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Predictors of an earlier diagnosis of Autism Spectrum Disorder in children and adolescents: a systematic review (1987–2017)

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Abstract

Autism Spectrum Disorder (ASD) is an early onset neurodevelopmental disorder in which the first signs generally emerge at approximately 12 months of age but its diagnosis is feasible only from the age of 18 months. According to the literature, the average age of diagnosis ranges from 2.7 to 7.2 years, which raises the question of factors associated with early diagnosis as a condition for early intervention.

In this systematic review, we aim to identify clinical, social, and environmental factors associated with the age at which the diagnosis of ASD is confirmed in children. A literature search was performed in the Pubmed, Web of Sciences, PsycInfo, and Cochrane databases. Among the 530 publications identified, 50 were selected according to the inclusion criteria. This review focuses on studies conducted in 21 countries using data collected over a period from 1987 to 2017. These studies were published before December 31st, 2019. The results suggest that the diagnosis of ASD occurs earlier if there is a delay in social communication or the presence of intellectual disability. There is a low level of evidence concerning associations between the age at diagnosis and sex, race, parental education, or socioeconomic status and accessibility to health care. Further studies using large and well-characterized data sets are needed to simultaneously explore clinical and socio-environmental factors involved in early diagnosis.

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Acknowledgements

The authors would like to thank Florine Dellapiazza, Cécile Rattaz, and Jeanne Sandrine Ongono for their advices and assistance in conducting the systematic review.

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Authors and Affiliations

  1. Centre de Ressource Autisme Languedoc-Roussillon et Centre d’Excellence sur l’Autisme et les Troubles Neuro-Développementaux (CeAND), CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France

    Julie Loubersac, Cécile Michelon, Laetitia Ferrando & Amaria Baghdadli

  2. Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France

    Julie Loubersac, Marie-Christine Picot & Amaria Baghdadli

  3. Department of Medical Information, University Hospital, Montpellier, France

    Marie-Christine Picot

  4. Faculté de Médecine, Université de Montpellier, Montpellier, France

    Amaria Baghdadli

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Contributions

JL and AB conceived the protocol and contributed to collection, analysis, and interpretation of the data, and drafted the manuscript. CM and LF contributed to the selection of the studies and assessment of the quality. MCP analyzed and interpreted the data and critically revised it for the draft of the manuscript. All authors read and approved the final version.

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Correspondence to Amaria Baghdadli.

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Loubersac, J., Michelon, C., Ferrando, L. et al. Predictors of an earlier diagnosis of Autism Spectrum Disorder in children and adolescents: a systematic review (1987–2017). Eur Child Adolesc Psychiatry 32, 375–393 (2023). https://doi.org/10.1007/s00787-021-01792-9

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  • DOI: https://doi.org/10.1007/s00787-021-01792-9

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