Predictors of Age of Diagnosis for Children with Autism Spectrum Disorder: The Role of a Consistent Source of Medical Care, Race, and Condition Severity

Emerson, Natacha D.; Morrell, Holly E. R.; Neece, Cameron L.

doi:10.1007/s10803-015-2555-x

Cited by 85 publications

(49 citation statements)

References 74 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study of children from the Autism and Developmental Disabilities Monitoring Network found the median age of ASD diagnosis in the United States to be 52 months [Baio et al, ], but the fact that the presence of specific COCs can inadvertently increase or decrease the age at which ASD is first diagnosed [Soke et al, ] suggests that the relationships between COCs and ASD are still poorly understood. Demographic and socioeconomic factors can also influence the timing of diagnosis, although these account for a relatively small portion of the variation [Herlihy et al, ; Emerson, Morrell, & Neece, ]. An improved understanding of COC trajectories in young children may hold potential for more informed and consistently timed ASD diagnoses.…”

Section: Introductionmentioning

confidence: 99%

Clustering of co‐occurring conditions in autism spectrum disorder during early childhood: A retrospective analysis of medical claims data

et al. 2019

View full text Add to dashboard Cite

Individuals with autism spectrum disorder (ASD) are frequently affected by co-occurring medical conditions (COCs), which vary in severity, age of onset, and pathophysiological characteristics. The presence of COCs contributes to significant heterogeneity in the clinical presentation of ASD between individuals and a better understanding of COCs may offer greater insight into the etiology of ASD in specific subgroups while also providing guidance for diagnostic and treatment protocols. This study retrospectively analyzed medical claims data from a private United States health plan between years 2000 and 2015 to investigate patterns of COC diagnoses in a cohort of 3,278 children with ASD throughout their first 5 years of enrollment compared to 279,693 children from the general population without ASD diagnoses (POP cohort). Three subgroups of children with ASD were identified by k-means clustering using these COC patterns. The first cluster was characterized by generally high rates of COC diagnosis and comprised 23.7% (n = 776) of the cohort. Diagnoses of developmental delays were dominant in the second cluster containing 26.5% (n = 870) of the cohort. Children in the third cluster, making up 49.8% (n = 1,632) of the cohort, had the lowest rates of COC diagnosis, which were slightly higher than rates observed in the POP cohort. A secondary analysis using these data found that gastrointestinal and immune disorders showed similar longitudinal patterns of prevalence, as did seizure and sleep disorders. These findings may help to better inform the development of diagnostic workup and treatment protocols for COCs in children with ASD.Lay Summary: Medical conditions that co-occur with autism spectrum disorder (ASD) vary significantly from person to person. This study analyzed patterns in diagnosis of co-occurring conditions from medical claims data and observed three subtypes of children with ASD. These results may aid with screening for co-occurring conditions in children with ASD and with understanding ASD subtypes.

show abstract

Section: Introductionmentioning

confidence: 99%

Clustering of co‐occurring conditions in autism spectrum disorder during early childhood: A retrospective analysis of medical claims data

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Based on these strengths, the pediatric healthcare system is moving toward greater involvement of parents in the process of identifying early developmental delays (Feldman et al, 2005; Nordahl-Hansen, Kaale & Ulvund, 2013). Specifically, routine developmental screening via parent report is increasingly being used to identify at risk children, in accordance with American Academy of Pediatrics recommendations (Emerson, Morrell, & Neece, 2016; Johnson & Myers, 2007). …”

