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Sunday, September 2, 2012

Pediatricians and Diagnosis

Previous posts have described the often-unhappy interactions between pediatricians and parents of ASD children.  In a letter to the Journal of Autism and Developmental Disorders, Amy Sudhinaraset and Alice Kuo write of a small-sample study:
For this interview series, 13 in depth interviews were conducted with a total of 3 fathers and 11 mothers who  were an average age of 44.7 years. The children consisted of 11 boys and 2 girls who at the time of  interview had an average age of 11.4 years. Transcripts were coded and analyzed using a qualitative analysis program to look for themes.
Of the 13 parent interviews conducted, all but 1 parent reported a negative experience when they approached their pediatrician with their concerns for their child’s development. [emphasis added] The average age that parents first suspected their child was not typical was 1.7 years, the average age of formal diagnosis was 4.4 years, resulting in a 2.7 year delay in diagnosis. The parent who had a positive experience had the earliest formal diagnosis at 17 months. Of the 13 parents who expressed concerns, 7 mentioned that their pediatrician did recognize some component of developmental delay in their child and 5 of them were referred to a specialized developmental service despite the fact that their pediatrician was unable to specifically recognize ASD.
Lisa Jo Rudy put the problem succinctly:  "Most pediatricians are not highly trained in picking up developmental red flags. And they see a lot of kids who have slight or brief delays and then develop normally. Parents, nannies and daycare or preschool providers, though, see your child every day. Where your pediatrican may see shyness or a mild delay, you may see a pattern."