Half of Autism Diagnoses Made at School Age

MedpageToday
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Only about half of children with an autism spectrum disorder received the diagnosis before they reached age 5, and once diagnosed, most were given psychotropic drugs, federal survey data indicated.

Interviews with parents or guardians of 1,420 children identified as having autism spectrum disorders revealed that the median age at diagnosis was 5, according to Beverly Pringle, PhD, of the National Institute of Mental Health, and colleagues in a Data Brief issued early Thursday by the National Center for Health Statistics.

And fully 40% were diagnosed at age 6 and older.

Parents of only 18.7% were told of the diagnosis before the child reached age 2, the researchers found.

The findings came from the 2011 Survey of Pathways to Diagnosis and Services, conducted with 4,032 parents and guardians of children identified in an earlier survey as having neurobehavioral development disorders, including intellectual disability, developmental delay, or autism spectrum disorders.

The new Data Brief contained summary statistics for the children with autism spectrum disorders.

Other key findings include:

  • 56% of children were taking at least one psychotropic medication including stimulants (32%), mood stabilizers (26%), antidepressants (20%), sleep enhancers (19%), and/or antipsychotic drugs (14%).
  • Among children younger than 12, 91% were using some type of healthcare service for their disability, such as speech therapy or social skills training, and 61% were using at least three.
  • Primary care providers and psychologists were the most common source of autism spectrum diagnoses before age 5, while older children were more often diagnosed by physician specialists.

Pringle and colleagues observed that the variety of psychotropic medications used in children with an autism spectrum disorder could have at least two explanations.

It may reflect the presence of "co-occurring symptoms," or perhaps the "absence of clear practice guidelines for psychotropic medications in children with autism spectrum disorders," they wrote.

They also expressed concern about the pattern of healthcare service use identified in the survey.

Although most children were receiving some type of therapy, 12% were not. Moreover, only about 40% of parents reported behavioral intervention or modification services, "the most well-established and efficacious intervention for autism spectrum disorders."