Faroy, M., Michaelovski, A., Flusser, H., Menashe, I., Koller, J., Zachor, D. A., & Dinstein, I. (2022). Early diagnosis of autism in the community is associated with marked improvement in social symptoms within 1-2 years. Autism: the international journal of research and practice, 26(6), 1353–1363. https://doi.org/10.1177/13623613211049011

Ghahari, N., Hosseinali, F., Cervantes de Blois, C. L., & Alesheikh, H. (2021). A space-time analysis of disparities in age at diagnosis of autism spectrum disorder: environmental and socioeconomic risk factors. Journal of environmental health science & engineering, 19(2), 1941–1950. https://doi.org/10.1007/s40201-021-00746-2

Ghahari, N., Yousefian, F., Behzadi, S., & Jalilzadeh, A. (2022). Rural-Urban Differences in Age at Autism Diagnosis: A Multiple Model Analysis. Iranian journal of psychiatry, 17(3), 294–303. https://doi.org/10.18502/ijps.v17i3.9729

Gibbs, V., Aldridge, F., Sburlati, E., Chandler, F., Smith, K., & Cheng, L. (2019). Missed opportunities: An investigation of pathways to autism diagnosis in Australia. Research in Autism Spectrum Disorders, 57, 55-62. https://doi.org/10.1016/j.rasd.2018.10.007

Hanley, A., Nguyen, Q. C., Badawi, D. G., Chen, J., Ma, T., & Slopen, N. (2021). The diagnostic odyssey of autism: a cross-sectional study of 3 age cohorts of children from the 2016-2018 National Survey of Children's Health. Child and adolescent psychiatry and mental health, 15(1), 58. https://doi.org/10.1186/s13034-021-00409-y

Hrdlicka, M., Vacova, M., Oslejskova, H., Gondzova, V., Vadlejchova, I., Kocourkova, J., Koutek, J., & Dudova, I. (2016). Age at diagnosis of autism spectrum disorders: is there an association with socioeconomic status and family self-education about autism?. Neuropsychiatric disease and treatment, 12, 1639–1644. https://doi.org/10.2147/NDT.S107239

Hyman, S. L., Levy, S. E., Myers, S. M., & Council on children with disabilities, section on developmental and behavioral pediatrics (2020). Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics, 145(1), e20193447. https://doi.org/10.1542/peds.2019-3447

Ilic, S. B., Nikolic, S. J., Ilic-Stosovic, D. D., & Golubovic, S. S. (2019). Early identification of children with developmental delay and behavioural problems according to parents concerns in the Republic of Serbia. Early Child Development and Care. https://doi.org/10.1080/03004430.2019.1595610

Iskrov, G., Vasilev, G., Mitev, M., Nikolova, R., Stoykova, M., & Stefanov, R. (2021). Practice Patterns for Early Screening and Evaluation for Autism Spectrum Disorder Diagnosis in Bulgaria. Journal of autism and developmental disorders, 51(3), 778–789. https://doi.org/10.1007/s10803-019-04170-2

Johnson, C. P., Myers, S. M., & American Academy of Pediatrics Council on Children with Disabilities (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120(5), 1183–1215. https://doi.org/10.1542/peds.2007-2361

Lappe, M., Lau, L., Dudovitz, R. N., Nelson, B. B., Karp, E. A., & Kuo, A. A. (2018). The Diagnostic Odyssey of Autism Spectrum Disorder. Pediatrics, 141(Suppl 4), S272–S279. https://doi.org/10.1542/peds.2016-4300C

Long, D., Yang, T., Chen, J., Dai, Y., Chen, L., Jia, F., Wu, L., Hao, Y., Li, L., Zhang, J., Ke, X., Yi, M., Hong, Q., Chen, J., Fang, S., Wang, Y., Wang, Q., Jin, C., & Li, T. (2022). Age of Diagnosis and Demographic Factors Associated with Autism Spectrum Disorders in Chinese Children: A Multi-Center Survey. Neuropsychiatric disease and treatment, 18, 3055–3065. https://doi.org/10.2147/NDT.S374840

McConkey R. (2022). Responding to Autism in Low and Middle Income Countries (LMIC): What to Do and What Not to Do. Brain sciences, 12(11), 1475. https://doi.org/10.3390/brainsci12111475

