title: Retention of autism spectrum diagnoses by community professionals:  findings from the autism and developmental disabilities monitoring network, 2000 and 2006.
abstract: OBJECTIVE
  Past research is inconsistent in the stability of autism spectrum disorder (ASD) diagnoses. The authors therefore sought to examine the proportion of children identified from a population-based surveillance system that had a change in classification from ASD to non-ASD and factors associated with such changes.
  
  
  METHODS
  Children with a documented age of first ASD diagnosis noted in surveillance records by a community professional (n = 1392) were identified from the Autism and Developmental Disabilities Monitoring Network. Children were considered to have a change in classification if an ASD was excluded after the age of first recorded ASD diagnosis. Child and surveillance factors were entered into a multivariable regression model to determine factors associated with diagnostic change.
  
  
  RESULTS
  Only 4% of our sample had a change in classification from ASD to non-ASD noted in evaluation records. Factors associated with change in classification from ASD to non-ASD were timing of first ASD diagnosis at 30 months or younger, onset other than developmental regression, presence of specific developmental delays, and participation in a special needs classroom other than autism at 8 years of age.
  
  
  CONCLUSIONS
  Our results found that children with ASDs are likely to retain an ASD diagnosis, which underscores the need for continued services. Children diagnosed at 30 months or younger are more likely to experience a change in classification from ASD to non-ASD than children diagnosed at 31 months or older, suggesting earlier identification of ASD symptoms may be associated with response to intervention efforts or increased likelihood for overdiagnosis.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30033, USA. lwiggins@cdc.gov
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Wiggins
authors.forename: Jon
authors.initials: J
authors.lastname: Baio
authors.forename: Laura
authors.initials: L
authors.lastname: Schieve
authors.forename: Li-Ching
authors.initials: LC
authors.lastname: Lee
authors.forename: Joyce
authors.initials: J
authors.lastname: Nicholas
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Rice
mesh_terms: D000367:Age Factors; D001321:Autistic Disorder / Q000175:diagnosis / Q000453:epidemiology; D016009:Chi-Square Distribution; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis* / Q000453:epidemiology; D002675:Child, Preschool; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology