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Longitudinal Analysis of Children Referred for ASD Evaluation: Exploring Outcomes for Individuals Without Confirmed
Shlomit Tsafrir1,2, Ran Barzilay3, Doron Gothelf4,5
1Division of Child and Adolescent Psychiatry, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5262000, Tel-Hashomer, Ramat Gan, Israel. Shlomit.Tsafrir@sheba.health.gov.il.
Insights
Children evaluated for autism spectrum disorder (ASD) but not diagnosed often have ADHD and learning disorders. Many require ongoing care, and some later receive an ASD diagnosis.
Area of Science:
- Neurodevelopmental disorders
- Pediatric psychology
- Clinical child psychology
Background:
- Diagnosing autism spectrum disorder (ASD) is challenging due to overlapping symptoms and frequent comorbidities.
- Understanding outcomes for children initially referred for ASD evaluation but not diagnosed is crucial for effective care.
- Long-term diagnostic trajectories and treatment patterns in this population are not well-defined.
Purpose of the Study:
- To explore clinical and developmental outcomes in children referred for ASD evaluation but not diagnosed with ASD.
- To describe long-term diagnostic changes and treatment patterns in this specific pediatric group.
- To compare outcomes with a matched cohort diagnosed with ASD.
Main Methods:
- Retrospective cohort study of 37 children (aged 1-13) evaluated for ASD but not diagnosed (non-ASD group).
- Included a control group of 32 children diagnosed with ASD during 2011-2017.
- Reviewed electronic medical records 2-9 years post-assessment for diagnostic changes, service use, and treatments.
Main Results:
- Both non-ASD and ASD groups showed significant impairments and high service utilization.
- Attention-Deficit/Hyperactivity Disorder (ADHD) was common in both groups; Specific Learning Disorders (SLD) were more prevalent in the non-ASD group.
- Approximately 20% of the non-ASD group received an ASD diagnosis at follow-up; most children received psychopharmacological treatment, primarily stimulants.
Conclusions:
- Children referred for ASD evaluation but not diagnosed often have substantial impairments and comorbidities like ADHD and SLD.
- This population requires ongoing, multifaceted care, highlighting the need for long-term monitoring.
- Tailored interventions and continued assessment are essential for children initially presenting with potential ASD symptoms.
Abstract:
Diagnosing autism spectrum disorder (ASD) is complex due to overlapping conditions and frequent comorbidities. This study aimed to explore the clinical and developmental outcomes of children referred for ASD evaluation but not diagnosed with ASD, describing the long-term diagnostic and treatment patterns in this population. We conducted a retrospective cohort study of 37 children (aged 1-13 years) evaluated for ASD at a regional clinic between 2011 and 2017 but not diagnosed with ASD (non-ASD group). A control group of 32 children consecutively diagnosed with ASD during the same period was included. Electronic medical records of both groups were reviewed 2-9 years post-assessment, focusing on diagnostic changes, service utilization, and treatment patterns. Both groups exhibited significant impairments and high service utilization at follow-up. ADHD was commonly diagnosed in both groups, while specific learning disorders (SLD) were more prevalent in the non-ASD group. Notably, approximately 20% of children in the non-ASD group received an ASD diagnosis at follow-up. Most children received psychopharmacological treatment, with stimulants being the most prescribed. Combination treatments were less common in the non-ASD group. Children referred for ASD evaluation but not initially diagnosed with ASD often experience substantial impairments and comorbidities, particularly ADHD and SLD. They require ongoing, multifaceted care. These findings underscore the need for long-term monitoring and tailored interventions for this population.
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