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Ip, Angie Wing Sum

University of British Columbia

Neurodevelopmental disabilities and disorders encompass a wide range of conditions that share overlapping symptoms. Even between individuals with the same diagnosis, there is enormous heterogeneity. The use of neurodevelopmental diagnostic labels rarely fully captures individual strengths and support needs. However, service funding access in some jurisdictions, including British Columbia, continue to rely on diagnosis to determine need. This thesis examined the developmental profiles and trajectories of children referred for autism assessment but who did not receive a diagnosis of autism spectrum disorder (ASD-), compared to those who did receive an autism diagnosis (ASD+), children with other neurodevelopmental disabilities, and typically developing children. Children referred for ASD have impairments warranting assessment, but those not diagnosed with ASD often do not get an alternate diagnosis that supports additional funding and intervention in British Columbia’s school system. In this dissertation, I used linked population level data to identify this subgroup of children who may have unidentified and under-supported developmental impairments impacting their school and community life. I first outlined the potential value of a function-based rather than diagnosis-based system for assessing the needs of children with neurodevelopmental disorders (chapter 2). Then, using a retrospective birth cohort, I compared the developmental profiles of children at kindergarten (chapter 3) and the changes in those profiles over time from kindergarten to grade 4 (chapter 4). I also examined these profiles in the context of educational funding, socio-economic status, and co-morbid conditions.I found that the ASD- and ASD+ children shared similar developmental profiles both at kindergarten and grade 4, showing more impairments than the other two groups. There was also a time by group interaction: the ASD- group improved less than the ASD+ group. The ASD- group also received less Ministry of Education of funding for supports than the ASD+ group and were more likely to be identified with ADHD-like symptoms and prescribed stimulant and psychotropic medications. These findings identified evidence for potential inequities in access to services for children with neurodevelopmental disabilities in a diagnosis-based system, and points to a need to move towards more holistic measures of children’s development and support needs.

Text

2025-05-31

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/84813

Population and Public Health

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/