How children with autism are diagnosed: difficulties in identification of children with multiple developmental delays.

We obtained chart reviews and parent surveys for 75 autistic children to understand better how they, and other children with uneven or unusual behavioral development, are identified and diagnosed. Our goal was to determine when parents became concerned about developmental delay, what concerns they expressed, to whom they expressed them, when evaluations were made, what kinds of evaluations were carried out, and which diagnostic models were most effective. We found that, most often, parents expressed their initial concerns to pediatricians, noting both language and social delays by the time their child was 1 1/2 years old; they began diagnostic evaluations when their child was around 2 1/2 years old, and received diagnoses of autism at around 4 1/2 years. These results are discussed in terms of the role of the child's primary care physician in improving early identification, and placement into early intervention programs. The relationship between problems in the diagnosis of autism and other developmental disabilities is considered.