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Age of diagnosis for autism: individual and community factors across 10 birth cohorts

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Fountain, Christine, King, Marissa D, Bearman, Peter S·2011·Journal of Epidemiology and Community Health

DOI 10.1136/jech.2009.104588PMC PMC3039707

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Abstract

Background: The incidence of autism rose dramatically between 1992 and 2001, while the age at which children were first diagnosed declined. During this period the size and composition of the autism caseload has changed, but little is known about whether the factors associated with the timing of diagnosis may also have shifted. Using a multilevel analysis strategy, the individual and community-level factors associated with age of diagnosis were modelled across 10 birth cohorts of California children. Methods: Linked birth and administrative records on 17 185 children with diagnoses of autistic disorder born in California between 1992 and 2001 and enrolled with the California Department of Developmental Services (DDS) were analysed. Information on cases, their parents and their residential location were extracted from birth and DDS records. Zip codes of residence were matched to census data to create community-level measures. Multilevel linear models were estimated for each birth cohort, with individual-level effects for sex, race, parental characteristics, poverty status, birth order and symptom expression. At the community level measures of educational and economic composition, local autism prevalence and the presence of a child psychiatrist were included. Results: Children with highly educated parents are diagnosed earlier, and this effect has strengthened over time. There is a persistent gap in the age of diagnosis between high and low socioeconomic status (SES) children that has shrunk but not disappeared over time. Conclusion: Routine screening for autism in early childhood for all children, particularly those of low SES, is necessary to eliminate disparities in early intervention.

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Authors: Fountain, C., King, M. D., & Bearman, P. S.
Affiliations: Columbia University (US)
Corresponding author: Bearman, Peter S
ORCID: Fountain, Christine
King, Marissa D
Bearman, Peter S
Venue: Journal of Epidemiology and Community Health
Publisher: BMJ
Published: 2010-10-25
Volume: 65
Issue: 6
Pages: 503-510
ISSN: 0141-7681 (ISSN-L)
0143-005X
1470-2738
DOI: 10.1136/jech.2009.104588
PMC: PMC3039707
OpenAlex: W2110150914
Cited by: 359
References: 14
Citations by year: 2026: 14 · 2025: 12 · 2024: 12 · 2023: 21 · 2022: 31 · 2021: 39 · 2020: 39 · 2019: 33 · 2018: 33 · 2017: 20 · 2016: 25 · 2015: 23 · 2014: 21 · 2013: 18 · 2012: 14
FWCI: 6.79
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Journal of Epidemiology & Community Health (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Columbia Academic Commons (Columbia University)
Funders: National Institutes of Health (DP1OD003635)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords: autism spectrum disorder, age at diagnosis, birth cohort, autism incidence, parental education, socioeconomic status, autism screening, early intervention, autism prevalence, child psychiatrists
MeSH terms: Age Factors, Autistic Disorder, California, Child, Child, Preschool, Educational Status, Female, Health Policy, Humans, Male, Parents, Regression Analysis, Social Class, Cohort Studies, Age of Onset

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Age of diagnosis for autism: individual and community factors across 10 birth cohorts

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