title: Stability of initial autism spectrum disorder diagnoses in community settings.
abstract: The study's objectives were to assess diagnostic stability of initial autism spectrum disorder (ASD) diagnoses in community settings and identify factors associated with diagnostic instability using data from a national Web-based autism registry. A Cox proportional hazards model was used to assess the relative risk of change in initial ASD diagnosis as a function of demographic characteristics, diagnostic subtype, environmental factors and natural history. Autistic disorder was the most stable initial diagnosis; pervasive developmental disorder-not otherwise specified was the least stable. Additional factors such as diagnosing clinician, region, when in time a child was initially diagnosed, and history of autistic regression also were significantly associated with diagnostic stability in community settings. Findings suggest that the present classification system and other secular factors may be contributing to increasing instability of community-assigned labels of ASD.
authors.affiliation: Department of Medical Informatics, Kennedy Krieger Institute, 3825 Greenspring Avenue, Painter Building 1st Floor, Baltimore, MD 21211, USA.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Daniels
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Rosenberg
authors.forename: J Kiely
authors.initials: JK
authors.lastname: Law
authors.forename: Catherine
authors.initials: C
authors.lastname: Lord
authors.forename: Walter E
authors.initials: WE
authors.lastname: Kaufmann
authors.forename: Paul A
authors.initials: PA
authors.lastname: Law
mesh_terms: D000293:Adolescent; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012042:Registries; D011795:Surveys and Questionnaires
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