Examining factors related to the age of diagnosis of children with autism spectrum disorder from immigrant and non-immigrant backgrounds in a diverse clinical sample.
Good language skills can hide autism and delay diagnosis, but speaking many languages at home speeds things up for immigrant families.
01Research in Context
What this study did
Vanegas (2021) looked back at clinic charts of kids with autism. They compared kids of immigrant moms with kids of U.S.-born moms.
They wanted to know what makes diagnosis happen earlier or later in each group.
What they found
Talking kids and kids with extra diagnoses got their autism label later, no matter where mom was born.
Kids in homes that speak many languages got diagnosed sooner, but only if mom was an immigrant.
How this fits with other research
Leng et al. (2024) saw the same delay in migrant kids inside China. Both papers show moving to a new country slows diagnosis.
Clark et al. (2018) prove the wait hurts: kids diagnosed after age 3 enter school with lower talk scores and need more help.
Aiona et al. (2025) add that parents from countries with less schooling or more gender bias often have kids with autism plus learning delay. Vanegas (2021) did not check country-level stats, so the new data deepen the story.
Why it matters
If you screen an immigrant child who talks, do not let the good speech fool you—keep probing. Ask what languages are spoken at home; a multilingual home can actually speed things up for immigrant families. Share this fact with parents to build trust and cut stigma.
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02At a glance
03Original abstract
A timely diagnosis of autism spectrum disorder (ASD) is important for children as that may help inform the best services and supports needed for optimal outcomes. However, disparities in the identification of ASD have been consistently documented for racial/ethnic minority and immigrant populations. The majority of studies of immigrant populations have focused on the qualitative experience of ASD, however, greater knowledge about the predictors of the age of initial ASD diagnosis is needed. This study examined the child, maternal, and family-level factors that predicted the age of initial ASD diagnosis in a diverse clinical sample through a retrospective medical record review. Medical records of clinical evaluations conducted between 2004 and 2014 were reviewed for children with ASD born to immigrant and non-immigrant mothers. Regression analyses found that for both groups of children with ASD, using verbal language to communicate and having another diagnosis (attention-deficit/hyperactivity disorder or another condition) predicted an older age of initial ASD diagnosis. For children with ASD born to immigrant mothers, residing in a multilingual household was associated with a younger age of diagnosis. These results highlight the complexities of an ASD diagnosis among diverse children and families, particularly among immigrant communities. LAY SUMMARY: This research looked at predictors of when children received their first autism spectrum disorder diagnosis across children born to immigrant mothers and children born to U.S.-born mothers. Living in a multilingual home was related to a younger age of diagnosis for children of immigrant mothers; being verbal and having another diagnosis was related to an older age of diagnosis for both groups of children. This highlights the need to improve diagnostic services for diverse children.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2489