Explaining Age at Autism Spectrum Diagnosis in Children with Migrant and Non-Migrant Background in Austria.

Patricia Garcia Primo,Manuel Posada de la Paz,Christoph Weber,Daniel Holzinger,Johannes Fellinger,Anna Dirmhirn

doi:10.3390/brainsci10070448

Abstract

This study explored (i) differences in age at Autism Spectrum Disorder (ASD) diagnosis between children with and without a migrant background in the main diagnostic centre for ASD in Upper Austria (ii) factors related to the age at diagnosis and (iii) whether specific factors differed between the two groups. A retrospective chart analysis included all children who received their first diagnosis before the age of 10 years (n = 211) between 2013 and 2018. Children with a migrant background were diagnosed 13 months earlier than those without (r = 0.278, p < 0.001), and had more severe delays in language, more severe autism, no Asperger’s syndrome, lower parental educational level and more frequent referrals by paediatricians. For the total sample, expressive language delay, severity of restricted and repetitive behaviours, higher nonverbal development, and paediatric referrals explained earlier diagnoses. There was a stronger effect of parental education and weaker effect of language impairment on age at ASD diagnosis in children with a migrant background. In conclusion, no delay in diagnosing ASD in children with a migrant background in a country with universal health care and an established system of paediatric developmental surveillance was found. Awareness of ASD, including Asperger’s syndrome, should be raised among families and healthcare professionals.

Highlights

Research Institute of Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria; Department for Inclusive Education, University of Education Upper Austria, 4020 Linz, Austria
All children of parents with and without a migrant background who attended the diagnostic centre of the Institute of Neurology of Language and Senses (ISSN) in the study period (01-01-2013 to 31-12-2018) and received an ICD-10- diagnosis
Migration background cannot be sufficiently defined by citizenship, since there are many families with parents born outside Austria who have Austrian citizenship

Summary

Introduction

Children with a migrant background were diagnosed 13 months earlier than those without (r = 0.278, p < 0.001), and had more severe delays in language, more severe autism, no Asperger’s syndrome, lower parental educational level and more frequent referrals by paediatricians. Expressive language delay, severity of restricted and repetitive behaviours, higher nonverbal development, and paediatric referrals explained earlier diagnoses. There was a stronger effect of parental education and weaker effect of language impairment on age at ASD diagnosis in children with a migrant background. No delay in diagnosing ASD in children with a migrant background in a country with universal health care and an established system of paediatric developmental surveillance was found. Awareness of ASD, including Asperger’s syndrome, should be raised among families and healthcare professionals

Objectives

Methods

Discussion

Conclusion