Early Childhood Autism Surveillance

描述(由申请人提供)：关于学龄儿童和学龄前儿童患病率增加的报道，加剧了公众对自闭症谱系障碍的担忧。虽然ASD的发病时间在出生后36个月内，但在出生后头3年的患病率尚未确定。这项建议旨在开发和试点儿童早期ASD监测的测试方法，为随后的单年出生队列患病率研究做准备。新出现的数据表明，自闭症可以在3岁以下的儿童中发现。然而，自闭症在1岁、2岁或3岁时是否明显可能会有所不同，特别是如果儿童经历了发育倒退。目前的申请提出了一项基于人群的患病率研究的设计，该研究将跟踪18-36个月的儿童，为期两年，并在整个过程中进行重复筛查，以捕捉表现为自闭症的儿童。当前建议的具体目标是试行这一筛查方法，并建立进行全面流行率研究所需的关系和数据联系。此外，我们将完成其他疾控中心流行率研究中使用的记录审查方法，并比较直接筛查和记录审查的病例比率，以确定仅有记录审查在这个年龄范围内是否足够。这项研究回应了机构间自闭症协调委员会概述的几个优先事项，包括呼吁进行密集的、基于社区的流行率研究，并进行临床评估，随着时间的推移，可以重复进行临床评估，以确定流行率的变化，制定基于社区的幼儿筛查方法，以及测试筛查工具。这项申请建立在犹他州自闭症研究的基础上，其中包括：2002年ADDM网络研究年；该大学与卫生部之间建立的关系；社区对自闭症研究的广泛支持；以及强大的大学研究环境。

DESCRIPTION (provided by applicant): Public concern about Autism Spectrum Disorders has been fueled by reports of increased prevalence in school age and preschool children. While the onset of ASD is within the first36 months of life, prevalence during the first 3 years of life is not established. This proposal aims to develop and pilot test methods for ASD surveillance in early childhood, in preparation for a subsequent prevalence study of a single year birth cohort. Emerging data indicate that autism can be identified in children under age 3. However, whether it is evident in the 1st, 2nd, or 3rd year of life can vary, especially if the child experiences a developmental regression. The current application presents a design for a population-based prevalence study that would follow children from ages 18-36 months for a 2 year period, with repeated screenings throughout to capture children as their autism manifests. Specific aims for the current proposal are to pilot test this screening approach, and to establish the relationships and data linkages necessary to conduct the full prevalence study. In addition, we will complete the record review methods used in other CDC prevalence studies and compare case rates between direct screening and record review only to determine whether record review alone is sufficient in this age range. This study responds to several of the priorities outlined by the lnteragency Autism Coordinating Committee, including a call for intensive, community-based prevalence studies with clinical evaluations that can be repeated over time to determine changes in prevalence, methods to develop community-based screening of very young children, and testing of screening tools. This application builds on a foundation of Utah research on autism that includes: ADDM network Study Year 2002; an established relationship between the University and the Health Department; widespread community support for autism research; and a strong University research environment.