Prevalence of Autism Spectrum Disorder in a large Italian catchment area: a school-based population study within the ASDEU project.
Prevalence of Autism Spectrum Disorder in a large Italian catchment area: a school-based population study within the ASDEU project.
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DOI：
10.1017/s2045796018000483
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发表时间：
2018-09-06
影响因子：
8.1
通讯作者：
Muratori F
中科院分区：
文献类型：
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作者：
Narzisi A;Posada M;Barbieri F;Chericoni N;Ciuffolini D;Pinzino M;Romano R;Scattoni ML;Tancredi R;Calderoni S;Muratori F
本研究旨在利用欧盟自闭症谱系障碍(ASDEU)项目的策略，评估意大利比萨省学龄儿童中自闭症谱系障碍(ASD)的患病率。采用多阶段方法在意大利比萨的7-9岁儿童的社区样本(N=10 138)中确定病例。首先，从当地卫生当局收集了持有残疾证书的儿童的数量，ASDEU小组核实了ASD的诊断。第二，参加研究的教师填写教师提名表以确定自闭症高危儿童，社交问卷由被自闭症高危儿童确定为阳性的儿童的家长填写；对自闭症诊断观察表第二版的儿童进行综合评估，包括自闭症诊断观察表第二版⩾9。共有81名具有残疾证书的儿童也患有自闭症(患病率：0.79%，即1/126)。具体地说，66名儿童(57名男性和9名女性；62%的智力残疾-ID-)被证明患有自闭症，而在那些被证明患有另一种神经发育障碍的儿童中，另有15名儿童(11名男性和4名女性；80%的ID)被确认为患有自闭症。考虑到4417人(属于同意参加TN/SCQ程序的学校的儿童)，并仅使用经证明患有自闭症的儿童数量，患病率(4417人中有38人)为0.86%，即每116人中有1人。就这一人群而言，如果我们考虑在没有既往诊断的儿童中发现的8例新病例(6名男性和2名女性；没有受试者有身份证)，患病率上升到1%；如果使用概率估计，患病率上升到1.15%，即每87人中就有一人。这是迄今为止在意大利进行的第一项基于人群的自闭症患病率研究，其结果表明，7-9岁儿童自闭症的患病率约为每87人中就有一人患有自闭症。这一发现可能有助于地区、国家和国际卫生规划者改善公共医疗体系中针对自闭症儿童及其家庭的自闭症政策。
This study aims to estimate Autism Spectrum Disorders (ASD) prevalence in school-aged children in the province of Pisa (Italy) using the strategy of the ASD in the European Union (ASDEU) project. A multistage approach was used to identify cases in a community sample (N = 10 138) of 7–9-year-old children attending elementary schools in Pisa – Italy. First, the number of children with a disability certificate was collected from the Local Health Authority and an ASD diagnosis was verified by the ASDEU team. Second, a Teacher Nomination form (TN) to identify children at risk for ASD was filled in by teachers who joined the study and the Social Communication Questionnaire (SCQ) was filled in by the parents of children identified as positive by the TN; a comprehensive assessment, which included the Autism Diagnostic Observation Schedule-Second Edition, was performed for children with positive TN and SCQ⩾9. A total of 81 children who had a disability certificate also had ASD (prevalence: 0.79%, i.e. 1/126). Specifically, 66 children (57 males and nine females; 62% with intellectual disability –ID-) were certified with ASD, whereas another 15 (11 males and four females; 80% with ID) were recognised as having ASD among those certified with another neurodevelopmental disorder. Considering the population of 4417 (children belonging to schools which agreed to participate in the TN/SCQ procedure) and using only the number of children certified with ASD, the prevalence (38 in 4417) was 0.86%, i.e. one in 116. As far as this population is concerned, the prevalence rises to 1% if we consider the eight new cases (six males and two females; no subject had ID) identified among children with no pre-existing diagnoses and to 1.15%, i.e., one in 87, if probabilistic estimation is used. This is the first population-based ASD prevalence study conducted in Italy so far and its results indicate a prevalence of ASD in children aged 7–9 years of about one in 87. This finding may help regional, national and international health planners to improve ASD policies for ASD children and their families in the public healthcare system.