lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

Mental Health and Social Difficulties of Late-Diagnosed Children with Autism, Across Childhood and Adolescence

27 Pages Posted: 29 Oct 2020

See all articles by William Mandy

William Mandy

University College London - Research Department of Clinical, Educational and Health Psychology

Emily Midouhas

Department of Psychology and Human Development, Institute of Education, UCL

Mariko Hosozawa

National Center for Global Health and Medicine - Institute for Global Health Policy Research

Noriko Cable

University College London - Department of Epidemiology and Public Health

Amanda Sacker

University College London - Department of Epidemiology and Public Health

Eirini Flouri

University of London - Institute of Education

More...

Abstract

Background: Autism can be diagnosed from two years of age, although most autistic people receive their diagnosis later than this, after they have started education. Research is required to understand: (1) why some autistic children are diagnosed late; and (2) the level and nature of unmet need prior to diagnosis for late-diagnosed children. To this end, we examined trajectories of emotional, behavioural and social difficulties (EBSDs) across childhood and adolescence, comparing ‘earlier-diagnosed’ (diagnosed 7 years or younger) with ‘late-diagnosed’ (diagnosed between 8 and 14 years) autistic children. 

Methods: Data were from the Millennium Cohort Study, a population-based UK birth cohort. EBSDs were measured using the parent-report Strengths and Difficulties Questionnaire, at 3, 5, 7, 11 and 14 years. We used Growth Curve Modelling to investigate levels and rates of change in these difficulties, and to compare earlier- (n=196) and late-diagnosed (n=286) autistic children.

Outcomes: Aged 5, earlier-diagnosed autistic children had more emotional, hyperactivity and social difficulties; although clinical difficulties in these areas were nevertheless common in late-diagnosed children. There was a faster annual increase in scores for all domains for late-diagnosed children, and by age 14 years, they had higher levels of emotional, conduct and social difficulties.

Interpretation: EBSDs are associated with, and may influence, timing of autism diagnosis. Late-diagnosed autistic children often have high levels of mental health and social difficulties prior to their autism diagnosis, and tend to develop even more severe problems as they enter adolescence. 

Funding: This work was supported by the Medical Research Council (MR/N022572/1), the Economic and Social Research Council (ES/N007921/1 & ES/R008930/1), the National Institute of Health Research, Autistica, and the Japan Foundation for Paediatric Research.

Declaration of Interests: None reported.

Ethics Approval Statement: Ethical approval was gained from NHS Multi-Centre Ethics Committees, and parents gave informed consent before interviews took place.

Keywords: Autism Spectrum Disorder (ASD), mental health, Internalising problems, Externalising problems, Emotional Problems, Conduct Problems, Attention deficit/hyperactivity disorder (ADHD), Peer problems, Late diagnosis

Suggested Citation

Mandy, William and Midouhas, Emily and Hosozawa, Mariko and Cable, Noriko and Sacker, Amanda and Flouri, Eirini, Mental Health and Social Difficulties of Late-Diagnosed Children with Autism, Across Childhood and Adolescence. Available at SSRN: https://ssrn.com/abstract=3721153 or http://dx.doi.org/10.2139/ssrn.3721153

William Mandy (Contact Author)

University College London - Research Department of Clinical, Educational and Health Psychology

17 Queen Square
London WC1N 3AR
United Kingdom

Emily Midouhas

Department of Psychology and Human Development, Institute of Education, UCL ( email )

Mariko Hosozawa

National Center for Global Health and Medicine - Institute for Global Health Policy Research ( email )

Japan

Noriko Cable

University College London - Department of Epidemiology and Public Health ( email )

1-19 Torrington Place
London, WC1E 6BT
United Kingdom

Amanda Sacker

University College London - Department of Epidemiology and Public Health ( email )

Eirini Flouri

University of London - Institute of Education ( email )

20 Bedford Way
London, WC1H 0AL
United Kingdom

Click here to go to TheLancet.com

Paper statistics

Downloads
72
Abstract Views
444
PlumX Metrics