Current situation and influencing factors of Chinese children's diagnosis delay in autism.

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurodevelopmental Disorders Pub Date : 2025-08-12 DOI:10.1186/s11689-025-09636-2

Feng-Lei Zhu, Yue Ji, Lu Wang, Min Xu, Xiao-Bing Zou

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引用次数: 0

Abstract

Background: Although experienced clinicians are capable of diagnosing autism in children before they reach the age of 2, the average age of diagnosis reported internationally is between 4 and 5 years, indicating a significant delay. This study aimed to determine the factors influencing the diagnostic delay time (DDT) in Chinese autistic children.

Methods: We employed the Cox proportional hazard model to examine the effects of individual, family, sociodemographic, and healthcare system indicators on DDT in 480 Chinese autistic children (age range: 16.10-190.16 months; male-to-female ratio: 5.67:1) recruited from a tertiary hospital between 2021 and 2023.

Results: The median DDT was 9.58 months (IQR = 15.01). Independent risk factors for delayed diagnosis included normal language competence (RR = 1.747, p < 0.001), non-core symptoms as first concerns (RR = 1.642, p = 0.013), school attendance (RR = 1.941, p < 0.001), irregular well-child visits (RR = 1.264, p = 0.028), and misdiagnosis history (RR = 0.648, p = 0.001).

Conclusions: Diagnosis delay in Chinese autistic children is heterogeneous. Early monitoring for children with normal language skills and school-aged children, alongside improved healthcare system practices, is critical.

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中国儿童自闭症诊断延迟现状及影响因素

背景：尽管经验丰富的临床医生能够在儿童2岁之前诊断出自闭症，但国际上报道的平均诊断年龄在4至5岁之间，这表明存在显著的延迟。本研究旨在探讨影响中国自闭症儿童诊断延迟时间（DDT）的因素。方法：采用Cox比例风险模型，对480例中国自闭症儿童(年龄范围：16.10 ~ 190.16个月；男女比例：5.67:1)于2021年至2023年间从三级医院招聘。结果：中位DDT为9.58个月（IQR = 15.01）。诊断延迟的独立危险因素包括正常语言能力（RR = 1.747, p）。结论：中国自闭症儿童的诊断延迟存在异质性。对语言技能正常的儿童和学龄儿童进行早期监测，同时改进卫生保健系统的做法至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurodevelopmental Disorders 医学-临床神经学

CiteScore

7.60

自引率

4.10%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Neurodevelopmental Disorders is an open access journal that integrates current, cutting-edge research across a number of disciplines, including neurobiology, genetics, cognitive neuroscience, psychiatry and psychology. The journal’s primary focus is on the pathogenesis of neurodevelopmental disorders including autism, fragile X syndrome, tuberous sclerosis, Turner Syndrome, 22q Deletion Syndrome, Prader-Willi and Angelman Syndrome, Williams syndrome, lysosomal storage diseases, dyslexia, specific language impairment and fetal alcohol syndrome. With the discovery of specific genes underlying neurodevelopmental syndromes, the emergence of powerful tools for studying neural circuitry, and the development of new approaches for exploring molecular mechanisms, interdisciplinary research on the pathogenesis of neurodevelopmental disorders is now increasingly common. Journal of Neurodevelopmental Disorders provides a unique venue for researchers interested in comparing and contrasting mechanisms and characteristics related to the pathogenesis of the full range of neurodevelopmental disorders, sharpening our understanding of the etiology and relevant phenotypes of each condition.