Age of diagnosis for autism: individual and community factors across 10 birth cohorts.
Age of diagnosis for autism: individual and community factors across 10 birth cohorts.
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DOI：
10.1136/jech.2009.104588
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发表时间：
2011-06
影响因子：
6.3
通讯作者：
Bearman PS
中科院分区：
文献类型：
--
作者：
Fountain C;King MD;Bearman PS
在1992至2001年间，自闭症的发病率急剧上升，而儿童首次确诊的年龄却有所下降。在此期间，自闭症病例的大小和组成发生了变化，但关于与诊断时机相关的因素是否也发生了变化，我们知之甚少。使用多水平分析策略，对加州儿童的10个出生队列中与诊断年龄相关的个人和社区水平的因素进行了建模。对1992年至2001年在加州出生并登记在加州发展服务部(DDS)的17 185名患有自闭症的儿童的出生和管理记录进行了分析。从出生和DDS记录中提取了有关病例、其父母和居住地的信息。居住的邮政编码与人口普查数据相匹配，以创建社区一级的衡量标准。估计了每个出生队列的多水平线性模型，并考虑了性别、种族、父母特征、贫困状况、出生顺序和症状表现的个体水平效应。在社区一级，衡量教育和经济构成、当地自闭症患病率和儿童精神病学家的人数也包括在内。父母受过高等教育的孩子被诊断得更早，这种影响随着时间的推移而加强。高社会经济地位(SES)儿童和低社会经济地位(SES)儿童之间的确诊年龄差距一直存在，这种差距已经缩小，但并未随着时间的推移而消失。有必要对所有儿童，特别是那些SES低的儿童进行儿童早期自闭症的常规筛查，以消除早期干预中的差异。
The incidence of autism rose dramatically between 1992 and 2001, while the age at which children were first diagnosed declined. During this period the size and composition of the autism caseload has changed, but little is known about whether the factors associated with the timing of diagnosis may also have shifted. Using a multilevel analysis strategy, the individual and community-level factors associated with age of diagnosis were modelled across 10 birth cohorts of California children. Linked birth and administrative records on 17 185 children with diagnoses of autistic disorder born in California between 1992 and 2001 and enrolled with the California Department of Developmental Services (DDS) were analysed. Information on cases, their parents and their residential location were extracted from birth and DDS records. Zip codes of residence were matched to census data to create community-level measures. Multilevel linear models were estimated for each birth cohort, with individual-level effects for sex, race, parental characteristics, poverty status, birth order and symptom expression. At the community level measures of educational and economic composition, local autism prevalence and the presence of a child psychiatrist were included. Children with highly educated parents are diagnosed earlier, and this effect has strengthened over time. There is a persistent gap in the age of diagnosis between high and low socioeconomic status (SES) children that has shrunk but not disappeared over time. Routine screening for autism in early childhood for all children, particularly those of low SES, is necessary to eliminate disparities in early intervention.
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DOI：
10.1016/s0270-4684(85)80005-7
发表时间：
1985-01-01
期刊：
ANALYSIS AND INTERVENTION IN DEVELOPMENTAL DISABILITIES
影响因子：
--
作者：
FENSKE, EC;ZALENSKI, S;MCCLANNAHAN, LE
通讯作者：
MCCLANNAHAN, LE
影响因子：
3.9
作者：
Croen, LA;Grether, JK;Selvin, S
通讯作者：
Selvin, S
影响因子：
3.9
作者：
Rogers, SJ
通讯作者：
Rogers, SJ
影响因子：
--
作者：
Landa, Rebecca J.;Holman, Katherine C.;Garrett-Mayer, Elizabeth
通讯作者：
Garrett-Mayer, Elizabeth
DOI：
10.1097/00004703-200604002-00005
发表时间：
2006-04-01
影响因子：
2.4
作者：
Wiggins, Lisa D.;Baio, Jon;Rice, Catherine
通讯作者：
Rice, Catherine