Faculty, Staff and Student Publications
Language
English
Publication Date
4-1-2026
Journal
Journal of Racial and Ethnic Health Disparities
DOI
10.1007/s40615-025-02316-w
PMID
39994155
Abstract
Purpose: Sociodemographic characteristics, such as race and ethnicity, are associated with delays in ASD diagnosis. However, limited literature has examined the characteristics associated with delayed diagnosis since the start of the COVID-19 pandemic. This study aimed to identify the individual and aggregate sociodemographic characteristics associated with the age at which a child receives a referral for a diagnosis (from March 2020 to May 2023) and evaluate the impacts of the pandemic on this association.
Methods: Using cross-sectional data obtained from patients' electronic health records and the U.S. Census Bureau, we examined associations using linear regressions (N = 507). A subgroup analysis was conducted comparing two pandemic-related time frame phases: acute (March 2020-December 2021) and endemic (January 2022-May 2023).
Results: The mean age of referral was 37.3 months; 83.2% were Medicaid recipients, 42.6% were Latino/Hispanic, and 29.8% were Black non-Hispanic. Children were referred for an evaluation at an older age during the acute phase compared to the endemic phase (40.4 vs. 35.4 months). There were no significant associations between race and ethnicity and age of referral. Population educational attainment was negatively associated with the age of referral (p < 0.05). The subgroup analysis showed a positive association between median population income and age of referral during the endemic phase (p < 0.05).
Conclusion: Referrals to receive a diagnosis occur later than the screening recommendations. Future work should focus on developing health system-wide practices, particularly among health systems serving large proportions of underserved populations, targeting early referrals for an evaluation to receive an ASD diagnosis.
Keywords
Humans, COVID-19, Male, Referral and Consultation, Child, Preschool, Female, Cross-Sectional Studies, United States, Autism Spectrum Disorder, Infant, Child, Age Factors, Sociodemographic Factors, Ethnicity, Delayed Diagnosis, SARS-CoV-2, Socioeconomic Factors, Pandemics, Age of referral, Autism spectrum disorder, COVID-19, Children, Sociodemographic.
Published Open-Access
yes
Recommended Citation
Mathur, Mallika; Li, Ruosha; McKay, Sandra; et al., "Associations Between Sociodemographic Predictors and Age of Referral for Autism Spectrum Disorder (Asd) Diagnosis Since the Beginning of the COVID-19 Pandemic" (2026). Faculty, Staff and Student Publications. 4222.
https://digitalcommons.library.tmc.edu/uthmed_docs/4222