Utilization of the Maternal and Child Health Handbook in Early Identification of Autism Spectrum Disorder and Other Neurodevelopmental Disorders
Utilization of the Maternal and Child Health Handbook in Early Identification of Autism Spectrum Disorder and Other Neurodevelopmental Disorders
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DOI：
10.1002/aur.2442
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发表时间：
2020-11-29
期刊：
影响因子：
4.7
通讯作者：
Nakamura, Kazuhiko
中科院分区：
文献类型：
--
作者：
Hirota, Tomoya;Bishop, Somer;Nakamura, Kazuhiko
对于那些被诊断为神经发育障碍（ndd），包括自闭症谱系障碍（ASD）的儿童的看护人，关于前瞻性发展里程碑的信息相对较少。目前的研究调查了日本弘崎市参加ndd综合面对面评估的5岁儿童的早期技能获得率。发育里程碑数据摘自妇幼保健手册（MCHH），这是一本作为全民保健的一部分分发给所有孕妇的小册子。720名儿童接受了评估，其中455名接受了一种或多种NDD诊断（ASD: n = 124，非ASD NDD: n = 331）。将发展技能分为四个领域（运动、社会互动、沟通、自助），并计算三个不同年龄段（12个月、24个月和36个月）的每个领域潜在延迟的累积数量。即使在12个月大的时候，与未接受NDD诊断的儿童相比，患有ASD/NDD的儿童在各领域表现出更多的潜在延迟。然而，自闭症患者和非自闭症ndd患者的差异直到24个月时才显现出来，直到36个月时才显现出来。这些发现提供了对可用于筛查ASD和其他ndd的特定行为的见解。此外，目前的研究表明，母婴健康中心作为一种宽带筛查工具的潜在效用，可以教育父母在绘制孩子的早期发育图表时应该寻找什么。本研究前瞻性地研究了720名来自日本弘崎市的75岁儿童的发展里程碑，这些儿童的家庭记录作为全民医疗保健的一部分。所有儿童都参加了一项综合评估，以确定他们是否符合神经发育障碍（NDD）的标准，包括自闭症谱系障碍（ASD）。与未被诊断为NDD的儿童相比，患有NDD的儿童在发育领域表现出更高的潜在延迟率，包括社会互动、沟通和自助。对于一些孩子来说，这些延迟在12个月前就很明显了。诊断组之间的差异在24个月和36个月时变得更加明显，远远早于诊断的平均年龄。这表明，以家庭为基础的记录可以成为一种有用的工具，教育照顾者在记录孩子的早期发育时应该注意什么，并有助于早期筛查工作。
There is relatively little information about prospectively reported developmental milestones from caregivers of children who go on to be diagnosed with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD). The current study examined rates of early skill attainment in 5-year-old children who participated in a comprehensive in-person assessment for NDDs in Hirosaki in Japan. Developmental milestone data were extracted from their Maternal and Child Health Handbook (MCHH), a booklet distributed to all pregnant women as part of universal health care. Seven hundred and twenty children underwent the assessment, among whom 455 received one or more NDD diagnoses (ASD: n = 124, non-ASD NDD: n = 331). Developmental skills were organized into four domains (motor, social interaction, communication, self-help), and the cumulative number of potential delays in each domain was calculated for each participant within three different age ranges (by 12 months, by 24 months, and by 36 months). Even by age 12 months, children with ASD/NDDs showed more potential delays across domains compared to those who received no NDD diagnosis. However, differences between those with ASD and those with non-ASD NDDs were not apparent until 24 months for social interaction and communication, and 36 months for self-help. These findings provide insights into specific behaviors that could be used to screen for ASD and other NDDs. In addition, the present study indicates the potential utility of the MCHH as a broadband screening tool to educate parents about what to look for in charting their child's early development.Lay Summary The present study examined prospectively charted developmental milestones from home-based records used as part of universal health care in 720 5-year-old children from Hirosaki, Japan. All children participated in a comprehensive evaluation to determine if they met criteria for a neurodevelopmental disorder (NDD), including autism spectrum disorder (ASD). Compared to those who received no NDD diagnosis, children with NDDs exhibited higher rates of potential delays across developmental domains, including social interaction, communication, and self-help. For some children, these delays were apparent before the age of 12 months. Differences between diagnostic groups became even more pronounced by 24 and 36 months, well before the average age of diagnosis. This suggests that home-based records can be useful tools to educate caregivers about what to look for in charting their child's early development and could assist with early screening efforts.