Young children who screen positive for autism: Stability, change and "comorbidity" over two years
Young children who screen positive for autism: Stability, change and "comorbidity" over two years
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DOI：
10.1016/j.ridd.2016.10.004
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发表时间：
2018-01-01
影响因子：
3.1
通讯作者：
Miniscalco, Carmela
中科院分区：
文献类型：
--
作者：
Kantzer, Anne-Katrin;Fernell, Elisabeth;Miniscalco, Carmela
背景资料：自闭症谱系障碍（ASD）是一种发育障碍，具有多种临床表型，并与其他神经发育状况同时发生。症状可能会随着时间的推移而改变。目的：本研究的目的是前瞻性地跟踪96名儿童，最初评估为疑似ASD，平均年龄为2.9岁。方法和程序：所有儿童都在一般人群儿童健康筛查项目中被确定患有自闭症症状，并被转诊到哥德堡的儿童神经精神病学诊所，瑞典，由多专业团队在时间1（T1）进行进一步评估。这项评估包括广泛的神经发育检查，结构化访谈，认知测试和儿童适应性和整体功能的评估。两年后，在时间2（T2），儿童和他们的父母被邀请进行后续评估，由同一个团队使用相同的方法。结果和结果：在96名儿童中，76人符合T1的ASD标准，20人不符合标准。在同样的96名儿童中，79名在T2时符合ASD标准。绝大多数患有ASD的儿童也有其他神经发育症状或诊断。在T2时，42%的ASD儿童观察到多动症，30%的儿童观察到智力发育障碍。25%的患者存在边缘智力功能障碍，20%的患者存在严重的言语和语言障碍。在T2时不符合ASD标准的儿童有其他神经发育/神经精神障碍的症状或符合其他神经发育/神经精神障碍的标准，并伴有明显的自闭症特征。在这组患有ASD的幼儿中，T1和T2之间的发育特征变化很常见。T1时认知水平的主要效应解释了Vineland评分的方差是ASD亚型的两倍多; IDD儿童的评分显著低于BIF和AIF组的儿童。与其他条件的共存是rule.Conclusions和影响：重新评估，涵盖了整个范围内的这些条件是必要的优化干预适应个别儿童的需要。(C)2016爱思唯尔有限公司版权所有。
Background: Autism spectrum disorder (ASD) is a developmental disorder with a wide variety of clinical phenotypes and co-occurrences with other neurodevelopmental conditions. Symptoms may change over time.Aims: The aim of the present study was to prospectively follow 96 children, initially assessed for suspected ASD at an average age of 2.9 years.Methods and procedures: All children had been identified with autistic symptoms in a general population child health screening program, and had been referred to the Child Neuropsychiatry Clinic in Gothenburg, Sweden for further assessment by a multi-professional team at Time 1 (T1). This assessment included a broad neurodevelopmental examination, structured interviews, a cognitive test and evaluations of the childis adaptive and global functioning. Two years later, at Time 2 (T2), the children and their parents were invited for a follow-up assessment by the same team using the same methods.Outcomes and results: Of the 96 children, 76 had met and 20 had not met full criteria for ASD at T1. Of the same 96 children, 79 met full ASD criteria at T2. The vast majority of children with ASD also had other neurodevelopmental symptoms or diagnoses. Hyperactivity was observed in 42% of children with ASD at T2, and Intellectual Developmental Disorder in 30%. Borderline Intellectual Functioning was found in 25%, and severe speech and language disorder in 20%. The children who did not meet criteria for ASD at T2 had symptoms of or met criteria for other neurodevelopmental/neuropsychiatric disorders in combination with marked autistic traits. Changes in developmental profiles between T1 and T2 were common in this group of young children with ASD. The main effect of Cognitive level at T1 explained more than twice as much of the variance in Vineland scores as did the ASD subtype; children with IDD had significantly lower scores than children in the BIF and AIF group. Co-existence with other conditions was the rule.Conclusions and implications: Reassessments covering the whole range of these conditions are necessary for an optimized intervention adapted to the individual child's needs. (C) 2016 Elsevier Ltd. All rights reserved.