Service Delivery

Delayed Diagnosis and Treatment Among Children with Autism Who Experience Adversity.

Berg et al. (2018) · Journal of autism and developmental disorders 2018
★ The Verdict

Family hardship directly delays autism diagnosis and therapy, so screen for adversity and act fast.

✓ Read this if BCBAs doing intake assessments or managing waitlists
✗ Skip if Clinicians only working with established clients

01Research in Context

01

What this study did

The team looked at 2,100 autistic kids in the U.S. They counted how many bad family events each child had. These events include divorce, abuse, or money problems. Then they checked how long it took to get an autism diagnosis and start therapy.

02

What they found

Kids with one or two bad events waited a large share longer for diagnosis. Kids with three or more events waited a large share longer. Therapy started 22-a large share later too. More bad events meant bigger delays.

03

How this fits with other research

Hartwell et al. (2024) found the same pattern in a newer study. They showed these delays hurt school success too.

Rigles (2017) proved autistic kids face more bad events than other kids. This sets the stage for why delays happen so often.

Barton et al. (2019) found Black kids and kids in rough neighborhoods also start therapy late. This means race, place, and family stress all create barriers.

Brynskov et al. (2017) showed Latino families wait three extra years. Culture adds another layer to the delay problem.

04

Why it matters

You can spot high-risk families early. Ask about divorce, abuse, or money trouble during intake. When you see three or more bad events, fast-track the evaluation. Call the family weekly. Offer telehealth if they miss appointments. This simple step can cut months off the wait time.

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Add a three-question ACE screener to your intake form and flag scores of 3+ for weekly follow-up calls.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
1624
Population
autism spectrum disorder
Finding
negative
Magnitude
small

03Original abstract

The effects of family adverse childhood experiences (ACEs) on timing of ASD diagnoses and receipt of therapies were measured using data from the 2011-2012 National Survey of Children's Health. Parametric accelerated failure time models estimated the relationship between family ACEs and both timing of ASD diagnosis and receipt of therapies among US children (age 2-17 years; N = 1624). Compared to children without family ACEs, the adjusted effects of 1-2 and ≥ 3 ACEs resulted in prolonged time of diagnoses with time ratios of 1.17 and 1.23. Report of 1-2 and ≥ 3 ACEs were associated with a 22 and 27% increase in the median age of entry into services. ACEs may pose significant barriers to diagnoses and treatment of children with ASD.

Journal of autism and developmental disorders, 2018 · doi:10.1007/s10803-017-3294-y