Stability of Initial Autism Spectrum Disorder Diagnoses in Community Settings
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The study’s objectives were to assess diagnostic stability of initial autism spectrum disorder (ASD) diagnoses in community settings and identify factors associated with diagnostic instability using data from a national Web-based autism registry. A Cox proportional hazards model was used to assess the relative risk of change in initial ASD diagnosis as a function of demographic characteristics, diagnostic subtype, environmental factors and natural history. Autistic disorder was the most stable initial diagnosis; pervasive developmental disorder—not otherwise specified was the least stable. Additional factors such as diagnosing clinician, region, when in time a child was initially diagnosed, and history of autistic regression also were significantly associated with diagnostic stability in community settings. Findings suggest that the present classification system and other secular factors may be contributing to increasing instability of community-assigned labels of ASD.
KeywordsDiagnosis stability Children Autism spectrum disorders Community settings
This study was supported by Autism Speaks. The funder had no role in determining content. We thank Ms. Teresa Foden for providing assistance with editing and Mr. Alden Gross and Ms. Janet Kuramoto for their assistance with the statistical analyses. We gratefully acknowledge the contributions of IAN families without which this research would not be possible.
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