Α. Παπανικολάου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Γ. Κολαΐτης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σ. Χριστογιώργος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Introduction: Autism spectrum disorder (ASD) is a range of pervasive developmental disorders. The mean age of parental concerns onset is 17-18 months after the child’s birth. As a result, the diagnosis of autism is often delayed, which translates into a missed opportunity to provide treatment during a critical developmental period.
Purpose: The aim of this study is to prove the correlation between the reason of referral and the severity of autism spectrum disorder symptoms. Specifically, the variables examined were time of children's referral, reasons of the first reference in relation to age, speech disorders in younger ages in relation to the severity of symptoms, family demographic factors and the role of heredity in relation to the parents’ timely mobilization on medical assessment.
Sample: Using data from the ASD outpatient clinic of the Department of Child Psychiatry, National and Kapodistrian University of Athens, at the "Aghia Sophia" Children’s Hospital, 469 children with a mean age of 5.7 years were examined.
Method: The measures used to evaluate the severity of the symptoms were the ‘Autism Diagnostic Observation Schedule (ADOS-2)’, and the ‘Vineland Adaptive Behavior Scales’, while reasons for referral -as recorded in the referral form and the psychosocial history of children- were also taken into consideration. Data was collected from a folder review.
Results: 81% of children had communication problems, 64,8% reduced response and 59,1% social difficulty. The average time that had passed from the first parental concern to the examination was 3,2 years. Children who were referred of reduced response had a 1,20 point higher severity compared to children who were not referred for this reason. The findings show that age is an important factor because the reasons for children's referral vary according to the age of the children. Communication problems, reduced response, and stereotypical movements are associated with higher severity and lower functionality. Only functionality was related to referral time, whereas severity was not found to be significantly related to it. Moreover, demographics were not related to the severity of the symptoms. Lastly, family’s history in regards to ASD heritance was not a factor important enough to dictate for an immediate medical referral. However, father's age appears to be associated with greater symptom severity.
Conclusion: Communication problems, reduced response, and stereotypical movements are associated with higher severity and lower functionality. The referral time from the first concern and the demographic factors was not found to be significantly related to it. Τhe family’s history in regards was not a factor important enough to dictate for an immediate medical referral. But needs further study the father’s age which has been associated with greater symptom severity.
Autism spectrum disorders, Referral, Severity, Adaptive Behavior, Functionality.