Prevalence and Treatment Patterns of Autism Spectrum Disorder in the United States, 2016
Prevalence and Treatment Patterns of Autism Spectrum Disorder in the United States, 2016
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DOI：
10.1001/jamapediatrics.2018.4208
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发表时间：
2019-02-01
期刊：
影响因子：
26.1
通讯作者：
Bao, Wei
中科院分区：
文献类型：
--
作者：
Xu, Guifeng;Strathearn, Lane;Bao, Wei
自闭症谱系障碍（ASD）是一种复杂的神经发育障碍。以前的调查报告说，在过去的几十年里，美国儿童的ASD患病率稳步上升。已经开发了几种行为疗法和药物来治疗ASD的症状;然而，目前对诊断为ASD的儿童的治疗使用状况知之甚少。目的使用全国代表性数据估计美国儿童ASD的患病率和治疗模式。设计，设置和参与者本研究使用的数据来自2016年全国儿童健康调查，基于人口的横断面调查。我们纳入了43032名3至17岁的儿童。通过父母或监护人填写的问卷收集数据。数据分析时间为2018年2月至2018年3月。主要结局和指标结局变量包括由医生或健康专业人员诊断的ASD以及ASD儿童中行为治疗或药物治疗的使用。结果在43032名纳入的参与者中，22072名（51.3%）为男性，平均（SD）年龄为10.7（4.4）岁。既往诊断ASD和当前ASD的加权患病率分别为2.79%（95%CI，2.46-3.12）和2.50%（95%CI，2.21-2.79）。曾诊断ASD的州一级患病率从德克萨斯州的1.54%（95%CI，0.60-2.48）到佛罗里达州的4.88%（95%CI，2.72-7.05）不等。在全国范围内，大约70%的自闭症儿童（70.5%; 95% CI，65.1-75.8）接受治疗; 43.3%（95%CI，37.4-49.2）仅接受行为治疗，6.9%（95%CI，3.7-10.1）仅接受药物治疗，20.3%（95%CI，16.5-24.1）接受行为和药物治疗。其余29.5%（95%CI，24.2-34.9）的儿童与当前ASD没有接受行为或药物治疗。结论和相关性这项研究表明，ASD在美国的患病率相对较高，它在美国各州的变化很大。近30%的美国ASD儿童没有接受行为或药物治疗，这就需要了解和解决这些儿童接受适当治疗的障碍。
IMPORTANCE Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder. Previous surveys have reported a steady increase in ASD prevalence in US children over the past decades. Several behavioral therapies and medications have been developed to treat the symptoms of ASD; however, little is known about the current status of treatment usage for children diagnosed as having ASD.OBJECTIVE To estimate the prevalence and treatment patterns of ASD among US children using nationally representative data.DESIGN, SETTING, AND PARTICIPANTS This study used data from the 2016 National Survey of Children's Health, a nationwide, population-based, cross-sectional survey. We included 43 032 children aged 3 to 17 years. Data were collected through questionnaires completed by a parent or guardian. Data were analyzed from February 2018 to March 2018.MAIN OUTCOMES AND MEASURES Outcome variables included ASD diagnosed by a physician or health professional and the use of behavioral treatment or medication treatment among children with ASD.RESULTS Of the 43 032 included participants, 22 072 (51.3%) were male, and the mean (SD) age was 10.7 (4.4) years. The weighted prevalence of ever-diagnosed ASD and current ASD were 2.79% (95% CI, 2.46-3.12) and 2.50% (95% CI, 2.21-2.79), respectively. The state-level prevalence of ever-diagnosed ASD varied from 1.54%(95% CI, 0.60-2.48) in Texas to 4.88% (95% CI, 2.72-7.05) in Florida. Nationally, about 70% of children with current ASD (70.5%; 95% CI, 65.1-75.8) were treated; 43.3%(95% CI, 37.4-49.2) received behavioral treatment only, 6.9%(95% CI, 3.7-10.1) received medication treatment only, and 20.3%(95% CI, 16.5-24.1) received both behavioral and medication treatments. The remaining 29.5% (95% CI, 24.2-34.9) of children with current ASD did not receive either behavioral or medication treatment.CONCLUSIONS AND RELEVANCE This study showed that the prevalence of ASD in the United States was relatively high, and it varied substantially across US states. Almost 30% of US children with ASD did not receive behavioral or medication treatment, which calls for a critical need to understand and address the barriers for those children to receive appropriate treatments.