Current situation and influencing factors of Chinese children’s diagnosis delay in autism

作者：Feng-lei Zhu, Yue Ji, Lu Wang, Min Xu, Xiaobing Zou · 发表于：Journal of Neurodevelopmental Disorders · 年份：2025 · DOI：10.1186/s11689-025-09636-2 · 被引用次数：2 · 研究领域：Autism Spectrum Disorder Research、Behavioral and Psychological Studies、Family and Disability Support Research

BACKGROUND: Although experienced clinicians are capable of diagnosing autism in children before they reach the age of 2, the average age of diagnosis reported internationally is between 4 and 5 years, indicating a significant delay. This study aimed to determine the factors influencing the diagnostic delay time (DDT) in Chinese autistic children. METHODS: We employed the Cox proportional hazard model to examine the effects of individual, family, sociodemographic, and healthcare system indicators on DDT in 480 Chinese autistic children (age range: 16.10-190.16 months; male-to-female ratio: 5.67:1) recruited from a tertiary hospital between 2021 and 2023. RESULTS: The median DDT was 9.58 months (IQR = 15.01). Independent risk factors for delayed diagnosis included normal language competence (RR = 1.747, p < 0.001), non-core symptoms as first concerns (RR = 1.642, p = 0.013), school attendance (RR = 1.941, p < 0.001), irregular well-child visits (RR = 1.264, p = 0.028), and misdiagnosis history (RR = 0.648, p = 0.001). CONCLUSIONS: Diagnosis delay in Chinese autistic children is heterogeneous. Early monitoring for children with normal language skills and school-aged children, alongside improved healthcare system practices, is critical.