Advertisement

Journal of Autism and Developmental Disorders

, Volume 48, Issue 7, pp 2396–2407 | Cite as

Characterizing Health Disparities in the Age of Autism Diagnosis in a Study of 8-Year-Old Children

  • Chandni Parikh
  • Margaret Kurzius-Spencer
  • Ann M. Mastergeorge
  • Sydney Pettygrove
Original Paper

Abstract

The diagnosis of autism spectrum disorder (ASD) is often delayed from the time of noted concerns to the actual diagnosis. The current study used child- and family-level factors to identify homogeneous classes in a surveillance-based sample (n = 2303) of 8-year-old children with ASD. Using latent class analysis, a 5-class model emerged and the class memberships were examined in relation to the child’s median age at ASD diagnosis. Class 3, with known language delays and a high advantage socioeconomically had the lowest age of ASD diagnosis (46.74 months) in comparison to Classes 1 (64.99 months), 4 (58.14 months), and 5 (69.78 months) in this sample. Findings demonstrate sociodemographic and developmental disparities related to the age at ASD diagnosis.

Keywords

Autism Early diagnosis Age Delayed diagnosis Health disparities 

Notes

Acknowledgments

The data in this article were collected by the Centers for Disease Control (CDC) and Prevention Autism and Developmental Disabilities Monitoring (ADDM) Network for Arizona during study years 2002–2010, and was funded by Grant Number 5UR3/DD000680. The results presented here are those of the authors and do not represent the official position of the Centers for Disease Control and Prevention. The study protocols have been reviewed by the human subjects review boards at the University of Arizona and at participating data sources. These review boards have deemed this work to be public health surveillance and exempt from consent requirements. The study personnel reviewed records only and had no interaction with the study subjects. This article is prepared from a doctoral dissertation of the corresponding author

Author Contributions

SP and MKS conceived of the study, participated in its design and coordination; CP participated in the coordination, performed the statistical analysis, interpreted the data, and drafted the manuscript; AMM helped to draft the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest to declare.

