Sociodemographic, clinical characteristics, and service utilization of young children diagnosed with autism spectrum disorder at a research center in Saudi Arabia: The road to autism spectrum disorder diagnosis

Abdullah M. Alotaibi; Katelyn A. Craig; Taghreed M. Alshareef; Elham S. AlQathmi; Sarah M. Aman; Hesham M. Aldhalaan; Cheryl L. Oandasan

doi:10.15537/smj.2021.42.8.20210297

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Figure 1
- Study design and variables. ASD: autism spectrum disorder, KSA: Kingdom of Saudi Arabia

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Table 1

- Sociodemographic characteristics of ASD sample (N=67).

Variables	n (%)
Gender
Female	18 (26.9)
Male	49 (73.1)
Age (months) at time of clinic visit
<24	8 (11.9)
24-47	30 (44.8)
49-71	20 (29.9)
72-95	9 (13.4)
>96	0 (0)
Nationality
Saudi	52 (77.6)
Non-Saudi	15 (22.4)
Area of residence
Central	55 (82.1)
West	3 (4.5)
North	2 (3.0)
South	3 (4.5)
East	4 (6.1)
Marital status of parents
Married	64 (95.5)
Separated/divorced	2 (3.0)
Widowed	1 (1.5)
Number of siblings
None	6 (9.0)
1	23 (34.3)
2-4	32 (47.8)
5-7	6 (9.0)
Parents consanguinity
Yes	25 (37.3)
No	40 (59.7)
Missing information	2 (3.0)
Consanguinity type (n=25)
First cousins	14 (56.0)
Second cousins	7 (28.0)
Same tribe	4 (16.0)
Father level of education
Primary school	1 (1.5)
Intermediate school	3 (4.5)
High school	9 (13.4)
Post-secondary education	39 (57.2)
Master’s or higher	10 (14.9)
Missing information	5 (7.5)
Mother level of education
Primary school	1 (1.5)
Intermediate school	3 (4.9)
High school	15 (22.2)
Post-secondary education	33 (49..6)
Master’s or higher	8 (11.9)
Missing information	7 (10.5)

ASD: autism spectrum disorder, PDD: pervasive developmental disorders

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Table 2

- Clinical characteristics of ASD sample (N=67).

Variables	n (%)
Family history
ASD, PDD	17 (25.4)
Speech delay	28 (41.8)
Intellectual disability	15 (22.4)
Attention-deficit/hyperactivity disorder	13 (19.4)
Psychiatric disability	4 (6.0)
Seizure disorder	6 (9.0)
Down’s syndrome	3 (4.5)
Parent’s initial concerns
Language delay	53 (79.0)
Social skills delays	55 (82.1)
Stereotypic behavior or restricted repetitive interests	31 (46.3)
Disruptive behavior (hyperactive, agitated,	11 (16.4)
impulsive, aggressive)
Inattention and distractibility	12 (17.9)
Self-injurious behavior	2 (3.0)
Cognitive delay	0 (0.0)
Motor delay	3 (4.5)
Other concerns	3 (4.5)
History of language regression
Yes	29 (43.3)
No	31 (46.3)
Missing data	7 (10.4)
Reported previous diagnoses rceived
ASD, PDD, Asperger’s syndrome	48 (71.6)
Language delay/language disorder	17 (25.4)
Attention-deficit/hyperactivity disorder	12 (17.9)
Motor delay/motor disorder	2 (0.03)
Global development delay	3 (0.04)
Genetic disorder	3 (0.04)
ASD severity, median (mean±SD)
ADOS-2 calibrated severity score (CSS), n=65	7 (6.49±1.59)
Vineland ABC composite score, n=53	62 (61.1±7.81)

ASD: autism spectrum disorder, PDD: pervasive developmental disorders, ADOS: autism diagnostic observation schedule

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Table 3

- Descriptive statistics: service utilization characteristics of ASD sample.

Variables	n (%)
Number of previous assesments prior to ASD diagnosis (n=67)
None	11 (16.4)
1	28 (41.8)
2	17 (25.4)
3	3 (4.5)
≥4	1 (1.5)
Missing data	7 (10.6)
Intervention in previous ASD diagnosis (n=48)
Medication	21 (43.2)
Alternative treatment	7 (14.6)
Intervention services	36 (75.0)
Intervention in no previous ASD diagnosis (n=19)
Medication	8 (42.1)
Alternative treatment	3 (15.8)
Intervention services	9 (47.4)
Type of intervention services (n=45)
Enrolled in daycare, preschool,	20 (44.4)
kindergarten, school, or special	33 (73.3)
education school	8 (17.8)
Speech therapy	7 (15.6)
Occupational therapy	20 (44.4)
Applied behavior analysis	1 (2.3)
Behavior therapy/training	12 (26.7)
Physiotherapy	3 (6.7)
Special education session
Psychology
Site of intervention services (n=45)
Clinic private/community	18 (40.0)
Clinic - hospital based	5 (11.1)
Home	14 (31.1)
Center	23 (51.1)
School	17 (37.8)

ASD: autism spectrum disorder

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Table 4

- Fixed-effects analysis of variance (ANOVA) comparing age of first concern, age of first ASD diagnosis, and time from concern to diagnosis with patient characteristics.

Variables	AOC		AOD		TTD
Variables	F-ratio	P-value	F-ratio	P-value	F-ratio	P-value
Number of siblings (n=66)	3.2423	0.0278^*	1.1176	0.3487	0.7762	0.5116
Family history (n=66)
ASD	0.2121	0.6466	2.2053	0.1424	6.2956	0.0146^*
Speech delay	1.1655	0.3183	0.3020	0.7404	0.3799	0.6855
Intellectual disability	2.1118	0.1294	0.5172	0.5987	1.0536	0.3547
Attention-deficit/hyperactivity disorder	3.1187	0.0510	1.9204	0.1549	1.4248	0.2481
Psychiatric disability	2.2088	0.1181	2.6351	0.0795	0.7945	0.4562
Seizure disorder (n=63)	2.0959	0.1317	0.5198	0.5972	1.3800	0.2593
Down’s syndrome (n=60)	0.0069	0.9340	0.0069	0.9340	0.6511	0.4230
Parent’s initial concerns (n=66)
Language delay	1.1162	0.2947	0.0013	0.9717	0.0040	0.9501
Social skills delays	0.8809	0.3514	0.2616	0.6107	0.5221	0.4726
Stereotypic behavior or restricted repetitive interests	0.5973	0.4424	0.4805	0.4907	0.5560	0.4586
Disruptive behavior - hyperactive, agitated, impulsive, aggressive	0.3048	0.5828	4.8450	0.0313^*	4.0284	0.0489^*
Inattention and distractibility	0.0583	0.8100	0.5770	0.4502	1.2831	0.2615
Self-injurious behavior	11.5057	0.0012^*	2.7308	0.1033	0.3031	0.5838
Motor delay	0.6220	0.4332	0.1231	0.7268	0.0060	0.9386
ASD symptom severity
Vineland ABC composite score (n=52)	0.4480	0.9754	1.4736	0.1616	0.4480	0.9754
The autism diagnostic observation schedule calibrated severity scores (n=64)	1.4329	0.2178	1.9802	0.0832	0.9587	0.4611