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Identification of Autism spectrum disorder by parents: a retrospective-comparative study of the role of early behavioral signs, developmental and demographic characteristics

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Abstract

A review of the research literature indicated that early diagnosis of Autism Spectrum Disorder (ASD) and acceleration in receiving specialist help is associated with beneficial clinical outcomes and better ASD prognosis. However, there is a significant gap between the onset of early signs of ASD and the receipt of specialist advice. This study aimed to investigate the factors affecting “the time of receiving specialized counseling (TSC)”; For this aim, a retrospective-comparative study was completed, 502 parents of children and adolescents with ASD were selected from seventeen ASD special schools and special services centers in Iran. Researchers examined the early behavioral signs and other developmental and demographic characteristics of the children. To investigate TSC, the participants were divided into three groups based on the child's age in the first action to receive specialized counseling: early action (n = 155), timely action (n = 178), and late action (n = 169). Data were analyzed to obtain a comprehensive view of intergroup differences as well as to examine relationships across the total sample. The results showed that the severity of signs, developmental delays, and parents' awareness plays an important role in receiving specialized help. This study also suggested that TSC can be considered an important factor for the early identification of ASD. We think that the mere focus on formal diagnosis of ASD can ignore the benefits of TSC and parental identification; Therefore, studying the different aspects of this can be an essential step in facilitating the early diagnosis of ASD and a better prognosis for children with ASD.

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Data Availability

The datasets generated during and/or analyzed during the current study are not publicly available due to provisions of the consent form of the participants but some data are available from the corresponding author on reasonable request.

Abbreviations

ASD :

Autism Spectrum Disorder

TSC :

The time of receiving specialized counseling

CFC :

Child's age at first parental concern

CPC :

Child's age at first pediatric/psychiatric consultation

CAD :

Child's age at diagnose time

CG :

Consultative gap

DG :

Diagnostic gap

MAC :

Mother's age at the first consultation

FAC :

Father’s age at the first consultation

EMC :

Employment status of mothers at the first consultation,

EFC :

Employment status of fathers at the first consultation

MEC :

Mother's education level at the first consultation

FEC :

Father’s education level at the first consultation

BO :

Birth order

PAA :

Pre-awareness of ASD

AFH :

ASD in Family History

PFH :

Psychiatric disorders in Family History

CP :

Cerebral palsy

ID :

Intellectual Disability

LEL :

Lack of expressive language

AEW :

Age of expression of the first word

AEW delay 1 :

AEW > 18 month

AEW delay 2 :

AEW > 24 month

AIW :

Age of independent walking

AIW delay 1 :

AIW > 16 month

AIW delay 2 :

AIW > 20 month

DR :

Developmental regression

ADR :

Age of developmental regression

ARB :

Age of onset of repetitive behaviors

ERB :

Early onset of repetitive behaviors/ARB < 24

MM :

Moebius Mouth

SJ :

Severe Jaundice

REP :

Respiratory problems

FCS :

Forced cesarean section

SRP :

Severe and recurrent pyrexias

EPP :

Emotional problems during pregnancy

SDP :

Systemic Diseases during pregnancy

MOP :

Means–end and Object permanence

GJA :

Gestures, joint attention and attentional shift

BRV :

Babbling and reaction to human voices

EC :

Eye Contact

PEE :

Positive Emotional Engagement

HI :

Human interactions

RBS :

Repetitive behaviors and sameness

STN :

Smell, Taste and Nutrition

VKB :

Vestibular-kinetic and body awareness

TBS :

Total Score of Behavioral signs

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Acknowledgements

We would like to thank all the children and parents, as well as Ms. Kiandokht Salehi, Director, and Founder of "MITA" Center (Service Center of Mothers of Children with Autism).

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This article was not funded by external research partners/organizations

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Authors and Affiliations

  1. Department of Psychology and Special Education, Faculty of Psychology and Education, University of Tehran, Tehran, Iran

    Masoud Shekarro & Saeid Hassanzadeh

  2. Department of Counseling Psychology and Special Education, Brigham Young University, Provo, UT, USA

    Ryan Kellems

  3. Department of Psychology and Special Education, Faculty of Psychology and Education, Allameh Tabataba’i University, Tehran, Iran

    Fatemeh Nikkhoo

Authors
  1. Masoud Shekarro
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  2. Saeid Hassanzadeh
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  3. Ryan Kellems
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  4. Fatemeh Nikkhoo
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Contributions

MS, SH and FNK contributed to the design and implementation of the research, analysis of the results, and writing of the manuscript. RK contributed to language editing and provided critical reviews of the manuscript and ensured data presented in tables and text were accurate. All authors approved the final manuscript as submitted and agree to be responsible for all aspects of the work.

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Correspondence to Masoud Shekarro.

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This study was reviewed and ethics committee-approved at the University of Tehran and followed the standards put forth by the Declaration of Helsinki.

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Shekarro, M., Hassanzadeh, S., Kellems, R. et al. Identification of Autism spectrum disorder by parents: a retrospective-comparative study of the role of early behavioral signs, developmental and demographic characteristics. Curr Psychol 43, 2403–2424 (2024). https://doi.org/10.1007/s12144-023-04458-8

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