title: Are there cultural differences in parental interest in early diagnosis and genetic risk assessment for autism spectrum disorder?
abstract: BACKGROUND
  There are many societal and cultural differences between healthcare systems and the use of genetic testing in the US and France. These differences may affect the diagnostic process for autism spectrum disorder (ASD) in each country and influence parental opinions regarding the use of genetic screening tools for ASD.
  
  
  METHODS
  Using an internet-based tool, a survey of parents with at least one child with ASD was conducted. A total of 162 participants from the US completed an English version of the survey and 469 participants from France completed a French version of the survey. Respondents were mainly females (90%) and biological parents (94.3% in the US and 97.2% in France).
  
  
  RESULTS
  The mean age of ASD diagnosis reported was not significantly different between France (57.5 ± 38.4 months) and the US (56.5 ± 52.7 months) (p = 0.82) despite significant difference in the average age at which a difference in development was first suspected [29.7 months (±28.4) vs. 21.4 months (±18.1), respectively, p = 7 × 10(-4)]. Only 27.8% of US participants indicated that their child diagnosed with ASD had undergone diagnostic genetic testing, whereas 61.7% of the French participants indicated this was the case (p = 2.7 × 10(-12)). In both countries, the majority of respondents (69.3% and 80% from France and the US, respectively) indicated high interest in the use of a genetic screening test for autism.
  
  
  CONCLUSIONS
  Parents from France and the US report a persistent delay between the initial suspicion of a difference in development and the diagnosis of ASD. Significantly fewer US participants underwent genetic testing although this result should be regarded as exploratory given the limitations. The significance of these between country differences will be discussed.
authors.affiliation: IntegraGen , Evry , France ; Department of Child and Adolescent Psychiatry, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Université Pierre et Marie Curie , Paris , France.
authors.forename: Claire
authors.initials: C
authors.lastname: Amiet
authors.affiliation: IntegraGen Inc. , Cambridge, MA , USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Couchon
authors.affiliation: University of Notre Dame , South Bend, IN , USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Carr
authors.affiliation: IntegraGen , Evry , France.
authors.forename: Jerôme
authors.initials: J
authors.lastname: Carayol
authors.affiliation: Department of Child and Adolescent Psychiatry, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Université Pierre et Marie Curie , Paris , France ; CNRS UMR 7222, Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie , Paris , France.
authors.forename: David
authors.initials: D
authors.lastname: Cohen
keywords: France; US; autism spectrum disorders; genetics; parents’ opinion; survey