Achieving Diagnostic Resolution in Young Children with Social Communication Concerns in a Predominantly Low-Income...

Area of Science:

• Pediatrics
• Developmental Neuroscience
• Public Health

Background:

• Children in low-income families face delays in autism spectrum disorder (ASD) diagnosis.
• The cascade-of-care model can reveal process inefficiencies in ASD evaluation.
• Predictors influencing timely ASD diagnosis remain under-researched.

Purpose of the Study:

• To identify predictors of timely ASD diagnostic evaluation and completion in young children.
• To examine the impact of primary care continuity and well-child visit adherence on ASD diagnostic timelines.

Main Methods:

• Retrospective chart review of 110 children under five with social communication concerns.
• Analysis of predictors for age of referral, time to diagnosis, and diagnostic completion.
• Comparison between children with continuous versus fragmented primary care and those with vs. without missed well-child visits.

Main Results:

• Continuity of primary care was associated with earlier referral ages for ASD evaluation.
• Children attending all well-child visits had a shorter median time to ASD diagnosis compared to those with missed visits.
• Fragmented care and missed visits were linked to delays in the diagnostic process.

Conclusions:

• Continuity of primary care is crucial for facilitating early ASD evaluations.
• Consistent engagement with well-child visits improves the timeliness of ASD diagnosis.
• Primary medical homes play a vital role in ensuring timely and efficient ASD diagnostic pathways for at-risk children.