time, transience, chronos

Diagnostic Delays: When Waiting Room Time Feels Eternal

What is diagnostic delay?

The time between first acknowledgement of symptoms to final diagnosis.

What are the various types of delays?

🔶PRIMARY DELAY:
At the level of patient before first contact with Health provider

  • Denial of symptoms or waiting for them to go away
  • Using home remedies or alternative practices

🔶SECONDARY DELAY:
After contact with health care provider to actual correct diagnosis

  • Delay in referral to child psychologist or mental health professional
  • Misdiagnosis
man wearing gray polo shirt beside dry-erase board

What has the latest research on diagnostic delay in ADHD and Autism revealed?

1️⃣ Females > Males are prone to a late diagnosis for both ADHD and Autism

2️⃣ Children with Autism alone were much younger at diagnosis as compared to children with both ADHD + Autism

3️⃣ Diagnostic delay more in ADHD than in Autism+ADHD

What interventions can help close the gap?

1️⃣ Awareness amongst caregivers/parents
2️⃣ Training focused on ADHD diagnosis and proper referral flow among GPs, Psychologists, and Paediatricians
3️⃣ Training of Primary Health Care Workers to catch early symptoms

What are the barriers in diagnosis of ADHD and Autism in Children?

1️⃣ Absence of biological markers and reliance on behavioral giveaways
2️⃣ Variations in symptoms
3️⃣ Broad diagnostic categories
4️⃣ Overlap with other conditions or nutritional deficiencies or development related delays due to other causes
5️⃣ Inability to distinguish between autism and ADHD in some cases
For instance, one of the features is poor social communication, in
Autism: Does not understand social cues
ADHD: Does not pay attention to social cues

What are the causes of Gender-bias in ADHD and Autism Diagnosis?

1️⃣ Differences in presentation
2️⃣ Inattentive type of ADHD is difficult to pick up and occurs more in females
3️⃣ In autism, females maybe using better coping strategies to mask symptoms


References

Knott, Rachael. “No Time to Waste: Identifying the Barriers to Earlier Autism and ADHD Diagnosis.” Monash Lens, 1 Feb. 2024, lens.monash.edu/@medicine-health/2024/01/15/1386344/no-time-to-waste-identifying-the-barriers-to-earlier-autism-and-adhd-diagnosis.


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