A new study has revealed that most Malaysian children are diagnosed with autism spectrum disorder (ASD) at a median age of 48 months, which is considered late for early intervention. Conducted at the country’s largest publicly funded neurodevelopmental centre, the research highlights several key factors that contribute to a later age of diagnosis, underscoring the challenges in identifying autism at an earlier stage.
The research, published in the journal Autism Research, gathered data from 446 children evaluated between 2017 and 2019. Of these, 71% were diagnosed with autism after 36 months, which places the majority of these children outside the ideal window for early diagnosis. Early identification, generally recommended before the age of three, can significantly improve outcomes through targeted therapies that address behavioural, social, and cognitive challenges associated with autism.
The study identified a variety of contributing factors to the delay in diagnosis, including socioeconomic status, severity of social communication impairments, and the presence of intellectual disabilities. Children from higher-income families were more likely to be diagnosed earlier, likely due to better access to resources, while those from lower-income backgrounds experienced longer delays. Additionally, the severity of the child’s symptoms played a key role. Children with more severe social communication impairments were diagnosed earlier, as parents and carers recognised the need for specialised care. In contrast, children with milder symptoms were often overlooked, leading to a delayed diagnosis until social demands increased, typically around school age.
Researchers found that children with co-occurring intellectual disabilities were also diagnosed sooner, reflecting the way these children’s cognitive impairments prompt more frequent interactions with healthcare providers, accelerating the diagnostic process. The study suggested that developmental delays detected early, particularly during routine health checks, contributed to the earlier diagnosis of ASD in these cases. However, concerns regarding repetitive behaviours, another key characteristic of autism, were less predictive of early diagnosis. This suggests that cultural perceptions about acceptable childhood behaviour may also contribute to the delay, as some behaviours that are common in autistic children might not immediately raise alarm.
One notable finding was the influence of daytime carers. Compared to children cared for solely by parents or grandparents, those who shared care with a maid or babysitter had earlier diagnoses. Researchers speculate that carers outside the family may be more likely to report concerns about developmental differences, leading to earlier medical evaluations.
The study’s findings indicate that socioeconomic disparities play a significant role in determining when a child is diagnosed with autism. Families from lower-income backgrounds face more barriers to diagnosis, despite Malaysia’s publicly funded healthcare system. Factors such as awareness, access to services, and transportation costs may contribute to the later diagnoses observed in these families.
