{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T16:04:35Z","timestamp":1775059475826,"version":"3.50.1"},"reference-count":17,"publisher":"Scientific Scholar","license":[{"start":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T00:00:00Z","timestamp":1583193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ruralneuropractice.com"],"crossmark-restriction":true},"short-container-title":["JNRP"],"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p>\n<jats:bold>Objective<\/jats:bold>\u2003There is no systematic report on pathway to care in autism from tertiary care medical centers of India. The present study was aimed to evaluate the pathways to care among parents of children with autism-seeking treatment at a tertiary care medical center.<\/jats:p>\n<jats:p>\n<jats:bold>Methods<\/jats:bold>\u2003Cross-sectional, observational study involving parents of 38 children with autism spectrum disorder diagnosed with INCLEN diagnostic tool. Pathway to care was assessed using World Health Organization Encounter Form.<\/jats:p>\n<jats:p>\n<jats:bold>Statistical Analysis<\/jats:bold>\u2003 IBM Statistical Package for Social Sciences (SPSS) 20.0 was used for analysis; categorical variables were assessed using Chi-square test keeping statistical significance at 0.05%.<\/jats:p>\n<jats:p>\n<jats:bold>Results<\/jats:bold>\u2003A total of 74% parents reported going to a general practitioner and 13% reported going to a child psychiatrist as point of first contact. Among them, 71% parents reported seeking care with a child psychiatrist in a tertiary medical center at the fourth point of contact. Also, 84% parents believed in biomedical explanation of autism. Majority of parents sought for speech therapy and medicines for their child with autism which is in tune with their biomedical explanation. Parents were the first to identify developmental concerns, average age of symptom recognition being 2.2 years. Average age of intervention initiation was 40 months, 8 months prior to diagnosis of autism.<\/jats:p>\n<jats:p>\n<jats:bold>Conclusions<\/jats:bold>\u2003Early symptom recognition and initiation of interventions is encouraging. Despite having a biomedical explanation of autism and ability to recognize developmental concerns, there is a lag of 4 years in diagnosis and reaching a specialized child psychiatry setup. This lag is a cause of concern owing to the impact on access to evidence-based interventions.<\/jats:p>","DOI":"10.1055\/s-0040-1701778","type":"journal-article","created":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T00:00:08Z","timestamp":1583280008000},"page":"164-169","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Symptom Recognition to Diagnosis: Pathway to Care for Autism in a Tertiary Care Medical Centre"],"prefix":"10.25259","volume":"11","author":[{"given":"Suravi","family":"Patra","sequence":"first","affiliation":[{"name":"Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binod Kumar","family":"Patro","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanta Kumar","family":"Padhy","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,3,3]]},"reference":[{"key":"10.1055\/s-0040-1701778\/ref-1","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1146\/annurev-clinpsy-032813-153710","article-title":"From Kanner to DSM-5: autism as an evolving diagnostic concept","volume":"10","author":"Volkmar","year":"2014","journal-title":"Annu Rev Clin Psychol"},{"key":"10.1055\/s-0040-1701778\/ref-2","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/S0140-6736(13)61539-1","article-title":"Autism","volume":"383","author":"Lai","year":"2014","journal-title":"Lancet"},{"issue":"7","key":"10.1055\/s-0040-1701778\/ref-3","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/S0277-9536(03)00330-7","article-title":"From symptom recognition to diagnosis: children with autism in urban India","volume":"58","author":"Daley","year":"2004","journal-title":"Soc Sci Med"},{"key":"10.1055\/s-0040-1701778\/ref-4","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ajp.2016.07.021","article-title":"Lost time-Need for more awareness in early intervention of autism spectrum disorder","volume":"25","author":"Srinath","year":"2017","journal-title":"Asian J Psychiatr"},{"issue":"2","key":"10.1055\/s-0040-1701778\/ref-5","doi-asserted-by":"crossref","first-page":"97","DOI":"10.4103\/0019-5545.82530","article-title":"Pathway of psychiatric care","volume":"53","author":"Trivedi","year":"2011","journal-title":"Indian J Psychiatry"},{"issue":"2","key":"10.1055\/s-0040-1701778\/ref-6","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/aur.1978","article-title":"The feasibility and effectiveness of PASS Plus, a lay health worker delivered comprehensive intervention for autism spectrum