Abstract
BackgroundInefficient diagnostic practices for autism spectrum disorder (ASD) may contribute to longer wait times, delaying access to intervention. The objectives were to describe the diagnostic practices of Canadian pediatricians and to identify determinants of longer wait time for ASD diagnosis.MethodsAn online survey was conducted through the Canadian Paediatric Society’s developmental pediatrics, community pediatrics, and mental health sections. Participants were asked for demographic information, whether they diagnosed ASD, and elements of their diagnostic assessment. A multiple linear regression of total wait time (time from referral to communication of the diagnosis to the family) as a function of practice characteristics was conducted.ResultsA total of 90 participants completed the survey, of whom 57 diagnosed ASD in their practices (63.3%). Respondents reported varied use of multi-disciplinary teams, with 53% reporting participation in a team. No two identically composed teams were reported. Respondents also had varied use of diagnostic tools, with 21% reporting no use of tools. The median reported total wait for ASD diagnosis time was 7 months (interquartile range 4–12 months). Longer time spent on assessment was the only variable that remained significantly associated with longer wait time in multiple regression (p = 0.002). Use of diagnostic tools did not significantly affect wait time.ConclusionCanadian ASD diagnostic practices vary widely and wait times for these assessments are substantial—7 months from referral to receipt of diagnosis. Time spent on the assessment is a significant determinant of wait time, highlighting the need for efficient assessment practices.
Highlights
Inefficient diagnostic practices for autism spectrum disorder (ASD) may contribute to longer wait times, delaying access to intervention
Pediatricians are frequently involved in ASD diagnosis in pre-school age children in Canada [3]
Three sections were chosen for survey distribution based on their likelihood of participating in ASD diagnosis: developmental pediatrics, community pediatrics, and mental health
Summary
Inefficient diagnostic practices for autism spectrum disorder (ASD) may contribute to longer wait times, delaying access to intervention. The objectives were to describe the diagnostic practices of Canadian pediatricians and to identify determinants of longer wait time for ASD diagnosis. Pediatricians are frequently involved in ASD diagnosis in pre-school age children in Canada [3]. Age at diagnosis has often been used as a proxy to understand wait times; other factors beyond diagnostic demand and supply influence this metric. Milder ASD subtypes have been associated with a later age at diagnosis [12]. These children may not show significant impairment associated with ASD until their
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