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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Factors associated with age of diagnosis among children with autism spectrum disorders.
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Factors associated with age of diagnosis among children with autism spectrum disorders.

机译：自闭症谱系障碍患儿与诊断年龄相关的因素。

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OBJECTIVE: Early diagnosis of children with autism spectrum disorders (ASD) is critical but often delayed until school age. Few studies have identified factors that may delay diagnosis. This study attempted to identify these factors among a community sample of children with ASD. METHODS: Survey data were collected in Pennsylvania from 969 caregivers of children who had ASD and were younger than 21 years regarding their service experiences. Linear regression was used to identify clinical and demographic characteristics associated with age of diagnosis. RESULTS: The average age of diagnosis was 3.1 years for children with autistic disorder, 3.9 years for pervasive developmental disorder not otherwise specified, and 7.2 years for Asperger's disorder. The average age of diagnosis increased 0.2 years for each year of age. Rural children received a diagnosis 0.4 years later than urban children. Near-poor children received a diagnosis 0.9 years later than those with incomes >100% above the poverty level. Children with severe language deficits received a diagnosis an average of 1.2 years earlier than other children. Hand flapping, toe walking, and sustained odd play were associated with a decrease in the age of diagnosis, whereas oversensitivity to pain and hearing impairment were associated with an increase. Children who had 4 or more primary care physicians before diagnosis received a diagnosis 0.5 years later than other children, whereas those whose pediatricians referred them to a specialist received a diagnosis 0.3 years sooner. CONCLUSION: These findings suggest improvements over time in decreasing the age at which children with ASD, especially higher functioning children, receive a diagnosis. They also suggest a lack of resources in rural areas and for near-poor families and the importance of continuous pediatric care and specialty referrals. That only certain ASD-related behaviors, some of which are not required to satisfy diagnostic criteria, decreased the age of diagnosis suggests the importance of continued physician education.
机译：目的：自闭症谱系障碍（ASD）患儿的早期诊断很关键，但通常要等到学龄前才开始。很少有研究确定可能延迟诊断的因素。这项研究试图在ASD儿童社区样本中确定这些因素。方法：从宾夕法尼亚州的969名有ASD且年龄不超过21岁的儿童的护理人员中收集调查数据。线性回归用于确定与诊断年龄相关的临床和人口统计学特征。结果：自闭症患儿的平均诊断年龄为3.1岁，未另作说明的普遍性发育障碍为3.9岁，阿斯伯格症为7.2岁。平均诊断年龄每岁增加0.2岁。农村儿童的诊断比城市儿童晚0.4年。比收入比贫困水平高出100％以上的儿童，将近贫困儿童的诊断晚了0.9年。语言严重缺陷的儿童被诊断出平均比其他儿童早1.2岁。手拍打，脚趾行走和持续的打杂与诊断年龄的减少有关，而对疼痛和听力障碍的过度敏感与增加的年龄有关。在诊断之前拥有4名或以上初级保健医生的孩子，其诊断比其他孩子晚了0.5年，而由儿科医生将他们转介给专科医生的孩子则得到了0.3年的诊断。结论：这些发现表明，随着年龄的增长，ASD儿童，尤其是功能更高的儿童，被诊断出年龄的降低。他们还表明，农村地区和贫困家庭的资源不足，以及持续的儿科护理和专科转诊的重要性。只有某些与ASD相关的行为（其中一些不需要满足诊断标准）才能降低诊断年龄，这表明继续接受医师教育非常重要。

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