disorders: pilot RCT in a rural low and middle income country setting","volume":"12","author":"Divan","year":"2019","journal-title":"Autism Res"},{"issue":"3","key":"10.1055\/s-0040-1701778\/ref-7","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1017\/S003329170002239X","article-title":"The pathways to psychiatric care: a cross-cultural study","volume":"21","author":"Gater","year":"1991","journal-title":"Psychol Med"},{"issue":"5","key":"10.1055\/s-0040-1701778\/ref-8","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s13312-014-0417-9","article-title":"INCLEN Study Group. INCLEN diagnostic tool for autism spectrum disorder (INDT-ASD): development and validation","volume":"51","author":"Juneja","year":"2014","journal-title":"Indian Pediatr"},{"issue":"2","key":"10.1055\/s-0040-1701778\/ref-10","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s12519-010-0029-y","article-title":"Diagnostic accuracy, reliability and validity of childhood autism rating scale in India","volume":"6","author":"Russell","year":"2010","journal-title":"World J Pediatr"},{"key":"10.1055\/s-0040-1701778\/ref-11","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.eurpsy.2016.10.007","article-title":"Examining cross-cultural differences in autism spectrum disorder: a multinational comparison from Greece, Italy, Japan, Poland, and the United States","volume":"42","author":"Matson","year":"2017","journal-title":"Eur Psychiatry"},{"key":"10.1055\/s-0040-1701778\/ref-12","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.jpeds.2016.12.030","article-title":"The necessity of early intervention in autism","volume":"184","author":"Lazaratou","year":"2017","journal-title":"J Pediatr"},{"issue":"1","key":"10.1055\/s-0040-1701778\/ref-13","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.rasd.2010.03.005","article-title":"Early concerns of mothers of children later diagnosed with autism: Implications for early identification","volume":"5","author":"Kishore","year":"2011","journal-title":"Res Autism Spectr Disord"},{"issue":"1","key":"10.1055\/s-0040-1701778\/ref-14","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1007\/s12098-016-2261-5","article-title":"Legal provisions, educational services and health care across the lifespan for autism spectrum disorders in India","volume":"84","author":"Barua","year":"2017","journal-title":"Indian J Pediatr"},{"issue":"1","key":"10.1055\/s-0040-1701778\/ref-15","doi-asserted-by":"crossref","first-page":"30","DOI":"10.3109\/17549507.2013.866271","article-title":"The status of early identification and early intervention in autism spectrum disorders in lower- and middle-income countries","volume":"16","author":"Samms-Vaughan","year":"2014","journal-title":"Int J Speech Lang Pathol"},{"issue":"1","key":"10.1055\/s-0040-1701778\/ref-16","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s11013-015-9440-0","article-title":"\u201cMaybe at birth there was an injury\u201d: drivers and implications of caretaker explanatory models of autistic characteristics in Kerala, India","volume":"39","author":"Sarrett","year":"2015","journal-title":"Cult Med Psychiatry"},{"issue":"1","key":"10.1055\/s-0040-1701778\/ref-17","first-page":"37","article-title":"Parental care-seeking pathway and challenges for autistic spectrum disorders children: A mixed method study from Bhubaneswar, Odisha","volume":"61","author":"Mahapatra","year":"2019","journal-title":"Indian J Psychiatry"},{"issue":"1","key":"10.1055\/s-0040-1701778\/ref-18","doi-asserted-by":"crossref","first-page":"27","DOI":"10.4103\/0253-7176.127243","article-title":"A comparative study of pathways to care for children with specific learning disability and mental retardation","volume":"36","author":"Chakraborty","year":"2014","journal-title":"Indian J Psychol Med"}],"container-title":["Journal of Neurosciences in Rural Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ruralneuropractice.com\/symptom-recognition-to-diagnosis-pathway-to-care-for-autism-in-a-tertiary-care-medical-centre\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ruralneuropractice.com\/symptom-recognition-to-diagnosis-pathway-to-care-for-autism-in-a-tertiary-care-medical-centre\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T04:41:38Z","timestamp":1691210498000},"score":1,"resource":{"primary":{"URL":"https:\/\/ruralneuropractice.com\/symptom-recognition-to-diagnosis-pathway-to-care-for-autism-in-a-tertiary-care-medical-centre\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,3]]},"references-count":17,"alternative-id":["10.1055\/s-0040-1701778"],"URL":"https:\/\/doi.org\/10.1055\/s-0040-1701778","relation":{},"ISSN":["0976-3147"],"issn-type":[{"value":"0976-3147","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,3]]},"article-number":"164"}}