Icasiano F, Hewson P, Machet P, Cooper C, Marshall A
Barwon Child Health Unit, Department of Paediatrics, Barwon Health, Geelong, Victoria, Australia.
J Paediatr Child Health. 2004 Dec;40(12):696-701. doi: 10.1111/j.1440-1754.2004.00513.x.
To establish a community database for children with autism spectrum disorder (ASD) to determine prevalence and identify subgroups based on key intellectual, clinical and family parameters.
Data were collected for children previously diagnosed with an ASD in the Barwon region using parental interview and review of the child's paediatric and psychological records. Preschool diagnoses were typically made by specialist psychologists and school-age diagnoses made by a multidisciplinary team.
One hundred and seventy-seven children in the Barwon region were identified as having ASD (82% response rate). The prevalence of ASD was one per 255 children aged two to 17 years. The prevalence increased 10 fold over a 16-year period and this increase was relatively even across all levels of child intellectual functioning. Forty-two percent of children were intellectually disabled (IQ < 70) and performance IQ was significantly higher than verbal IQ but typical block design-comprehension subtest patterns were not common. Nine sibling pair families were identified, 24% were labelled as having attention deficit hyperactivity disorder (ADHD), 6% had epilepsy, and 18.3% were macrocephalic where data were available. Family difficulty was associated with the degree of obsessions/rituals, frequency and intensity of anger/aggression, and ADHD but overall was not associated with the child's intellectual status.
The relatively rapid increase in prevalence is consistent with overseas studies and suggests significant changes in diagnostic criteria, increasing community awareness and the need for support at all levels of intellectual functioning. Increased occurrence in siblings and relatives gives further evidence for a genetic cause.
建立一个自闭症谱系障碍(ASD)儿童社区数据库,以确定患病率,并根据关键的智力、临床和家庭参数确定亚组。
通过对家长进行访谈并查阅儿童的儿科和心理记录,收集了曾在巴尔文地区被诊断为患有ASD的儿童的数据。学龄前儿童的诊断通常由专业心理学家做出,学龄儿童的诊断由多学科团队做出。
巴尔文地区有177名儿童被确定患有ASD(应答率为82%)。ASD的患病率为每255名2至17岁儿童中有1例。在16年的时间里,患病率增加了10倍,且在儿童智力功能的各个水平上,这种增加相对均匀。42%的儿童存在智力障碍(智商<70),操作智商显著高于言语智商,但典型的积木图案-理解分测验模式并不常见。确定了9个同胞对家庭,其中24%被标记为患有注意力缺陷多动障碍(ADHD),6%患有癫痫,在有数据的情况下,18.3%的儿童头围较大。家庭困难与强迫观念/仪式行为的程度、愤怒/攻击行为的频率和强度以及ADHD有关,但总体上与儿童的智力状况无关。
患病率相对快速的增长与海外研究一致,表明诊断标准发生了重大变化、社区意识提高以及对各智力功能水平支持的需求。同胞和亲属中发病率的增加进一步证明了遗传原因。