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Purpose <p>Sociodemographic characteristics, such as race and ethnicity, are associated with delays in ASD diagnosis. However, limited literature has examined the characteristics associated with delayed diagnosis since the start of the COVID-19 pandemic. This study aimed to identify the individual and aggregate sociodemographic characteristics associated with the age at which a child receives a referral for a diagnosis (from March 2020 to May 2023) and evaluate the impacts of the pandemic on this association.</p> Methods <p>Using cross-sectional data obtained from patients’ electronic health records and the U.S. Census Bureau, we examined associations using linear regressions (<i>N</i> = 507). A subgroup analysis was conducted comparing two pandemic-related time frame phases: acute (March 2020–December 2021) and endemic (January 2022–May 2023).</p> Results <p>The mean age of referral was 37.3&#xa0;months; 83.2% were Medicaid recipients, 42.6% were Latino/Hispanic, and 29.8% were Black non-Hispanic. Children were referred for an evaluation at an older age during the acute phase compared to the endemic phase (40.4 vs. 35.4&#xa0;months). There were no significant associations between race and ethnicity and age of referral. Population educational attainment was negatively associated with the age of referral (<i>p</i> &lt; 0.05). The subgroup analysis showed a positive association between median population income and age of referral during the endemic phase (<i>p</i> &lt; 0.05).</p> Conclusion <p>Referrals to receive a diagnosis occur later than the screening recommendations. Future work should focus on developing health system-wide practices, particularly among health systems serving large proportions of underserved populations, targeting early referrals for an evaluation to receive an ASD diagnosis.</p>

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Associations Between Sociodemographic Predictors and Age of Referral for Autism Spectrum Disorder (ASD) Diagnosis Since the Beginning of the COVID-19 pandemic

  • 期刊论文

  • 发表日期：

    2025年2月24日

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  • Mallika Mathur,
  • Ruosha Li,
  • Sandra McKay,
  • Christine Markham,
  • Deepali K. Ernest,
  • Shreela Sharma

摘要

Purpose

Sociodemographic characteristics, such as race and ethnicity, are associated with delays in ASD diagnosis. However, limited literature has examined the characteristics associated with delayed diagnosis since the start of the COVID-19 pandemic. This study aimed to identify the individual and aggregate sociodemographic characteristics associated with the age at which a child receives a referral for a diagnosis (from March 2020 to May 2023) and evaluate the impacts of the pandemic on this association.

Methods

Using cross-sectional data obtained from patients’ electronic health records and the U.S. Census Bureau, we examined associations using linear regressions (N = 507). A subgroup analysis was conducted comparing two pandemic-related time frame phases: acute (March 2020–December 2021) and endemic (January 2022–May 2023).

Results

The mean age of referral was 37.3 months; 83.2% were Medicaid recipients, 42.6% were Latino/Hispanic, and 29.8% were Black non-Hispanic. Children were referred for an evaluation at an older age during the acute phase compared to the endemic phase (40.4 vs. 35.4 months). There were no significant associations between race and ethnicity and age of referral. Population educational attainment was negatively associated with the age of referral (p < 0.05). The subgroup analysis showed a positive association between median population income and age of referral during the endemic phase (p < 0.05).

Conclusion

Referrals to receive a diagnosis occur later than the screening recommendations. Future work should focus on developing health system-wide practices, particularly among health systems serving large proportions of underserved populations, targeting early referrals for an evaluation to receive an ASD diagnosis.