Table 3.

Parents’ reported ASD diagnosis circumstances

Code label	Code definition	Frequency**
Little knowledge	Parents reported no developmental warning signs in their child, having no relatives with ASD, or little or no knowledge of ASD	1
Unclear path	Parents reported a non-linear or unclear path to receiving a diagnosis	4
Experience with ASD diagnosis	Parents reported having already experienced the referral process with an older child diagnosed with ASD	1
Mexico diagnosis*	Parents reported receiving a diagnosis in Mexico	6
Services before diagnosis*	Parent reported that child received ASD intervention treatment before receiving a formal diagnosis	11
Missed early diagnosis*	Parents reported that the child could have received a formal diagnosis but did not due to a doctor’s missed diagnosis, or a parent/grandparent not documenting the child’s developmental milestones	8
Two diagnoses*	Parents reported receiving a formal diagnosis from one health care provider and then another formal diagnosis from another health care provider	8
Developmental-behavioral pediatrician*	Parents reported developing a positive rapport with a particular Developmental- Behavioral Pediatrician during diagnosis	8
Little professional support*	Parents reported receiving little or no support during the diagnostic process	6
Rural county*	Parent reported living in a rural area with limited access to health and education services	14
Efficient, positive diagnostic pathway*	Parents reported a positive experience of the referral process	3

^*Participants featured in the narrative case study analysis. Circumstance for Elena: Positive case. Circumstances for Emilia: Mexico diagnosis, Two diagnoses. Circumstances for Marcela: Services before diagnosis, Rural county. Circumstances for Graciela: Missed early diagnosis, Developmental Behavioral Pediatrician, Little professional support. **Participants’ referral circumstances were double coded if necessary