Standardized Screening Facilitates Timely Diagnosis of Autism Spectrum Disorders in a Diverse Sample of Low-Risk Toddlers
Standardized Screening Facilitates Timely Diagnosis of Autism Spectrum Disorders in a Diverse Sample of Low-Risk Toddlers
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DOI：
10.1097/dbp.0000000000000014
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发表时间：
2014-02-01
影响因子：
2.4
通讯作者：
Robins, Diana L.
中科院分区：
文献类型：
--
作者：
Herlihy, Lauren E.;Brooks, Bianca;Robins, Diana L.
目的：自闭症谱系障碍（ASD）的常规标准化筛查被认为可以减少首次诊断年龄的已知种族/民族和社会经济地位（SES）差异。本研究探讨了在ASD评估时，幼儿年龄和发育指标表现的人口统计学差异。方法：幼儿（16-39个月的评价），谁筛选的风险为发展迟缓的自闭症幼儿改良清单（M-CHAT）或M-CHAT-修订（M-CHAT-R）和后续采访参加了诊断评估。其中，44.7%为少数民族，53.5%为非少数民族。儿童种族/民族，母亲受教育年限（MEd）和家庭年收入（YI）由父母报告。结果如下：MEd或YI和评估年龄和适应性沟通，社会化和运动评分之间存在小但显着的相关性。控制MEd和YI，少数种族/民族群体不能预测儿童在大多数措施上的表现，也不能预测ASD诊断的可能性。在评估和接受语言技能的年龄差异是小的影响。结论：社会经济地位和少数民族地位对幼儿评估年龄和父母报告的适应技能有显着但很小的影响，但这些并不能预测ASD的诊断。这些影响的小幅度表明，在幼儿中进行ASD的常规标准化筛查和及时获得诊断评估可以减少诊断时年龄的差异，并可能减少ASD和其他发育迟缓服务的种族/民族差异。
Objective: Routine, standardized screening for autism spectrum disorder (ASD) has been hypothesized to reduce known racial/ethnic and socioeconomic status (SES) disparities in age of first diagnosis. This study explored demographic differences in toddlers' age and performance on developmental measures at the time of ASD assessment. Method: Toddlers (16-39 months at evaluation) who screened at-risk for developmental delay on the Modified Checklist for Autism in Toddlers (M-CHAT) or M-CHAT-Revised (M-CHAT-R) and follow-up interview participated in a diagnostic assessment. Of these, 44.7% were racial/ethnic minorities and 53.5% were non-minorities. Child race/ethnicity, years of maternal education (MEd), and household yearly income (YI) were parent-reported. Results: Small but significant correlations were observed between MEd or YI and evaluation age and adaptive communication, socialization, and motor scores. Controlling for MEd and YI, minority racial/ethnic group did not predict child's performance on most measures and did not predict likelihood of ASD diagnosis. Differences in age at evaluation and receptive language skills were small effects. Conclusion: Significant but small effects emerged for SES and minority status on toddlers' age at evaluation and parent-reported adaptive skills, but these did not predict ASD diagnosis. The small magnitude of these effects suggests that routine, standardized screening for ASD in toddlers and timely access to diagnostic evaluation can reduce disparities in age at diagnosis and possibly reduce racial/ethnic disparities in access to services for ASD and other developmental delays.