Missed opportunities: An investigation of pathways to autism diagnosis in Australia

Background: Reliable diagnoses of autism can be made as early as two years of age. Many children in Australia are diagnosed with autism at a later age. Delayed diagnosis can lead to missed opportunities for early intervention. This study aims to investigate the factors associated with age of diagnosis in Australia and to examine where delays are occurring in the diagnostic pathway. Method: Family and child characteristics, age of first concern, and outcomes of previous professional consultations were collected and analysed for 215 children undergoing assessment for autism in Sydney, Australia. Results: The average age of diagnosis was 5 years. Children with more severe autism, and those with no co-morbid diagnosis were diagnosed at a younger age. Average age of first concern was 23 months, and parents consulted professionals, on average, just over 8 months later. Seventy percent of the children were not identified as having possible autism at this initial consultation. The average gap between first consultation and diagnosis of autism was 2 years, 4 months. Conclusions: This study provided further evidence of delayed diagnosis of children in Australia. Those with level 2 or 3 autism, no co-morbid diagnosis and earlier parental first concerns were diagnosed earlier. In general, parents have concerns and take action in a timely manner. Delays in the diagnostic pathway were apparent from the first professional consultation where autism was often not identified. This could be addressed by training professionals about early indicators, milder forms of autism, and differential diagnosis.