References

  1. Al-Qabandi, M., Gorter, J. W., & Rosenbaum, P. (2011). Early autism detection: Are we ready for routine screening? Pediatrics, 128(1), e211–e217.  https://doi.org/10.1542/peds.2010-1881.CrossRefPubMedGoogle Scholar
  2. Asparouhov, T., & Muthén, B. (2014). Auxiliary variables in mixture modeling: Three-step approaches using Mplus. Structural Equation Modeling: A Multidisciplinary Journal, 21(3), 329–341.  https://doi.org/10.1080/10705511.2014.915181.CrossRefGoogle Scholar
  3. Barbaro, J., & Dissanayake, C. (2009). Autism spectrum disorders in infancy and toddlerhood: A review of the evidence on early signs, early identification tools, and early diagnosis. Journal of Developmental & Behavioral Pediatrics, 30(5), 447–459.CrossRefGoogle Scholar
  4. Barbaro, J., & Halder, S. (2016). Early identification of autism spectrum disorder: Current challenges and future global directions. Current Developmental Disorders Reports, 3(1), 67–74.  https://doi.org/10.1007/s40474-016-0078-6.CrossRefGoogle Scholar
  5. Barton, M. L., Dumont-Mathieu, T., & Fein, D. (2012). Screening young children for autism spectrum disorders in primary practice. Journal of Autism and Developmental Disorders, 42(6), 1165–1174.  https://doi.org/10.1007/s10803-011-1343-5.CrossRefPubMedGoogle Scholar
  6. Bickel, J., Bridgemohan, C., Sideridis, G., & Huntington, N. (2015). Child and family characteristics associated with age of diagnosis of an autism spectrum disorder in a tertiary care setting. Journal of Developmental & Behavioral Pediatrics, 36(1). Retrieved from http://journals.lww.com/jrnldbp/Fulltext/2015/01000/Child_and_Family_Characteristics_Associated_With.1.aspx.
  7. Boyd, B. a., Odom, S. L., Humphreys, B. P., & Sam, A. M. (2010). Infants and toddlers with autism spectrum disorder: Early identification and early intervention. Journal of Early Intervention, 32(2), 75–98.  https://doi.org/10.1177/1053815110362690.CrossRefGoogle Scholar
  8. Brett, D., Warnell, F., McConachie, H., & Parr, J. R. (2016). Factors affecting age at ASD diagnosis in UK: No evidence that diagnosis age has decreased between 2004 and 2014. Journal of Autism and Developmental Disorders, 46(6), 1974–1984.  https://doi.org/10.1007/s10803-016-2716-6.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Bryson, S. E., Zwaigenbaum, L., Brian, J., Roberts, W., Szatmari, P., Rombough, V., & McDermott, C. (2007). A prospective case series of high-risk infants who developed autism. Journal of Autism and Developmental Disorders, 37(1), 12–24.  https://doi.org/10.1007/s10803-006-0328-2.CrossRefPubMedGoogle Scholar
  10. Caronna, E. B., Milunsky, J. M., & Tager-Flusberg, H. (2008). Autism spectrum disorders: Clinical and research frontiers. Archives of Disease in Childhood, 93(6), 518–523.  https://doi.org/10.1136/adc.2006.115337.CrossRefPubMedGoogle Scholar
  11. Christensen, D. L., Baio, J., Van Naarden Braun, K., Bilder, D., Charles, J., Constantino, J. N., … Yeargin-Allsopp, M. (2016). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 sites, United States, 2012. MMWR Surveillance Summaries, 65(3), 1–23.CrossRefGoogle Scholar
  12. Costanzo, V., Chericoni, N., Amendola, F. A., Casula, L., Muratori, F., Scattoni, M. L., & Apicella, F. (2015). Early detection of autism spectrum disorders: From retrospective home video studies to prospective “high risk” sibling studies. Neuroscience and Biobehavioral Reviews, 55, 1–9.  https://doi.org/10.1016/j.neubiorev.2015.06.006.CrossRefGoogle Scholar
  13. Crais, E., Watson, L., Baranek, G., & Reznick, J. (2006). Early identification of autism: How early can we go? Seminars in Speech and Language, 27(3), 143–160.  https://doi.org/10.1055/s-2006-948226.CrossRefPubMedGoogle Scholar
  14. Daniels, A. M., & Mandell, D. S. (2013). Explaining differences in age at autism spectrum disorder diagnosis: A critical review. Autism: The International Journal of Research and Practice, 18(5), 583–597.  https://doi.org/10.1177/1362361313480277.CrossRefGoogle Scholar
  15. Dereu, M., Raymaekers, R., Warreyn, P., Schietecatte, I., Meirsschaut, M., & Roeyers, H. (2012). Can child care workers contribute to the early detection of autism spectrum disorders? A comparison between screening instruments with child care workers versus parents as informants. Journal of Autism and Developmental Disorders, 42(5), 781–796.  https://doi.org/10.1007/s10803-011-1307-9.CrossRefPubMedGoogle Scholar
  16. Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., … Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: Evidence from a U.S. cross-sectional study. PLoS ONE, 5(7), 1–8.  https://doi.org/10.1371/journal.pone.0011551.CrossRefGoogle Scholar
  17. Emerson, N. D., Morrell, H. E. R., & Neece, C. (2016). Predictors of age of diagnosis for children with autism spectrum disorder: The role of a consistent source of medical care, race, and condition severity. Journal of Autism and Developmental Disorders, 46(1), 127–138.  https://doi.org/10.1007/s10803-015-2555-x.CrossRefPubMedGoogle Scholar
