Copyright @ 2009 American Academy of Child and Adolescent Psychiatry. Unauthorized reproduction of this article is prohibited. Timing of Identification Among Children With an Autism Spectrum Disorder: Findings From a Population-Based Surveillance Study

Objective: At what age are children with an autism spectrum disorder (ASD) identified by community providers? What factors influence the timing of when children are identified with ASDs? This study examined the timing of when children with ASDs are identified. Method: Data came from 13 sites participating in the Centers for Disease Control and Prevention’s 2002 multisite ongoing autism surveillance program, the Autism and Developmental Disabilities Monitoring Network. Survival analysis was used to examine factors that influence the timing of community-based identification and diagnosis. Result: Data from health and education records reveal that the median age of identification was 5.7 years (SE 0.08 years). Parametric survival models revealed that several factors were associated with a younger age of identification: being male, having an IQ of 70 or lower, and having experienced developmental regression. Significant differences in the age of identification among the 13 sites were also discovered. Conclusions: The large gap between the age at which children can be identified and when they actually are identified suggests a critical need for further research, innovation, and improvement in this area of clinical practice. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(5):474Y483. Key Words: pervasive child development disorders, autism, diagnosis, epidemiology, survival analysis. Timely community-based identification of children with an autism spectrum disorder (ASD) has importan