Examination of the time between first evaluation and first autism spectrum diagnosis in a population-based sample
Examination of the time between first evaluation and first autism spectrum diagnosis in a population-based sample
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DOI：
10.1097/00004703-200604002-00005
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发表时间：
2006-04-01
影响因子：
2.4
通讯作者：
Rice, Catherine
中科院分区：
文献类型：
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作者：
Wiggins, Lisa D.;Baio, Jon;Rice, Catherine
早期识别患有自闭症谱系障碍（ASD）的幼儿可以使其更早进入支持改善发展结果的干预计划。本研究的目的是研究生活在大城市的自闭症儿童的识别和诊断模式。疾病控制和预防中心的一个基于人口的监测系统确定了115名被诊断患有自闭症谱系障碍的8岁儿童。感兴趣的主要变量包括从监测记录中确定的最早评估年龄和最早诊断年龄，初始ASD诊断类型，记录首次ASD诊断的评估来源，分配首次ASD诊断的专业人员的特征，以及用于辅助诊断过程的诊断工具。我们发现，通过监测系统识别出的自闭症儿童在平均48个月大时进行了初步评估，但直到平均61个月大时才被诊断为自闭症。尽管与ASD相关的损害程度可以预测首次评估时的平均年龄和首次诊断时的平均年龄，但基于性别或种族/民族分类的诊断时间没有差异。大多数儿童是在医院和诊所等非学校来源发现的；24%的样本在进入学校之前没有接受记录在案的自闭症诊断。大多数医生（70%）在首次诊断ASD时没有使用诊断仪器。讨论了早期识别ASD的意义。
Early identification of young children with an autism spectrum disorder (ASD) can lead to earlier entry into intervention programs that support improved developmental outcomes. The purpose of the present study was to examine identification and diagnostic patterns of children with ASD who live in a large metropolitan area. One hundred fifteen 8-year-old children diagnosed with ASD were identified from a population-based surveillance system at the Centers for Disease Control and Prevention. Primary variables of interest included earliest age of evaluation and earliest age of diagnosis identified from surveillance records, type of initial ASD diagnosis, evaluation sources that documented first ASD diagnosis, characteristics of professionals assigning first ASD diagnosis, and diagnostic tools used to aid the diagnostic process. We found that children with ASD identified by the surveillance system were initially evaluated at a mean of 48 months but were not diagnosed with ASD until a mean age of 61 months. There were no differences in timing of diagnosis based on sex or racial/ethnic classification, although degree of impairment associated with ASD predicted mean age at first evaluation and mean age at first ASD diagnosis. Most children were identified at nonschool sources, such as hospitals and clinics; 24% of the sample did not receive a documented ASD diagnosis until entering school. Most practitioners (70%) did not use a diagnostic instrument when assigning the first ASD diagnosis. Implications for early identification of ASD are discussed.