Montiel-Nava, C., Montenegro, M. C., Ramirez, A. C., Valdez, D., Rosoli, A., Garcia, R., Garrido, G., Cukier, S., Rattazzi, A., & Paula, C. S. (2023). Age of autism diagnosis in Latin American and Caribbean countries. Autism: the international journal of research and practice, 13623613221147345. Advance online publication. https://doi.org/10.1177/13623613221147345

Pejovic-Milovancevic, M., Stankovic, M., Mitkovic-Voncina, M., Rudic, N., Grujicic, R., Herrera, A. S., Stojanovic, A., Nedovic, B., Shih, A., Mandic-Maravic, V., & Daniels, A. (2018). Perceptions on Support, Challenges and Needs among Parents of Children with Autism: the Serbian Experience. Psychiatria Danubina, 30(Suppl 6), 354–364.

Petrusheva, T. K., & Trajkovski, V. E. (2022). The importance of early diagnosis of autism spectrum disorder for adequate treatment and rehabilitation in Macedonia. Specijalna edukacija i rehabilitacija, 21(3), 163-176. https://doi.org/10.5937/specedreh21-36888

Pierce, K., Gazestani, V., Bacon, E., Courchesne, E., Cheng, A., Barnes, C. C., Nalabolu, S., Cha, D., Arias, S., Lopez, L., Pham, C., Gaines, K., Gyurjyan, G., Cook-Clark, T., & Karins, K. (2021). Get SET Early to Identify and Treatment Refer Autism Spectrum Disorder at 1 Year and Discover Factors That Influence Early Diagnosis. The Journal of pediatrics, 236, 179–188. https://doi.org/10.1016/j.jpeds.2021.04.041

Pistoljevic, N., Dzanko, E., & Ghaziuddin, M. (2021). Practice Patterns and Potential Barriers to Early Diagnosis of Autism in Bosnia and Herzegovina: A Preliminary Study. Journal of autism and developmental disorders, 51(12), 4447–4455. https://doi.org/10.1007/s10803-021-04875-3

Prahbhjot, M., & Singhi, P. (2022). Age at diagnosis for autism spectrum disorders: Does it differ by place of residence? Indian journal of public health, 66(2), 166–170. https://doi.org/10.4103/ijph.ijph_1801_21

Rattaz, C., Loubersac, J., Michelon, C., Geoffray, M. M., Picot, M. C., Munir, K., & Baghdadli, A. (2022). Factors associated with age of diagnosis in children with autism spectrum disorders: Report from a French cohort. Autism: the international journal of research and practice, 26(8), 2108–2116. https://doi.org/10.1177/13623613221077724

Reichow, B., Hume, K., Barton, E. E., & Boyd, B. A. (2018). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). The Cochrane database of systematic reviews, 5(5), CD009260. https://doi.org/10.1002/14651858.CD009260.pub3

Remington, B., Hastings, R. P., Kovshoff, H., degli Espinosa, F., Jahr, E., Brown, T., Alsford, P., Lemaic, M., & Ward, N. (2007). Early intensive behavioral intervention: outcomes for children with autism and their parents after two years. American journal of mental retardation: AJMR, 112(6), 418–438. https://doi.org/10.1352/0895-8017(2007)112[418:EIBIOF]2.0.CO;2

Saban-Bezalel, R., Zachor, D. A., & Ben-Itzchak, E. (2022). Relationship between cognitive ability and predictors for age at the time of autism spectrum disorder diagnosis. Psychiatry research, 315, 114696. https://doi.org/10.1016/j.psychres.2022.114696

Salomone, E., Charman, T., McConachie, H., & Warreyn, P. (2016). Child's verbal ability and gender are associated with age at diagnosis in a sample of young children with ASD in Europe. Child: care, health and development, 42(1), 141–145. https://doi.org/10.1111/cch.12261

Samadi S. A. (2022). The Challenges of Establishing Healthcare Services in Low- and Middle-Income Countries: The Case of Autism Spectrum Disorders (ASD) in the Kurdistan Region of Iraq-Report from the Field. Brain sciences, 12(11), 1433. https://doi.org/10.3390/brainsci12111433

