Explaining differences in age at autism spectrum disorder diagnosis: a critical review.
Explaining differences in age at autism spectrum disorder diagnosis: a critical review.
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DOI：
10.1177/1362361313480277
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发表时间：
2014-07
期刊：
影响因子：
--
通讯作者：
Mandell DS
中科院分区：
文献类型：
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作者：
Daniels AM;Mandell DS
自闭症的诊断常常被延误，这意味着在关键的发育时期错过了提供治疗的机会。本研究回顾了评估自闭症谱系障碍诊断年龄相关因素的研究，并为未来的研究、项目和政策提供了建议，以提高早期发现。检索所有在标题或摘要中包含自闭症、年龄和诊断等词的同行评审文章。从1990年1月到2012年3月共发表了42项研究。所有自闭症谱系障碍的平均诊断年龄从38个月到120个月不等，并且随着时间的推移而降低。与早期诊断相关的因素包括症状严重程度高、社会经济地位高、父母对初始症状的关注程度高。诊断前家庭与卫生和教育系统的相互作用也影响诊断时的年龄。许多研究发现自闭症谱系障碍诊断年龄的地理差异，表明社区资源和国家政策在早期识别中发挥了作用。早期发现工作应包括加强父母和提供者关于早期认识发育问题的教育，旨在简化从最初关注到最终诊断的过程的干预措施，以及针对服务不足人口的战略。
The diagnosis of autism is often delayed, which translates into a missed opportunity to provide treatment during a critical developmental period. This study reviews studies that assessed factors associated with age at autism spectrum disorder diagnosis and provides recommendations on future research, programs, and policies to improve early detection. A search for all peer-reviewed articles containing the words autism, age, and diagnosis in either the title or abstract was performed. A total of 42 studies published from January 1990 through March 2012 were identified. Mean age at diagnosis for all autism spectrum disorders ranged from 38 to 120 months and has decreased over time. Factors associated with earlier diagnosis included greater symptom severity, high socioeconomic status, and greater parental concern about initial symptoms. Family interactions with the health and education systems prior to diagnosis also influenced age at diagnosis. Geographic variation in age at autism spectrum disorder diagnosis was identified in a number of studies, suggesting that community resources and state policies play a role in early identification. Early detection efforts should include enhanced parental and provider education on the early recognition of developmental problems, interventions aimed at streamlining the process from first concern to eventual diagnosis, and strategies that target underserved populations.