20260
Timeliness of Autism Spectrum Disorder Diagnosis and Subsequent Use of Services
Objectives: We assessed the relationship between age of ASD diagnosis and delay in ASD diagnosis with current use of psychotropic medications, intensive behavioral interventions (IBI), complementary and alternative medicine (CAM), and school-based therapy, in a nationally-representative sample of U.S. elementary school-aged children.
Methods: The Center for Disease Control’s 2011 Survey of Pathways to Diagnosis and Services was used to assess age and delay in ASD diagnosis, and its relationship with health services use, among 722 children age 6-11 with autism spectrum disorder. Older age of diagnosis was defined as diagnosis at age 5 years or older. Longer delay in diagnosis was defined as 3 or more years between first parent concern and ASD diagnosis. Bivariate and multivariable logistic regression analyses were used to assess the association between age and delay and current use of psychotropic medications, IBI, CAM, and school-based therapy
Results: Nearly half (44.8%) of children were diagnosed at age 5 or older (95% confidence interval [CI] 38.5%-51.3%), and 39.6% (95% CI: 33.3%-46.3%) experienced a diagnostic delay of 3 or more years. Multivariable regression results showed younger age of diagnosis was associated with more frequent use of school-based therapy (adjusted odds ratio [AOR]: 2.21, 95% CI 1.12-4.35). Longer delay in diagnosis was associated with increased likelihood of CAM use (AOR: 2.55, 95% CI: 1.38-4.73). Use of psychotropic medications or IBI did not have any significant associations with age or delay in diagnosis on adjusted analysis.
Conclusions: Both older age of diagnosis and longer delay in diagnosis were associated with different health and educational services utilization patterns among elementary school-aged children with ASD. Results suggest that prompt and early diagnosis may be associated with increased use of conventional therapies for ASD.