Improving early detection, diagnosis and intervention for children with autism spectrum disorder: A cross-sectional survey in China.
In China, one in four children with ASD still receive no intervention after diagnosis—screening and referral workflows need tightening, especially for low-income and non-parent caregiver families.
01Research in Context
What this study did
Dai et al. (2023) asked 303 Chinese families about the steps from first worry to diagnosis and treatment. They used a one-time survey to map how long each step took and who never got help.
What they found
Half the kids waited three extra months to see a doctor after parents noticed signs. Diagnosis took another six months. One in four children left the clinic with no therapy plan. Low-income families and kids cared for by grandparents faced the longest gaps.
How this fits with other research
Siklos et al. (2007) saw even longer waits—three years—in Canada. The shorter Chinese lag shows global timelines are improving, but the one-in-four no-treatment rate is still a red flag.
Shrestha et al. (2021) proved community volunteers in Nepal can spot toddlers early. Their success highlights that detection tools exist; Yushen’s data show the weak link is what happens after the label is given.
Bejarano-Martín et al. (2020) surveyed 14 EU countries and found parents rated early services far lower than professionals did. The Chinese numbers add hard timeline proof to that same parent frustration.
Why it matters
You can tighten your own referral loop today. Hand families a written next-step sheet at intake: local diagnosis centers, phone numbers, and funding options. Schedule a follow-up call in one month to see if they booked the appointment. These two steps alone can shave weeks off the wait and push that no-intervention rate downward.
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02At a glance
03Original abstract
BACKGROUND: Detection and diagnosis of autism spectrum disorder (ASD) are prerequisites for early interventions. However, few studies focused on this topic. AIM: This study aims to characterize the timing from symptom detection to intervention in children with ASD and identify predictors of age at ASD diagnosis, presence of intervention, and the time lag between detection and diagnosis. METHODS AND PROCEDURES: A cross-sectional survey was conducted with 303 parents (111 fathers and 192 mothers, 21-54 years) of children with ASD in Guangzhou, China. OUTCOMES AND RESULTS: The median time from symptom observation to the first doctor visit was 3 months, while the time to ASD diagnosis averaged 6 months. Most children (76.24 %) were diagnosed within one year after detection, and 25.58 % had no intervention after diagnosis. Predictors of earlier ASD diagnosis included ASD-related symptoms identified at an older age, less serious symptoms, and initial symptoms with atypical motor development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with social deficits, sensory anomalies, and without language impairment, primary caregivers other than parents, families with lower income, and less social support utilization increased the odds of a time lag between detection and diagnosis. Children with fathers having lower education were less likely to receive interventions. CONCLUSIONS AND IMPLICATIONS: Earlier ASD identification and intervention might be facilitated by health education on typical symptoms of ASD for parents with young children and incorporating ASD screening during routine health examinations for children. For children whose primary caregivers are not their parents and from lower-income families, additional support may be required for timely diagnosis after reporting ASD-related symptoms. Moreover, more intervention supports are expected for children whose fathers have lower education levels. Helping families take full advantage of support is also important for early diagnosis and intervention.
Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2023.104616