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Mental Health and Social Difficulties of Late-Diagnosed Children with Autism, Across Childhood and Adolescence
27 Pages Posted: 29 Oct 2020
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: Suggested Citation