  18. Enders, C. (2010). Applied missing data analysis. New York: The Guilford Press.Google Scholar
  19. Fountain, C., King, M. D., & Bearman, P. S. (2011). Age of diagnosis for autism: Individual and community factors across 10 birth cohorts. Journal of Epidemiology and Community Health, 65(6), 503–510.  https://doi.org/10.1136/jech.2009.104588.CrossRefPubMedGoogle Scholar
  20. Goin-Kochel, R. P., Mackintosh, V. H., & Myers, B. J. (2006). How many doctors does it take to make an autism spectrum diagnosis? Autism: The International Journal of Research and Practice, 10(5), 439–451.  https://doi.org/10.1177/1362361306066601.CrossRefGoogle Scholar
  21. Hrdlicka, M., Vacova, M., Oslejskova, H., Gondzova, V., Vadlejchova, I., Kocourkova, 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.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Johnson, C. P., & Myers, S. M. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120(5), 1183–1215.  https://doi.org/10.1542/peds.2007-2361.CrossRefPubMedGoogle Scholar
  23. Landa, R. J., Holman, K. C., & Garrett-Mayer, E. (2007). Social and communication development in toddlers with early and later diagnosis of autism spectrum disorders. Archives of General Psychiatry, 64(7), 853–864.  https://doi.org/10.1001/archpsyc.64.7.853.CrossRefPubMedGoogle Scholar
  24. Lanza, S. T., & Cooper, B. R. (2016). Latent class analysis for developmental research. Child Development Perspectives, 10(1), 59–64.CrossRefGoogle Scholar
  25. Lord, C., Cook, E. H., Leventhal, B. L., & Amaral, D. G. (2000). Autism Spectrum Disorders. Neuron, 28(2), 355–363.  https://doi.org/10.1016/S0896-6273(00)00115-X.PubMedGoogle Scholar
  26. Lord, C., & Jones, R. M. (2012). Annual research review: Re-thinking the classification of autism spectrum disorders. Journal of Child Psychology and Psychiatry and Allied Disciplines, 53(5), 490–509.  https://doi.org/10.1111/j.1469-7610.2012.02547.x.CrossRefGoogle Scholar
  27. Mandell, D., Listerud, J., Levy, S., & Pinto-Martin, J. (2002). Race differences in the age at diagnosis among medicaid-eligible children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 41(12), 1447–1453.  https://doi.org/10.1097/00004583-200212000-00016.CrossRefPubMedGoogle Scholar
  28. Mandell, D., Novak, M., & Zubritsky, C. (2005). Factors associated with age of diagnosis among children with autism spectrum disorders. Pediatrics, 45(6), 657.  https://doi.org/10.1542/peds.2005-0185.Google Scholar
  29. Mandell, D., Wiggins, L. D., Yeargin-Allsopp, M., Carpenter, L. A., Daniels, J., Thomas, K. C., … Kirby, R. S. (2009). Racial/ethnic disparities in the identification of children with autism spectrum disorders. American Journal of Public Health, 99(3), 493–498.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Masyn, K. E. (2013). Latent class analysis and finite mixture modeling. Retrieved from http://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199934898.001.0001/oxfordhb-9780199934898-e-025#.WAvnW9Cys2M.mendeley.
  31. Matson, J. L., Nebel-Schwalm, M., & Matson, M. L. (2007). A review of methodological issues in the differential diagnosis of autism spectrum disorders in children. Research in Autism Spectrum Disorders, 1(1), 38–54.  https://doi.org/10.1016/j.rasd.2006.07.004.CrossRefGoogle Scholar
  32. Mazurek, M. O., Handen, B. L., Wodka, E. L., Nowinski, L., Butter, E., & Engelhardt, C. R. (2014). Age at first autism spectrum disorder diagnosis: The role of birth cohort, demographic factors, and clinical features. Journal of Developmental & Behavioral Pediatrics, 35(9). Retrieved from http://journals.lww.com/jrnldbp/Fulltext/2014/11000/Age_at_First_Autism_Spectrum_Disorder_Diagnosis__.1.aspx.
  33. McMorris, C. A., Cox, E., Hudson, M., Liu, X., & Bebko, J. M. (2013). The diagnostic process of children with autism spectrum disorder: Implications for early identification and intervention. Journal on Developmental Disabilities, 19(2), 42–49.Google Scholar
  34. Munson, J., Dawson, G., Sterling, L., Beauchaine, T., Zhou, A., Koehler, E., … Abbott, R. (2008). Evidence for latent classes of IQ in young children with autism spectrum disorder. American Journal on Mental Retardation, 113(6), 439–452.  https://doi.org/10.1352/2008.113:439-452.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Newschaffer, C. J., Croen, L. A., Daniels, J., Giarelli, E., Grether, J. K., Levy, S. E., … Windham, G. C. (2007). The epidemiology of autism spectrum disorders. Annual Review of Public Health, 28(1), 235–258.  https://doi.org/10.1146/annurev.publhealth.28.021406.144007.CrossRefPubMedGoogle Scholar
  36. Oswald, D. P., Haworth, S. M., Mackenzie, B. K., & Willis, J. H. (2015). Parental report of the diagnostic process and outcome: ASD compared with other developmental disabilities. Focus on Autism and Other Developmental Disabilities.  https://doi.org/10.1177/1088357615587500.Google Scholar
