The referral features of autistic children in a tertiary Medical Center of Southern China: a Chinese cohort

Objectives: To study the referral recognition features of autistic children in a tertiary Women and Children’s Medical Center.

Methods: The diagnostic autistic children in the past four years in Guangzhou Women and Children’s Medical Center were reviewed. The five groups were classified based on different ways of referral: (1) Parent/Guardian (PG); (2) Medical institutions’ personnel (MIP); (3) Educational services (kindergarten/Early Education Institutes); (4) Relatives or friends or others around (RFO); (5) Media (TV, Internet, We Media). The other 15 groups were classified according to the first noticed symptoms (1) Language developmental abnormalities (LDB) (Non-verbal/delay/idiosyncratic); (2) Name is ignored; (3) Don’t play with other children (DBWOC)/asocial/Live in own world (LOW); (4) Poor eye contact (PEC); (5) Hyperactivity; (6) Repetitive motor mannerisms (RMM) (Body rotation/Walk on tiptoe/Weird Hand Style/Look sideways/Upturn of eyes); (7) Don’t listen to instructions (DLI); (8) Motor developmental delay (MDD); (9) Regression; (10) Stereotyped behaviors (SB) (Turn things around/Playing with toy wheels/Repeat a road); (11) Emotional disorders (ED) (Hasty temper/cry and scream/Beat somebody); (12) Stay delay/Poor understanding/Can’t teach); (13) Inappropriate facial expressions (IFE) (Gelastic/Farewell without expression/Can’t make him/her laugh/No smile); (14) No pointing; (15) Others (Poor self-care ability/Sleep disorders/Fear of strangers/Fear of banyan whiskers). The age of PG first noticed were recorded.

Results: The total 716 autistic cases were included (mean diagnostic age 3.28 years, M/F: 639/77). The referral rates of different groups were as follows: (1) PG (82%); (2) MIP (7.3%); (3) Educational services (6.8%); (4) RFO (2.8%) and Media (1.1%). The referral rates of first noticed symptoms were as follows: LDB (46.4%), Name is ignored (10.2%), DBWOC/asocial/LOW (9.8%), Poor eye contact (4.3%), Stay delay/poor understanding/Can’t teach) (4.3%), MDD (4.1%), SB (3.9%), Hyperactivity (3.1%), ED (2.9%), DLI (2.8%), Regression (2.5%), Others (2.5%), IFE (0.7%), and the No pointing (0.3%). The mean age of PG first noticed was 2.13 years, with the more than one year later than the diagnostic age.

Conclusions: The most common referral method is by PG, while the most common symptom of first noticed is language retardation. Exploiting the potential of medical/educational institutions, or even media referrals, is a concern in the future.