National autism prevalence trends from United States special education data
National autism prevalence trends from United States special education data
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DOI：
10.1542/peds.2004-1958
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发表时间：
2005-03-01
期刊：
影响因子：
8
通讯作者：
Gurney, JG
中科院分区：
文献类型：
--
作者：
Newschaffer, CJ;Falb, MD;Gurney, JG
目的。自闭症患病率大幅上升的报道一直是临床医生、教育工作者和家长极为关注的问题。本分析利用一个全国性数据源，比较美国学龄儿童连续出生队列中自闭症与其他残疾的患病率。
设计。根据行政数据构建的出生队列曲线比较。
环境与人群。1992年至2001年间6至17岁的美国儿童。
主要观察指标。由州教育部门记录并报告给美国教育部特殊教育项目办公室的自闭症、智力障碍、言语和语言障碍、创伤性脑损伤或其他健康障碍的残疾类别分类。
结果。1975年至1995年每年出生队列的残疾类别分类患病率通过使用美国人口普查局估计的分母进行计算。对于自闭症分类，存在出生队列差异，连续（较年轻的）队列中的患病率上升。1987年至1992年出生的年度队列患病率上升幅度最大。对于1992年以后出生的队列，患病率逐年上升，但上升幅度似乎没有那么大，尽管队列内可用的数据点较少。未观察到智力障碍或言语/语言障碍类别相应减少。其他健康障碍（包括患有注意缺陷/多动障碍的儿童的类别）的曲线也显示出明显的队列差异。
结论。队列曲线表明自闭症患病率随着时间的推移一直在上升，较年轻出生队列中患病率较高证明了这一点。近年来队列曲线垂直间距的缩小可能标志着自闭症患病率上升速度放缓。
Objective. Reports of large increases in autism prevalence have been a matter of great concern to clinicians, educators, and parents. This analysis uses a national data source to compare the prevalence of autism with that of other disabilities among successive birth cohorts of US school-aged children.Design. Comparison of birth cohort curves constructed from administrative data.Setting and Population. US children 6 to 17 years of age between 1992 and 2001.Main Outcome Measures. A disability category classification of autism, mental retardation, speech and language impairment, traumatic brain injury, or other health impairment, as documented by state departments of education and reported to the Office of Special Education Programs, US Department of Education.Results. Prevalences of disability category classifications for annual birth cohorts from 1975 to 1995 were calculated by using denominators from US Census Bureau estimates. For the autism classification, there were birth cohort differences, with prevalences increasing among successive (younger) cohorts. The increases were greatest for annual cohorts born from 1987 to 1992. For cohorts born after 1992, the prevalence increased with each successive year but the increases did not appear to be as great, although there were fewer data points available within cohorts. No concomitant decreases in categories of mental retardation or speech/language impairment were seen. Curves for other health impairments, the category including children with attention-deficit/hyperactivity disorder, also showed strong cohort differences.Conclusions. Cohort curves suggest that autism prevalence has been increasing with time, as evidenced by higher prevalences among younger birth cohorts. The narrowing in vertical separation of the cohort curves in recent years may mark a slowing in the autism prevalence increase.