  37. Ozonoff, S., Heung, K., Byrd, R., Hansen, R., & Hertz-Picciotto, I. (2008). The onset of autism: patterns of symptom emergence in the first years of life. Autism Research, 1(6), 320–328.  https://doi.org/10.1002/aur.53.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Ozonoff, S., Young, G. S., Carter, A., Messinger, D., Yirmiya, N., Zwaigenbaum, L., … Stone, W. L. (2011). Recurrence risk for autism spectrum disorders: A baby siblings research consortium study. Pediatrics, 128, e488–e495.PubMedPubMedCentralGoogle Scholar
  39. Pierce, K., Glatt, S. J., Liptak, G. S., & McIntyre, L. L. (2009). The power and the promise of identifying autism early: Insights from the search for clinical and biological markers. Annals of Clinical Psychiatry, 21(3), 132–147.PubMedPubMedCentralGoogle Scholar
  40. Rice, C. (2009). Prevalence of autism spectrum disorders: autism and developmental disabilities monitoring network, United States, 2006. Morbidity and Mortality Weekly Report, 58, 1–20Google Scholar
  41. Robins, D., Adamson, L., Barton, M., Connell, J., Dumont-Mathieu, T., Dworkin, P., … Vivanti, G. (2016). Universal autism screening for toddlers: Recommendations at odds. Journal of Autism & Developmental Disorders, 46, 1880–1882CrossRefGoogle Scholar
  42. Rosenberg, R. E., Landa, R., Law, J. K., Stuart, E. a., & Law, P. a. (2011). Factors affecting age at initial autism spectrum disorder diagnosis in a national survey. Autism Research & Treatment.  https://doi.org/10.1155/2011/874619.Google Scholar
  43. Shattuck, P. T., Durkin, M., Maenner, M., Newschaffer, C., Mandell, D. S., Wiggins, L., … 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 & Adolescent Psychiatry, 48(5), 474–483.  https://doi.org/10.1097/CHI.0b013e31819b3848.CrossRefGoogle Scholar
  44. Szatmari, P., Chawarska, K., Dawson, G., Georgiades, S., Landa, R., Lord, C., … Halladay, A. (2016). Prospective longitudinal studies of infant siblings of children with autism: Lessons learned and future directions. Journal of the American Academy of Child & Adolescent Psychiatry, 55(3), 179–187.  https://doi.org/10.1016/j.jaac.2015.12.014.CrossRefGoogle Scholar
  45. Thomas, P., Zahorodny, W., Peng, B., Kim, S., Jani, N., Halperin, W., & Brimacombe, M. (2012). The association of autism diagnosis with socioeconomic status. Autism, 16(2), 201–213.  https://doi.org/10.1177/1362361311413397.CrossRefPubMedGoogle Scholar
  46. Van Naarden Braun, K., Pettygrove, S., Daniels, J., Miller, L., Nicholas, J. S., Baio, J., … Rice, C. (2007). Evaluation of a methodology for a collaborative multiple source surveillance network for autism spectrum disorders—autism and developmental disabilities monitoring network, 14 sites, United States, 2002. Surveillance Summaries, 56, 29–40. Retrieved from https://www.cdc.gov/mmWr/preview/mmwrhtml/ss5601a3.htm.
  47. Wiggins, L. D., Baio, J., & Rice, C. (2006). Examination of the time between first evaluation and first autism spectrum diagnosis in a population-based sample. Journal of Developmental and Behavioral Pediatrics: JDBP, 27(2 Suppl), S79–S87.  https://doi.org/10.1097/00004703-200604002-00005.CrossRefPubMedGoogle Scholar
  48. Woods, J. J., & Wetherby, A. M. (2003). Early identification of and intervention for infants and toddlers who are at risk for autism spectrum disorder. Language, Speech, and Hearing Services in Schools, 34(3), 180–193.  https://doi.org/10.1044/0161-1461(2003/015).CrossRefPubMedGoogle Scholar
  49. Zablotsky, B., Colpe, L. J., Pringle, B. A., Kogan, M. D., Rice, C., & Blumberg, S. J. (2017). Age of parental concern, diagnosis, and service initiation among children with autism spectrum disorder. American Journal on Intellectual and Developmental Disabilities, 122(1), 49–61.  https://doi.org/10.1352/1944-7558-122.1.49.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Zuckerman, K. E., Mattox, K. E., Donelan, K., Batbayar, O., Baghaee, A., & Bethell, C. (2013). Pediatrician identification of Latino children at risk for autism spectrum disorder. Pediatrics, 132(3), 445–453.  https://doi.org/10.1542/peds.2013-0383.CrossRefPubMedPubMedCentralGoogle Scholar
  51. Zwaigenbaum, L., Bauman, M. L., Choueiri, R., Fein, D., Kasari, C., Pierce, K., … Roley, S. S. (2015). Early identification and interventions for autism spectrum disorder: Executive summary. Pediatrics, 136, S1–S9.CrossRefPubMedGoogle Scholar
  52. Zwaigenbaum, L., Bryson, S., Lord, C., Rogers, S., Carter, A., Carver, L., … Yirmiya, N. (2009). Clinical assessment and management of toddlers with suspected autism spectrum disorder: Insights from studies of high-risk infants. Pediatrics, 123(5), 1383–1391.CrossRefPubMedPubMedCentralGoogle Scholar
  53. Zwaigenbaum, L., Bryson, S., Rogers, T., Roberts, W., Brian, J., & Szatmari, P. (2005). Behavioral manifestations of autism in the first year of life. International Journal of Developmental Neuroscience, 23(2), 143–152.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.MIND InstituteUniversity of California-DavisSacramentoUSA
  2. 2.Genetics and Developmental PediatricsUniversity of ArizonaTucsonUSA
  3. 3.Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonUSA
  4. 4.Texas Tech UniversityLubbockUSA

Personalised recommendations