Social and demographic factors that influence the diagnosis of autistic spectrum disorders

Purpose Recent studies in epidemiology have highlighted the existence of children with autistic difficulties who remain undiagnosed. Other studies have identified ‘access barriers’ to clinics which include factors mediated by parents as well as health and education services. The purpose of this study was to examine whether social and demographic factors play a role in receiving a diagnosis of autistic spectrum disorder (ASD) independently of symptom severity. Methods Retrospective secondary analysis of a longitudinal UK cohort study, namely, the Avon Longitudinal Study of Parents and Children (ALSPAC). Results With the severity of autistic traits held constant, boys were more likely to receive an ASD diagnosis than girls. Younger mothers and mothers of first-born children were significantly less likely to have children diagnosed with ASD. Maternal depression before and around the time of their children’s autistic difficulties was associated with lack of diagnosis. Conclusions The study provides evidence that social as well as biological factors can influence whether children are brought to the clinic. Keywords Pervasive developmental disorders - ALSPAC - Autism - Autistic spectrum disorders - Child psychiatry - Access barriers