Child and Family Characteristics Associated With Age of Autism Spectrum Disorder Diagnosis in a Primary Care Population.

This study looked at what factors help children get diagnosed with autism earlier. Researchers found that children who were connected to Early Intervention services, had regular check-ups with the same doctor, scored higher on autism screening tests (M-CHAT), and had private insurance were diagnosed earlier. Children with public insurance still face delays in getting diagnosed. The study shows that having good healthcare relationships and early screening tools can help families get autism diagnoses sooner.

This cross-sectional study examined child and family characteristics associated with age of autism spectrum disorder (ASD) diagnosis in primary care settings. Researchers analyzed medical records from two large urban practices for patients diagnosed with ASD between 2018-2022, comparing them with the general clinic population. The study found that children diagnosed with ASD were more likely to be male, Hispanic, publicly insured, and medically complex compared to the general population. Key factors associated with earlier diagnosis included connection with Early Intervention services, better continuity of care, higher M-CHAT scores, and commercial insurance.

The research highlights persistent disparities in diagnostic timing, particularly for publicly insured children, despite shifting prevalence patterns in ASD diagnosis.

Results emphasize need for systematic developmental screening, strong Early Intervention connections, and continuity of care to facilitate earlier ASD diagnosis. Persistent insurance-related disparities require targeted interventions to improve access for publicly insured families. Primary care practices should prioritize M-CHAT implementation and care coordination.

Cross-sectional design limits causal inferences. Sample size not reported, limiting generalizability assessment. Study restricted to two urban primary care practices may not represent broader populations. Relies on medical record data which may have documentation gaps.

To compare a sample of pediatric primary care patients diagnosed with autism spectrum disorder (ASD) with the general clinic population, as well as associations of child and caregiver characteristics with age of diagnosis. Cross-sectional data for patients from 2 large, urban primary care practices diagnosed with ASD between March 1, 2018, and February 28, 2022, were collected from the medical record through extraction and chart review. The sample was compared with the total primary care population using χ 2 analysis. Unadjusted bivariate linear regression and multivariate linear regression were used to evaluate associations of each variable with age of diagnosis.

Patients diagnosed with ASD were more likely to be male, Hispanic, publicly insured and medically complex than the general clinic population. There was also a higher maternal education level in the autism group. In unadjusted linear regression analyses, language delay, connection with Early Intervention (EI), earlier age of parental concern, earlier age of referral, having an M-CHAT completed, higher M-CHAT scores, and having a first-degree relative with ASD were associated with earlier age of diagnosis. In multivariate linear regression analysis, connection with EI, better continuity of care, higher M-CHAT scores and having commercial insurance were associated with earlier diagnosis.

Race/ethnicity, language, and Social Vulnerability Index ≥ 90%ile were not significantly associated with age of ASD diagnosis. This study reflects shifting prevalence patterns of ASD, but a persistent disparity in age of diagnosis among publicly insured children. It highlights the importance of developmental monitoring, continuity of care, and navigation support to help families obtain ASD diagnoses promptly.