The diagnostic odyssey of autism: a cross-sectional study of 3 age cohorts of children from the 2016-2018 National Survey of Children's Health.
The diagnostic odyssey of autism: a cross-sectional study of 3 age cohorts of children from the 2016-2018 National Survey of Children's Health.
复制标题
DOI：
10.1186/s13034-021-00409-y
复制
发表时间：
2021-10-10
影响因子：
5.6
通讯作者：
Slopen N
中科院分区：
文献类型：
--
作者：
Hanley A;Nguyen QC;Badawi DG;Chen J;Ma T;Slopen N
近年来，自闭症患病率迅速上升，然而，对首次确诊和干预年龄的全国代表性估计已经过时。目的：(1)估计自闭症儿童接受首次诊断、干预计划和发展服务的年龄；(2)通过出生队列和社会人口学特征来评估事件发生时的年龄差异。使用2016-2018年全国儿童健康调查（NSCH）的横断面数据，我们通过线性回归研究了2303名年龄在2 - 17岁的儿童样本之间的关联，这些儿童曾经被诊断为自闭症，并且(1)曾经接受过特殊教育或早期干预计划，或(2)曾经接受过满足发展需求的特殊服务。暴露包括年龄队列、儿童、家庭和医疗保健提供者特征。研究样本中的大多数儿童（n = 2303）是6岁以上的男性，非西班牙裔白人，患有轻度/中度自闭症。初诊平均年龄为4.56岁（SE = 0.13）；第一方案为4.43 (SE = 0.11)；首次服务为4.10 （SE = 0.11）。在调整暴露和调查年份后，中期儿童队列在首次干预时比早期儿童大18个月（β = 1.49, 95% CI, 1.18-1.81），青少年在首次诊断时比早期儿童大38个月（β = 3.16, 95% CI, 2.72-3.60）。在事件中观察到的年龄更小：西班牙裔/拉丁裔儿童与白人儿童相比，中度或重度症状儿童与轻度症状儿童相比，从专家那里接受诊断的儿童与心理学家或精神科医生的儿童相比。自闭症儿童接受第一次诊断、干预计划和发展服务的年龄比过去要小。未来的研究需要在早期识别和干预中确定这些改进的机制，以加速进一步的进展。在线版本包含补充资料，可在10.1186/s13034-021-00409-y获得。
Autism prevalence has increased rapidly in recent years, however, nationally representative estimates on the ages of first identification and intervention are out of date. Objectives: (1) To estimate the ages at which children with autism receive their first diagnosis, intervention plan, and developmental services; and (2) To evaluate differences in ages at events by birth cohort and sociodemographic characteristics. Using cross-sectional data from the 2016–2018 National Survey of Children’s Health (NSCH), we examined associations via linear regression among a sample of 2303 children aged 2–17 years old, who had ever been diagnosed with autism and either (1) ever had a plan for special education or early intervention, or (2) ever received special services to meet developmental needs. Exposures included age cohort, child, household and healthcare provider characteristics. Most children in the study sample (n = 2303) were over age 6 years, male, of non-Hispanic white race/ethnicity and had mild/moderate autism. Mean ages (years) at first diagnosis was 4.56 (SE = 0.13); first plan was 4.43 (SE = 0.11); and first services was 4.10 (SE = 0.11). After adjustment for exposures and survey year, the middle childhood cohort was 18 months older at first intervention (β = 1.49, 95% CI, 1.18–1.81), and adolescents were 38 months older at first diagnosis (β = 3.16, 95% CI, 2.72–3.60) compared to those in early childhood. Younger ages at events were observed among: Hispanic/Latinx as compared to white children, those with moderate or severe symptoms as compared to mild symptoms, and children who received their diagnosis from a specialist as compared to psychologists or psychiatrists. Children with autism receive their first diagnosis, intervention plans and developmental services at younger ages than they had in the past. Future research is needed to identify the mechanisms for these improvements in early identification and intervention to accelerate additional progress. The online version contains supplementary material available at 10.1186/s13034-021-00409-y.
登录
查看更多内容
影响因子：
8
作者：
Zablotsky, Benjamin;Black, Lindsey, I;Boyle, Coleen A.
通讯作者：
Boyle, Coleen A.
影响因子：
--
作者：
Rosenberg, Rebecca E;Landa, Rebecca;Law, Paul A
通讯作者：
Law, Paul A
DOI：
10.15585/mmwr.ss6706a1
发表时间：
2018-04-27
期刊：
Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002)
影响因子：
--
作者：
Baio J;Wiggins L;Christensen DL;Maenner MJ;Daniels J;Warren Z;Kurzius-Spencer M;Zahorodny W;Robinson Rosenberg C;White T;Durkin MS;Imm P;Nikolaou L;Yeargin-Allsopp M;Lee LC;Harrington R;Lopez M;Fitzgerald RT;Hewitt A;Pettygrove S;Constantino JN;Vehorn A;Shenouda J;Hall-Lande J;Van Naarden Braun K;Dowling NF
通讯作者：
Dowling NF
影响因子：
8
作者：
Lappé M;Lau L;Dudovitz RN;Nelson BB;Karp EA;Kuo AA
通讯作者：
Kuo AA
影响因子：
3.9
作者：
Kleinman, Jamie M.;Ventola, Pamela E.;Fein, Deborah
通讯作者：
Fein, Deborah