Practice patterns and determinants of wait time for autism spectrum disorder diagnosis in Canada

Melanie Penner, Evdokia Anagnostou, Wendy J. Ungar

Inefficient diagnostic practices for autism spectrum disorder (ASD) may contribute to longer wait times, delaying access to intervention. The objectives were to describe the diagnostic practices of Canadian pediatricians and to identify determinants of longer wait time for ASD diagnosis. An online survey was conducted through the Canadian Paediatric Society's developmental pediatrics, community pediatrics, and mental health sections. Participants were asked for demographic information, whether they diagnosed ASD, and elements of their diagnostic assessment. A multiple linear regression of total wait time (time from referral to communication of the diagnosis to the family) as a function of practice characteristics was conducted. A total of 90 participants completed the survey, of whom 57 diagnosed ASD in their practices (63.3%). Respondents reported varied use of multi-disciplinary teams, with 53% reporting participation in a team. No two identically composed teams were reported. Respondents also had varied use of diagnostic tools, with 21% reporting no use of tools. The median reported total wait for ASD diagnosis time was 7 months (interquartile range 4-12 months). Longer time spent on assessment was the only variable that remained significantly associated with longer wait time in multiple regression (p = 0.002). Use of diagnostic tools did not significantly affect wait time. Canadian ASD diagnostic practices vary widely and wait times for these assessments are substantial-7 months from referral to receipt of diagnosis. Time spent on the assessment is a significant determinant of wait time, highlighting the need for efficient assessment practices.