Grandma knows best

Sicherman N, Loewenstein G, Tavassoli T, Buxbaum JD. Grandma knows best: Family structure and age of diagnosis of autism spectrum disorder. Autism. 2016 Dec 1:1362361316679632. doi: 10.1177/1362361316679632. [Epub ahead of print]

Abstract

This pilot study estimates the effects of family structure on age of diagnosis, with the goal of identifying factors that may accelerate or delay diagnosis. We conducted an online survey with 477 parents of children with autism. In addition, we carried out novel, follow-up surveys of 196 "friends and family," who were referred by parents. Family structure and frequency of interactions with family members have significant effects on age of diagnosis (p < 0.05). In all, 25% of parents report that other individuals indicated that their child might have a serious condition before they themselves suspected it. Moreover, around 50% of friends and family report that they suspected that the child had a serious condition before they were aware that either parent was concerned, suggesting that the clues were there to see, especially for experienced viewers. While half of those individuals shared their concerns with the parents, the other half either did not raise any concern (23%) or just "hinted" at their concern (27%). Among children with siblings, children with an older sibling are diagnosed approximately 10 months earlier (p < 0.01) than those without, and children with no siblings were diagnosed 6-8 months earlier than children with siblings (p < 0.01). Interestingly, frequent interactions with grandparents, especially grandmothers, significantly lowered the age of diagnosis by as much as 5 months (p < 0.05). While this pilot study requires replication, the results identify potential causes for accelerated or delayed diagnosis, which if better understood, could ultimately improve age of diagnosis and treatment, and hence outcomes.

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Kids with autism who spend a lot of time with their grandmothers may get diagnosed with the disorder at a younger age, a small study suggests.

“This finding is incredibly important, as these individuals have the potential to lower the age of diagnosis,” senior study author Joseph Buxbaum of the Icahn School of Medicine at Mount Sinai in New York said by email. “Early diagnosis means early intervention, which is critical for improving treatment outcomes.”

Even though autism spectrum disorder (ASD) may be identified starting when kids are around 2 years old, many children are not formally diagnosed until they are closer to 4, the researchers note in the journal Autism, online February 8. The earlier autism is caught and treated, the better, because younger kids have more adaptable brains that may respond more to therapy than older children.

In the current study, an online survey of parents of children with autism as well as some friends and family members, parents reported about 25 percent of the time that another person close to the child noticed signs of autism first.

Kids in the study were diagnosed with autism when they were about 40 months old on average. When they regularly spent time with their grandmothers, however, they typically were diagnosed about 5 months sooner.

“Around 50 percent of friends and family noticed something was wrong with the child before they were aware that the parents themselves suspected something,” lead study author Nachum Sicherman of Columbia University in New York said by email…

Children without siblings were diagnosed with autism about six to eight months earlier on average than kids with brothers or sisters living in the household at the time of their diagnosis, the study found.

Birth order also matters. Kids with older siblings get diagnosed about nine to 10 months sooner than children who only have younger brothers and sisters.

When parents said another adult close to the child first identified the possibility of autism, that person was a maternal grandmother 27 percent of the time and a teacher in 24 percent of cases…

“Parents need to be open to concerns from their family members, including their parents, regarding their children,” Frazier, who wasn’t involved in the study, said by email. “The more eyes the better, and this is especially true in situations where the child with possible difficulties is the older child with younger siblings.”

http://www.medscape.com/viewarticle/878070