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

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月12日

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

摘要

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.