Age of Initial Caregiver Concern and Diagnosis in Asian Children at a Regional Satellite Autism Clinic

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication, interaction and restricted, repetitive patterns of behavior/interests (American Psychiatric Association, 2013). Studies have found that caregiver reports regarding initial age of developmental concerns in children occur between 12 and 24 months (Rogers & DiLalla, 1990; DeGiacomo and Fombonne, 1998). ASD diagnoses can be made as early as 24 months (Charman & Baird, 2002), allowing for earlier intervention, leading 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 (CDC, 2014). Studies have begun to investigate ethnic differences in these areas, with some research finding that the age of initial caregiver concern and first diagnosis is older in Asians compared to other ethnicities (Daley, 2004; Mandell, et al, 2009).

Objectives: This study examined caregiver reports of age of initial concern with regard to their child’s development and the age of first diagnosis in an Asian and clinical sample at a regional clinic. It was hypothesized that the age of first concerns and age of first diagnosis for the Asian sample would be significantly older than the clinical sample.

Methods: Data from a sample of 11 Asian children (ages 20 to 44 months) and the clinical sample of 119 children (ages 16 to 44) who were diagnosed with ASD at a regional clinic was used. Data from record review for the Asian sample included age (M=31.09 months), gender (male N = 10, female N = 1), and caregiver report of initial concern (M = 19.09). Similar data was obtained for the clinical sample: age (M = 29.78), gender (male N =99, female N = 20), and caregiver report of initial concern (M = 16.05). Data from the Asian sample were compared to the clinical sample children diagnosed with ASD at a regional clinic using an independent samples t-test.

Results: This sample of Asian children did not differ significantly from the clinical sample with regard to caregiver recognition of developmental concern (19 months and 16 months, respectively) or age of first diagnosis (31 months and 29 months, respectively). Further analyses will be conducted to examine possible relations between type of caregiver concern with age of first concern and age of first diagnosis.

Conclusions: These finding show that parents of Asian children and parents of the clinical sample of children at a regional clinic are reporting similar ages of initial concern. Additionally, these children are being diagnosed at a similar age. Although some studies have suggested that caregiver recognition of initial developmental concerns as well as age at first diagnosis are significantly older for Asian children, the results of this study are not showing these significant differences. These results are encouraging in that they suggest that Asian parents are recognizing concerns and having their children evaluated at an age similar to the clinical sample, allowing for earlier diagnosis and treatment of Asian children.