Autism: Its Recognition, Early Diagnosis, and Service Implications

A generation ago, most children with autism did not receive a diagnosis until the school-age years. That has changed as a result of both an increased awareness of the syndrome and better diagnostic measures. Nowadays, it is much more usual for diagnoses to be made in the preschool period, although it tends to be later when there is not an associated intellectual disability. Harrington et al (this issue), in their parental questionnaire study of 2 private practices, found the mean age of diagnosis of autism was 34 months, some 16 months after the first parental concern. The comparable figure for Asperger syndrome was 51 and 21 months, but these concerned only 8 children. Wiggins et al (this issue), using a populationbased surveillance system, found a mean age of first professional evaluation of 48 months with the mean age of diagnosis some 13 months later at 61 months. As a consequence, there is now an expectation that developmental pediatricians should be familiar with autism and know how to diagnosis it.