Section: Introductionmentioning

confidence: 99%

Comparison of parent report and direct assessment of child skills in toddlers

Miller

Perkins

Dai

et al. 2017

Research in Autism Spectrum Disorders

View full text Add to dashboard Cite

Background There are unique challenges associated with measuring development in early childhood. Two primary sources of information are used: parent report and direct assessment. Each approach has strengths and weaknesses, particularly when used to identify and diagnose developmental delays. The present study aimed to evaluate consistency between parent report and direct assessment of child skills in toddlers with and without Autism Spectrum Disorder (ASD) across receptive language, expressive language, and fine motor domains. Method 109 children were evaluated at an average age of two years; data on child skills were collected via parent report and direct assessment. Children were classified into three groups (i.e., ASD, Other Developmental Disorder, or Typical Development) based on DSM-IV-TR diagnosis. Mixed design ANOVAs, with data source as a within subjects factor and diagnostic group as a between subjects factor, were used to assess agreement. Chi square tests of agreement were then used to examine correspondence at the item level. Results Results suggested that parent report of language and fine motor skills did not significantly differ from direct assessment, and this finding held across diagnostic groups. Item level analyses revealed that, in most cases of significant disagreement, parents reported a skill as present, but it was not seen on direct testing. Conclusions Results indicate that parents are generally reliable reporters of child language and fine motor abilities in toddlerhood, even when their children have developmental disorders such as ASD. However, the fullest picture may be obtained by using both parent report and direct assessment.

show abstract

“…Studies from the United States have found earlier diagnosis age with higher parental education level and income [Mazurek et al, ; Thomas et al, ]. While non‐Hispanic Blacks in the United States were found to have an earlier diagnosis age when compared to Hispanics and non‐Hispanic Whites, this effect was limited to low severity ASD cases [Emerson, Morrell, & Neece, ; Jo et al, ]. To the best of our knowledge, there is no literature outlining diagnosis age in Israel according to sociodemographic factors.…”

Section: Introductionmentioning

confidence: 99%

Incidence time trends and socioeconomic factors in the observed incidence of autism spectrum disorder in israel: A nationwide nested case–control study

et al. 2019

View full text Add to dashboard Cite

Autism spectrum disorder (ASD) trends have been gaining a great deal of focus in recent decades, as many studies worldwide show a continued rise in incidence rates. Many researchers have begun analyzing socioeconomic data in relation to ASD in an effort to understand the source of these changing rates and the role of awareness and access to resources. In this study, we aim to contribute to this body of knowledge by examining incidence time trends of ASD in Israel according to socioeconomic factors. While similar studies have been conducted in Israel, this study is the first of its kind to include the total population. Individual‐level data from the Israeli National Insurance Institute were used to determine cumulative incidence of ASD, first for the total population, and then stratified by population group and income categories. Multivariable logistic regression models were fit to analyze associations between income category and both risk of ASD and risk of ASD diagnosis in later age. A total of 431,348 children were examined in this study, with 13,841 cases of ASD. The cumulative incidence of all children aged 8 in 2015 was 0.64%, marking an increase compared to previous literature from Israel. Within our study period, ASD incidence followed this increase until the 2009 birth cohort, where it began to stabilize. Our initial findings from regression models showed strong positive associations between household income and ASD incidence, as expected. After factoring in population group, however, the elevated ASD incidence rates in the highest income bracket decreased. Autism Res 2019, 12: 1870–1879. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary This study contributes comprehensive and current data on ASD trends overtime in Israel and introduces crucial insights regarding the impact of socioeconomic factors on ASD diagnoses. We found a rise in ASD that began leveling off in 2009. We identified more ASD diagnoses occurring in families with higher incomes and in the General Population, pointing to the important role of sociodemographic factors on ASD diagnoses.

show abstract

Predictors of Age of Diagnosis for Children with Autism Spectrum Disorder: The Role of a Consistent Source of Medical Care, Race, and Condition Severity

Cited by 85 publications

References 74 publications

Clustering of co‐occurring conditions in autism spectrum disorder during early childhood: A retrospective analysis of medical claims data

Clustering of co‐occurring conditions in autism spectrum disorder during early childhood: A retrospective analysis of medical claims data

Comparison of parent report and direct assessment of child skills in toddlers

Incidence time trends and socioeconomic factors in the observed incidence of autism spectrum disorder in israel: A nationwide nested case–control study

Contact Info

Product

Resources

About