Time Trends in Diagnostics and Clinical Features of Young Children Referred on Suspicion of Autism: A Population-Based Clinical Cohort Study, 2000–2010

Abstract

The present study aimed to explore clinical trends in the period 2000–2010, along with discriminating clinical factors for autism spectrum disorder (ASD), in young children suspected of ASD. The following trends were observed: (1) a rise in referrals including an increase in referrals among language-abled children, (2) an increase in children assigned an ASD diagnosis after assessment, and (3) a decrease in Autism Diagnostic Observation Schedule total score. The distribution of ASD subtypes and IQ level did not change. Results suggest that a higher proportion of children with less severe autism symptoms were referred and diagnosed. Further, restricted and repetitive behaviors seemed to be a key discriminating factor when distinguishing between ASD and no-ASD children with a discordant symptom profile.

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Acknowledgments

None of the authors have any financial or personal relationships with people or organizations that could influence the work of this article. This work was supported by Aarhus University Hospital, Department of Child and Adolescent Psychiatry, and by grants from the Research fund of Child and Adolescent Psychiatry, Central Denmark Region, Denmark, Sofie Foundation, Butcher Wörzner and Wife Memorial Fund, and Mrs C. Hermansen Memorial Fund. The funders had no involvement in any aspects of the study. The authors would like to thank Emilie Riis Kjeldsen and Katrine Jaquet Mavraganis for assistance in the data collection process, Astrid Voldstedt Lund Høy for reviewing cognitive test results, and Jens Søndergaard Jensen for invaluable statistical assistance.

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All authors contributed to the study conception, design and interpretation of results. Data collection and analyses were performed by Sara Højslev Avlund. The first draft of the manuscript was written by Sara Højslev Avlund and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Sara Højslev Avlund.

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Avlund, S.H., Thomsen, P.H., Schendel, D. et al. Time Trends in Diagnostics and Clinical Features of Young Children Referred on Suspicion of Autism: A Population-Based Clinical Cohort Study, 2000–2010. J Autism Dev Disord 51, 444–458 (2021). https://doi.org/10.1007/s10803-020-04555-8

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Keywords

  • Autism spectrum disorder
  • Time trends
  • Ambiguous autism symptoms
  • Young children
  • ADOS
  • Repetitive ritualistic stereotyped behaviors