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Timing of Parents’ Concerns Related to Autism Spectrum Disorder and its Diagnosis: A Mediation Analysis

Published online by Cambridge University Press:  27 November 2018

Dunia Garrido*
Universidad de Granada (Spain)
Gloria Carballo
Universidad de Granada (Spain)
Jonet Artis
University of North Carolina at Chapel Hill (USA)
Rocio Garcia-Retamero
Universidad de Granada (Spain)
*Correspondence concerning this article should be addressed to Dunia Garrido. Centro de Investigación Mente, Cerebro y Comportamiento de la Universidad de Granada. Campus de Cartuja, S/N. 18071 Granada (Spain). Telephone: +34–691633482. E-mail:


Parents are the first to indicate concerns about their child’s development in up to 80% of children with autism spectrum disorder (ASD). They often notice symptoms related to ASD around the first two years, but the average age of diagnosis is 3.5 years old. This study examined the relationships between parents’ early concerns and the time lag between suspicion and diagnosis. Forty-eight Spanish-speaking families were enrolled in this study. Parents were asked about early signs that made them think that their child could possibly have ASD. Mediation analyses showed that the child’s age at suspicion mediated between sibling status and the time lag between suspicion and a formal diagnosis (β = –.53, p < .01). Having another child with typical development accelerated parents’ detection of ASD signs (β = –.62, p < .001). The number of social-communication concerns that parents detected mediated this relationship (β = –.28, p < .01). Parents who reported more social-communication concerns perceived these signs earlier, but have to cope with a longer time lag until diagnosis than those who reported more concerns related to restrictive and repetitive behaviors and interests, or other developmental concerns. Moreover, this relationship between concerns of ASD and the diagnoses was explained by the child’s age. Training pediatricians on how to respond to parent questions and concerns could reduce the time lag between parents’ concerns and diagnosis of ASD.

Research Article
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2018 

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Harding Center for Risk Literacy, Max Planck Institute for Human Development, Berlin (Germany)

We are grateful to the families who participated in this study for their continued support of our research. This research was supported by a grant from the Spanish Ministerio de Economía y Competitividad, PSI2014–51842–R; and the Spanish Ministerio de Ciencia, Innovación y Universidades, FPU14/00723.

How to cite this article:

Garrido, D., Carballo, G., Artis, J., & Garcia-Retamero, R. (2018). Timing of parents’ concerns related to Autism Spectrum Disorder and its diagnosis: A mediation analysis. The Spanish Journal of Psychology, 21. e59. Doi:10.1017/sjp.2018.64


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