Sex Differences in Age of Diagnosis and First Concern among Children with Autism Spectrum Disorder
Sex Differences in Age of Diagnosis and First Concern among Children with Autism Spectrum Disorder
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DOI：
10.1080/15374416.2020.1823850
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发表时间：
2020-11-01
影响因子：
4.2
通讯作者：
Stevenson, Ryan A.
中科院分区：
文献类型：
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作者：
McDonnell, Christina G.;DeLucia, Elizabeth A.;Stevenson, Ryan A.
自闭症谱系障碍（ASD）的早期识别是一个重要的医疗优先事项。女孩可能有晚期诊断的风险，尽管关于性别和其他因素与ASD识别的关系研究是模棱两可的。目前调查的目的是（1）确定儿童性别、认知能力和人口统计学因素与首次关注年龄（AOC）和诊断年龄（AOD）的关系，（2）评估AOC/AOD随时间的趋势，（3）考虑性别对AOC/AOD的主要影响是否受认知能力或时间的调节。（N = 365; 20%为女性; 85.6%为白色）ASD患者通过安大略省神经发育障碍（POND）网络参与。研究记录包括AOD，诊断的日期/时间（1996年至2017年），第一次父母关心的年龄，人口统计学，和标准化的认知测试结果（24.7%的儿童的智商得分低于标准得分70）。女孩AOC没有差异，但有较晚的AOD比男孩。较高的语言智商与后期AOD的女孩比男孩更强烈。关于与时间有关的变化，平均AOC和AOD增加整个研究期间，更强烈的girls.ConclusionsResults支持，性别是一个关键因素，潜在的ASD识别延迟，并强调迫切需要改善女孩的诊断实践。改进诊断过程的局限性和影响进行了讨论。
ObjectiveEarly identification of autism spectrum disorder (ASD) is an essential healthcare priority. Girls may be at risk for late diagnosis, although research is equivocal regarding how sex and other factors relate to ASD identification. The goals of the current investigation were to (1) identify how child sex, cognitive abilities, and demographic factors relate to age of first concern (AOC) and age of diagnosis (AOD), (2) evaluate trends in AOC/AOD over time, and (3) consider whether main effects of sex on AOC/AOD are moderated by cognitive abilities or time.MethodChildren (N = 365; 20% female; 85.6% identified as White) with ASD participated through the Province of Ontario Neurodevelopmental Disorders (POND) Network. Study records included AOD, date/timing of diagnosis (between 1996 and 2017), age of first parent concern, demographics, and standardized cognitive testing results (24.7% of children had IQ scores below standard scores of 70).ResultsAverage AOC occurred before 2 years of age whereas average AOD occurred after 5 years of age. Girls did not differ on AOC but had a later AOD than boys. Higher verbal IQ was associated with later AOD more strongly in girls than boys. Regarding time-related changes, average AOC and AOD increased across the study period, more strongly for girls.ConclusionsResults support that sex is a key factor underlying delays in ASD identification and highlight the urgent need to improve diagnostic practices among girls. Limitations and implications for improving the diagnostic process are discussed.