Factors Associated with a Delayed Autism Spectrum Disorder Diagnosis in Children Previously Assessed on Suspicion of Autism

J Autism Dev Disord. 2021 Nov;51(11):3843-3856. doi: 10.1007/s10803-020-04849-x. Epub 2021 Jan 3.


This study aimed to investigate factors associated with a delayed autism spectrum (ASD) diagnosis when compared to children with either no or early ASD diagnosis. Among 893 children assessed for ASD before age 8, 39% had no ASD at baseline, of which 21% received a later ASD diagnosis. Autism symptoms, diagnostic history of other developmental disorders, cognitive ability, and socioeconomic factors were associated with delayed ASD. Autism Diagnostic Observation Schedule (ADOS) scores in delayed ASD fell between early and no ASD. Other developmental disorders, time and clinical trends like ADOS use and low parental education distinguished delayed and early ASD, whereas higher frequency of IQ < 70 at baseline and a diagnosis of emotional disorders during follow-up distinguished delayed and no ASD.

Keywords: ADOS; Age at diagnosis; Autism spectrum disorder; Delayed diagnosis.

MeSH terms

  • Affect
  • Autism Spectrum Disorder* / diagnosis
  • Autistic Disorder*
  • Child
  • Early Diagnosis
  • Humans
  • Parents