First Parental Concerns and Age at Diagnosis of Autism Spectrum Disorder: A Retrospective Review from Malaysia.

Subhashini Jayanath,Sally Ozonoff

doi:10.21315/mjms2020.27.5.8

Abstract

BackgroundAutism spectrum disorder (ASD) is a neurodevelopmental disorder. This is the first study to examine first parental concerns in ASD in Malaysia. We examined: i) age and type of first parental concerns (AOC); ii) association between AOC and severity; iii) time lag between AOC and diagnosis; and iv) factors associated with diagnostic delay.MethodsMedical records of 366 patients (aged 1–18 years) with ASD, at the Developmental Paediatrics Clinic of University of Malaya Medical Centre (UMMC), Kuala Lumpur, were reviewed for this 16-month retrospective cohort study. A validated coding system was used for initial parent concerns. Severity was classified via the Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) criteria. Time lag between AOC and age at diagnosis (AOD) was calculated. Potential predictors of delayed diagnosis were extracted.ResultsThree-quarters (75.1%) of parents had concerns by 36 months. Speech/language/communication concerns were most frequent (60.1%). Number of first concerns was significantly correlated with severity (social communication/interaction, SCI [P = 0.019] and restricted, repetitive patterns of behaviours and/or interests/activities, RRB [P < 0.001]). AOC and AOD were significantly negatively correlated with SCI and RRB (P < 0.001). Medians; AOC: 24 months, AOD: 46 months and time lag: 17 months. Higher initial screen time was associated with diagnostic delay (P = 0.031).ConclusionFirst parental concerns and AOD were comparable to studies across countries. Speech/communication delays may represent universal first parental recognition of ASD.

Highlights

The prevalence of autism spectrum disorder (ASD) is steadily rising
This study explored the above factors in Malaysian paediatric patients with ASD and factors associated with delayed diagnosis
This study aims to: i) Determine the age of first parental concern and the type of parental concern for paediatric patients who subsequently received a diagnosis of ASD

Summary

Introduction

The prevalence of autism spectrum disorder (ASD) is steadily rising. According to the Centers for Disease Control and Prevention (CDC), the prevalence is 1 in 54 [1] for children aged 8 years. Prevalence rates vary considerably across regions [2] This variation likely has many causes, including medical resources and community services for evaluation [2]. Another potential reason for regional variation is cultural differences in early parent concerns and how these are reported to healthcare professionals. Parents in Poland reported restricted interests, while Greek parents were more likely to notice unusual routines and rituals. Another cross-cultural study [4] in India, Japan and the (http://creativecommons.org/licenses/by/4.0/). Autism spectrum disorder (ASD) is a neurodevelopmental disorder This is the first study to examine first parental concerns in ASD in Malaysia. We examined: i) age and type of first parental concerns (AOC); ii) association between AOC and severity; iii) time lag between AOC and diagnosis; and iv) factors associated with diagnostic delay

Methods

Results

Discussion

Conclusion