Nachum Sicherman1, Jimmy Charite2, Gil Eyal3, Magdalena Janecka4, George Loewenstein5, Kiely Law6, Paul H Lipkin6, Alison R Marvin7, Joseph D Buxbaum8. 1. Columbia University, Graduate School of Business, 511 Uris Hall, 3022 Broadway, New York, NY, 10027, USA. ns38@columbia.edu. 2. Columbia University, Graduate School of Business, 511 Uris Hall, 3022 Broadway, New York, NY, 10027, USA. 3. Department of Sociology, Columbia University, New York, NY, USA. 4. Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA. 5. Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, PA, USA. 6. Kennedy Krieger Institute and Johns Hopkins School of Medicine, Baltimore, MD, USA. 7. Kennedy Krieger Institute and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 8. Seaver Autism Center for Research and Treatment, Department of Psychiatry, Friedman Brain Institute, Mindich Institute for Child Health and Development, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Abstract
BACKGROUND: The objective of this study is to gain new insights into the relationship between clinical signs and age at diagnosis. METHOD: We utilize a new, large, online survey of 1743 parents of children diagnosed with ASD, and use multiple statistical approaches. These include regression analysis, factor analysis, and machine learning (regression tree). RESULTS: We find that clinical signs that most strongly predict early diagnosis are not necessarily specific to autism, but rather those that initiate the process that eventually leads to an ASD diagnosis. Given the high correlations between symptoms, only a few signs are found to be important in predicting early diagnosis. For several clinical signs we find that their presence and intensity are positively correlated with delayed diagnosis (e.g., tantrums and aggression). Even though our data are drawn from parents' retrospective accounts, we provide evidence that parental recall bias and/or hindsight bias did not play a significant role in shaping our results. CONCLUSION: In the subset of children without early deficits in communication, diagnosis is delayed, and this might be improved if more attention will be given to clinical signs that are not necessarily considered as ASD symptoms. Our findings also suggest that careful attention should be paid to children showing excessive tantrums or aggression, as these behaviors may interfere with an early ASD diagnoses.
BACKGROUND: The objective of this study is to gain new insights into the relationship between clinical signs and age at diagnosis. METHOD: We utilize a new, large, online survey of 1743 parents of children diagnosed with ASD, and use multiple statistical approaches. These include regression analysis, factor analysis, and machine learning (regression tree). RESULTS: We find that clinical signs that most strongly predict early diagnosis are not necessarily specific to autism, but rather those that initiate the process that eventually leads to an ASD diagnosis. Given the high correlations between symptoms, only a few signs are found to be important in predicting early diagnosis. For several clinical signs we find that their presence and intensity are positively correlated with delayed diagnosis (e.g., tantrums and aggression). Even though our data are drawn from parents' retrospective accounts, we provide evidence that parental recall bias and/or hindsight bias did not play a significant role in shaping our results. CONCLUSION: In the subset of children without early deficits in communication, diagnosis is delayed, and this might be improved if more attention will be given to clinical signs that are not necessarily considered as ASD symptoms. Our findings also suggest that careful attention should be paid to children showing excessive tantrums or aggression, as these behaviors may interfere with an early ASD diagnoses.
Authors: P A Filipek; P J Accardo; G T Baranek; E H Cook; G Dawson; B Gordon; J S Gravel; C P Johnson; R J Kallen; S E Levy; N J Minshew; S Ozonoff; B M Prizant; I Rapin; S J Rogers; W L Stone; S Teplin; R F Tuchman; F R Volkmar Journal: J Autism Dev Disord Date: 1999-12
Authors: Katarzyna Chawarska; Frederick Shic; Suzanne Macari; Daniel J Campbell; Jessica Brian; Rebecca Landa; Ted Hutman; Charles A Nelson; Sally Ozonoff; Helen Tager-Flusberg; Gregory S Young; Lonnie Zwaigenbaum; Ira L Cohen; Tony Charman; Daniel S Messinger; Ami Klin; Scott Johnson; Susan Bryson Journal: J Am Acad Child Adolesc Psychiatry Date: 2014-10-02 Impact factor: 8.829
Authors: David S Mandell; John Listerud; Susan E Levy; Jennifer A Pinto-Martin Journal: J Am Acad Child Adolesc Psychiatry Date: 2002-12 Impact factor: 8.829