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The Influence of Social and Developmental Factors on the Timing of Autism Spectrum Disorder Diagnosis of Preschool-Aged Children: Evidence from a Specialized Chilean Center

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Abstract

We investigated the influence of developmental and social factors on the age of autism diagnosis (AoD) in a cohort of toddlers living in Chile. A cross-sectional study was conducted among 509 preschool children diagnosed with autism spectrum disorder [M = 40.2 months (SD = 8.6), girls: 32%] in the neurodevelopmental unit of a university clinic in Santiago, Chile (2015–2023). Structural changes in the annual trend of AoD were tested. Generalized linear models (gamma distribution) with and without interaction terms were used for the multivariate analysis, adjusting for gender, residential area, year of diagnosis, developmental variables (language regression, delayed walking, and use of expressive verbal language), and primary caregiver age and education level (CEL). 95% confidence intervals of the unstandardized regression coefficients (B) were calculated using 1000 bootstrap resampling to estimate associations. AoD increased between 2021–2022 and decreased in 2023. Female gender (B = 2.72 [1.21–4.23]), no history of language regression (B = 3.97 [1.66–6.28]), and the presence of expressive verbal language at diagnosis (B = 1.57 [0.05–3.08]) were associated with higher AoD. Children whose caregivers had tertiary education were diagnosed earlier than those with ≤ 12 years of formal education. Although the influence of CEL increased with caregiver age, differences between CEL groups were significant only for caregivers aged ≥ 30 years. Improved education and early screening for clinical features of autism among healthcare professionals and the community, with a focus on young children without highly apparent developmental concerns and those from vulnerable social groups, are warranted.

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Acknowledgements

The authors thank the speech-language and occupational therapists at UC CHRISTUS Clinical Hospital, as well as the participants and their families, for their contributions to this work.

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Authors and Affiliations

  1. Section of Neurology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Mauricio A. Lopez-Espejo & Alicia C. Nuñez

  2. Neurodevelopmental Unit, UC CHRISTUS Clinical Hospital, Santiago, Chile

    Mauricio A. Lopez-Espejo, Alicia C. Nuñez, Valentina Saez, Melanie Ruz & Odalie C. Moscoso

  3. Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Alejandra Vives

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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by MA. Lopez-Espejo, AC. Nuñez, V. Saez, M. Ruz, and OC. Moscoso. Data analysis was performed by MA. Lopez-Espejo. The first draft of the manuscript was written by MA. Lopez-Espejo and all authors commented on previous versions of the manuscript. All authors read, corrected, and approved the final manuscript.

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Correspondence to Mauricio A. Lopez-Espejo.

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The authors declare no competing interests, financial or otherwise, related to this work or its publication, and confirm that it was conducted without specific funding.

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The protocol of this study (ID: 210819009) was approved by the Institutional Ethics Committee (Comité Ético Científico de Ciencias de la salud (CEC SALUD UC), Pontificia Universidad Católica de Chile).

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Lopez-Espejo, M.A., Nuñez, A.C., Saez, V. et al. The Influence of Social and Developmental Factors on the Timing of Autism Spectrum Disorder Diagnosis of Preschool-Aged Children: Evidence from a Specialized Chilean Center. J Autism Dev Disord (2024). https://doi.org/10.1007/s10803-024-06376-5

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