Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb 25;21(1):96.
doi: 10.1186/s12887-021-02551-0.

Clinical signs associated with earlier diagnosis of children with autism Spectrum disorder

Nachum Sicherman  1 , Jimmy Charite  2 , Gil Eyal  3 , Magdalena Janecka  4 , George Loewenstein  5 , Kiely Law  6 , Paul H Lipkin  6 , Alison R Marvin  7 , Joseph D Buxbaum  8
Affiliations

Clinical signs associated with earlier diagnosis of children with autism Spectrum disorder

Nachum Sicherman et al. BMC Pediatr. .

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.

Keywords: Autism spectrum disorder; Clinical signs; Diagnosis age; Early diagnosis; Regression trees; Symptoms.

PubMed Disclaimer

Conflict of interest statement

No author of this article had any financial or otherwise conflict of interest relating to the article.

Figures

Fig. 1
Fig. 1
“Correlation Between Clinical Signs & Symptoms Severity and Age of Diagnosis” Note: “Negative” months indicate earlier diagnosis”
Fig. 2
Fig. 2
“Regression Tree of Age of Diagnosis and Clinical Signs & Symptoms”. Note: Out of the sample of 1743, only 1330 respondents were able to see the full list of clinical signs and symptoms (see footnote to Table 1). Only 1203 of the 1330 also had a valid age of diagnosis reported
See this image and copyright information in PMC

References

    1. McPheeters ML, Weitlauf A, Vehorn A, Taylor C, Sathe NA, Krishnaswami S, et al. Screening for Autism Spectrum Disorder in Young Children: A Systematic Evidence Review for the U.S. Preventive Services Task Force. AHRQ Publ. 2016;13-05185-E(129):202. - PubMed
    1. Bradshaw J, Steiner AM, Gengoux G, Koegel LK. Feasibility and Effectiveness of Very Early Intervention for Infants At-Risk for Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord. 2014. - PubMed
    1. Anderson DK, Liang JW, Lord C. Predicting young adult outcome among more and less cognitively able individuals with autism spectrum disorders. J Child Psychol Psychiatry Allied Discip. 2014;55(5):485–494. doi: 10.1111/jcpp.12178. - DOI - PMC - PubMed
    1. Siu AL, Bibbins-Domingo K, Grossman DC, Baumann LC, Davidson KW, Ebell M, et al. Screening for Autism Spectrum Disorder in Young Children. JAMA. 2016;315(7):691. doi: 10.1001/jama.2016.0018. - DOI - PubMed
    1. Brasher S, Stapel-Wax JL. Autism Spectrum Disorder in the Primary Care Setting. Adv Fam Pract Nurs. 2020;2:159–168. doi: 10.1016/j.yfpn.2020.01.006. - DOI

Publication types