Shattuck, P. T., Durkin, M., Maenner, M., Newschaffer, C., Mandell, D. S., Wiggins, L., Lee, L. C., Rice, C., Giarelli, E., Kirby, R., Baio, J., Pinto-Martin, J., & Cuniff, C. (2009). Timing of identification among children with an autism spectrum disorder: findings from a population-based surveillance study. Journal of the American Academy of Child and Adolescent Psychiatry, 48(5), 474–483. https://doi.org/10.1097/CHI.0b013e31819b3848

Shaw, K. A., Bilder, D. A., McArthur, D., Williams, A. R., Amoakohene, E., Bakian, A. V., Durkin, M. S., Fitzgerald, R. T., Furnier, S. M., Hughes, M. M., Pas, E. T., Salinas, A., Warren, S., Williams, S., Esler, A., Grzybowski, A., Ladd-Acosta, C. M., Patrick, M., Zahorodny, W., Green, K. K., … Maenner, M. J. (2023). Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C.: 2002), 72(1), 1–15. https://doi.org/10.15585/mmwr.ss7201a1

Siu, A. L., US Preventive Services Task Force (USPSTF), Bibbins-Domingo, K., Grossman, D. C., Baumann, L. C., Davidson, K. W., Ebell, M., García, F. A., Gillman, M., Herzstein, J., Kemper, A. R., Krist, A. H., Kurth, A. E., Owens, D. K., Phillips, W. R., Phipps, M. G., & Pignone, M. P. (2016). Screening for Autism Spectrum Disorder in Young Children: US Preventive Services Task Force Recommendation Statement. JAMA, 315(7), 691–696. https://doi.org/10.1001/jama.2016.0018

Towle, P. O., Patrick, P. A., Ridgard, T., Pham, S., & Marrus, J. (2020). Is Earlier Better? The Relationship between Age When Starting Early Intervention and Outcomes for Children with Autism Spectrum Disorder: A Selective Review. Autism research and treatment, 2020, 7605876. https://doi.org/10.1155/2020/7605876

Trajkovski, V. (2017). Macedonia and Autism. In: Volkmar, F. (ed.) Encyclopedia of Autism Spectrum Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6435-8_102172-1

Van't Hof, M., Tisseur, C., van Berckelear-Onnes, I., van Nieuwenhuyzen, A., Daniels, A. M., Deen, M., Hoek, H. W., & Ester, W. A. (2021). Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019. Autism: the international journal of research and practice, 25(4), 862–873. https://doi.org/10.1177/1362361320971107

Waddington, H., Macaskill, E., Whitehouse, A. J. O., Billingham, W., & Alvares, G. A. (2022). Parent-reported atypical development in the first year of life and age of autism diagnosis. Journal of autism and developmental disorders. Advance online publication. https://doi.org/10.1007/s10803-022-05506-1

Ward, S. L., Sullivan, K. A., & Gilmore, L. (2016). Practitioner perceptions of the assessment and diagnosis of autism in Australia. Australian Psychologist, 51(4), 272-279. https://doi.org/10.1111/ap.12211

World Bank. (2023). World Bank Country and Lending Groups. Available at: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups. Accessed: 25 March 2023.

Zwaigenbaum, L., Bauman, M. L., Fein, D., Pierce, K., Buie, T., Davis, P. A., Newschaffer, C., Robins, D. L., Wetherby, A., Choueiri, R., Kasari, C., Stone, W. L., Yirmiya, N., Estes, A., Hansen, R. L., McPartland, J. C., Natowicz, M. R., Carter, A., Granpeesheh, D., Mailloux, Z, Wagner, S. (2015). Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research. Pediatrics, 136 Suppl 1(Suppl 1), S41–S59. https://doi.org/10.1542/peds.2014-3667D

Zwaigenbaum, L., Bryson, S. E., Brian, J., Smith, I. M., Roberts, W., Szatmari, P., Roncadin, C., Garon, N., & Vaillancourt, T. (2016). Stability of diagnostic assessment for autism spectrum disorder between 18 and 36 months in a high-risk cohort. Autism research: official journal of the International Society for Autism Research, 9(7), 790–800. https://doi.org/10.1002/aur.1585

Published

24.04.2023

How to Cite

Stojanovska, I. (2023). Age of Autism Spectrum Disorder diagnosis and associated factors. Journal of Health and Rehabilitation Sciences, 2(1), 60–72. https://doi.org/10.33700/jhrs.2.1.66

Issue

Section

Autism Research

Citations

Metrics