Age-related Patterns of Presenting Symptoms in Children with Autism Spectrum Disorder: A Retrospective Chart Review from South India

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Introduction: Autism spectrum disorder (ASD), a highly prevalent neurodevelopmental disorder in children, is associated with social communication and interaction issues. Although various studies describe the clinical profiles of children with ASD, limited data exist on age-related symptom patterns within the Indian population. This study aimed to analyze the age-wise presentation of developmental, behavioral, and social challenges among children diagnosed with ASD presenting to a tertiary care setting. Methods: The study was a retrospective analysis conducted at a tertiary care hospital in Bengaluru, India, from July to November 2024. The study population comprised 578 individuals with ASD, who were divided into three age groups: 0–4 years, 5–8 years, and 9–12 years. Presenting symptoms described by parents during the child’s first assessment at our center were noted. Descriptive analysis, chi-square tests, and Fisher’s exact tests were employed to determine the significant associations between age groups and symptoms. Results: Of the 578 children, 463 (80.01%) were males. Children under 4 years most frequently presented with speech delay, poor eye contact, poor response to name, and sensory processing difficulties. Those aged 5–8 years more commonly exhibited repetitive behaviors, hyperactivity, and aggression, whereas children aged 9–12 years showed prominent academic and social adjustment difficulties. Conclusions: Distinct age-related symptom patterns were observed among children with ASD. Early developmental concerns predominated in younger children, while behavioral challenges and academic difficulties became more prominent in older age groups. Understanding these evolving symptom profiles may support earlier recognition, guide age-appropriate interventions, and inform clinical practice in the Indian context.