Age of First Diagnosis in Asian Children at a Regional Autism Clinic

Background:  Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication, social interaction and restricted, repetitive patterns of behavior/interests (American Psychiatric Association, 2013). ASD diagnoses can be made as early as two years of age (Charman & Baird, 2002), allowing for earlier intervention, which leads to improved outcomes (Dawson, Rogers, & Munson, 2010; Eapen, Crncec, & Walkter, 2013; Reichow, 2012). While prevalence rates of autism has increased and the age of diagnosis has decreased among US children, ethnic differences exist in age of diagnosis (CDC, 2014). Studies have begun to investigate ethnic differences in age of first diagnosis, which has resulted in mixed findings for Asians. Specifically, some research has found that the age of first diagnosis is older in Asians as compared to other ethnicities in the US (Mandell, et al, 2009). In contrast, other research suggests that no significant difference exists between these groups (Windham, et al., 2011).

Objectives:  This study examined the age of first diagnosis of Asian children at a regional autism clinic as compared to the ADDM Network’s (CDC, 2014) national and state samples (comprised of Caucasian, Hispanic, Asian, and African American children). Further, a comparison was made between the Asian sample and the overall clinic sample. It was hypothesized that the age of first diagnosis for the Asian clinic sample would be significantly older as compared to the age of first diagnosis for the ADDM Network (nationally and regionally) and the overall clinic sample.

Methods:  Data from the clinical sample of 59 Asian children (aged 23 to 128 months) who were diagnosed with ASD a regional autism clinic was used. Data from record review included information regarding age (M=55.85 months) and gender (male N = 49; female N = 10). Data from this sample were compared to the ADDM Network’s reported national and state mean age of diagnosis using one-sample T-tests.

Results:  This sample of Asian children (n=59) did not differ significantly from national norms (CDC, 2014) in terms of age of first diagnosis (53 months), nor did they differ significantly from the overall clinic sample (56 months).  However, the age of diagnosis was significantly older than the average for their region as reported by the CDC (2014) (49 months; t=2.22; p<.05), mirroring results from previous work. Further analyses will be conducted to examine possible relations between IQ and region of origin, with age of diagnosis.

Conclusions:  Asian children receive a first time ASD diagnosis at an older age within a regional autism clinic when compared to the overall state sample of children. Factors contributing to this may include cultural and/or family influences. This is concerning because important intervention services are implemented later in development and may have less optimal outcomes (Reichow, 2012). However, the findings are not consistent with the national sample and the regional autism clinic, where the age of diagnosis is similar for both samples. This finding shows that compared to the national sample, Asian children from the clinic are being diagnosed at a similar age.