Diagnosis lost: Differences between children who had and who currently have an autism spectrum disorder diagnosis.
Diagnosis lost: Differences between children who had and who currently have an autism spectrum disorder diagnosis.
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DOI：
10.1177/1362361315607724
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发表时间：
2016-10
期刊：
影响因子：
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通讯作者：
Kogan MD
中科院分区：
文献类型：
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作者：
Blumberg SJ;Zablotsky B;Avila RM;Colpe LJ;Pringle BA;Kogan MD
自闭症谱系障碍（ASD）的诊断有时会因误诊、成熟或治疗而改变。本研究采用了一项基于概率的全国调查——诊断和服务途径调查——来比较目前诊断的（n=1420）和以前诊断的（n=187） 6-17岁的儿童，这些儿童基于父母对他们孩子早期发展的担忧的回顾性报告，医生和其他卫生保健提供者对这些担忧的反应，首次做出ASD诊断的提供者类型，以及收到的ASD亚型诊断（如果有的话）。倾向评分匹配用于控制儿童当前功能水平和其他可能与诊断损失相关的当前特征组之间的差异。据估计，曾经被诊断为自闭症谱系障碍的儿童中，约有13%已经失去了诊断，其中74%的父母认为，由于新的信息，诊断发生了变化。先前被诊断出患有自闭症的儿童，其父母早期对语言技能、非语言沟通、学习能力和不寻常的手势或动作的担忧程度较低。他们也不太可能被专家推荐和诊断。以前被诊断出患有阿斯伯格症或自闭症的孩子很少被诊断出患有这种疾病。
Autism spectrum disorder (ASD) diagnoses sometimes change due to misdiagnosis, maturation, or treatment. This study uses a probability-based national survey—the Survey of Pathways to Diagnosis and Services—to compare currently diagnosed (n=1420) and previously diagnosed (n=187) children aged 6–17 years based on retrospective parental reports of early concerns about their children’s development, responses to those concerns by doctors and other health care providers, the type of provider who made the first ASD diagnosis, and the ASD subtype diagnoses received (if any). Propensity score matching was used to control for differences between the groups on children’s current level of functioning and other current characteristics that may have been related to diagnosis loss. Approximately 13% of the children ever diagnosed with ASD were estimated to have lost the diagnosis, and parents of 74% of them believe it was changed due to new information. Previously diagnosed children were less likely to have parents with early concerns about verbal skills, nonverbal communication, learning, and unusual gestures or movements. They were also less likely to have been referred to and diagnosed by a specialist. Previously diagnosed children were less likely to have ever received a diagnosis of Asperger’s disorder or autistic disorder.