Shattuck Paul T, Durkin Maureen, Maenner Matthew, Newschaffer Craig, Mandell David S, Wiggins Lisa, Lee Li-Ching, Rice Catherine, Giarelli Ellen, Kirby Russell, Baio Jon, Pinto-Martin Jennifer, Cuniff Christopher
Dr. Shattuck is with the Brown School of Social Work, Washington University in St. Louis; Dr. Durkin and Mr. Maenner are with the Department of Population Health Sciences, University of Wisconsin-Madison; Dr. Newschaffer is with the Department of Epidemiology and Biostatistics, Drexel University; Dr. Mandell is with the Department of Psychiatry, University of Pennsylvania School of Medicine; Drs. Giarelli and Pinto-Martin are with the School of Nursing, University of Pennsylvania; Ms. Wiggins, Dr. Rice, and Mr. Baio are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention; Dr. Kirby is with the Department of Community and Family Health, University of South Florida; Dr. Lee is with the Department of Epidemiology, Johns Hopkins University. Dr. Cuniff is with the University of Arizona College of Medicine.
Dr. Shattuck is with the Brown School of Social Work, Washington University in St. Louis; Dr. Durkin and Mr. Maenner are with the Department of Population Health Sciences, University of Wisconsin-Madison; Dr. Newschaffer is with the Department of Epidemiology and Biostatistics, Drexel University; Dr. Mandell is with the Department of Psychiatry, University of Pennsylvania School of Medicine; Drs. Giarelli and Pinto-Martin are with the School of Nursing, University of Pennsylvania; Ms. Wiggins, Dr. Rice, and Mr. Baio are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention; Dr. Kirby is with the Department of Community and Family Health, University of South Florida; Dr. Lee is with the Department of Epidemiology, Johns Hopkins University. Dr. Cuniff is with the University of Arizona College of Medicine.
J Am Acad Child Adolesc Psychiatry. 2009 May;48(5):474-483. doi: 10.1097/CHI.0b013e31819b3848.
At what age are children with an autism spectrum disorder (ASD) identified by community providers? What factors influence the timing of when children are identified with ASDs? This study examined the timing of when children with ASDs are identified.
Data came from 13 sites participating in the Centers for Disease Control and Prevention's 2002 multisite ongoing autism surveillance program, the Autism and Developmental Disabilities Monitoring Network. Survival analysis was used to examine factors that influence the timing of community-based identification and diagnosis.
Data from health and education records reveal that the median age of identification was 5.7 years (SE 0.08 years). Parametric survival models revealed that several factors were associated with a younger age of identification: being male, having an IQ of 70 or lower, and having experienced developmental regression. Significant differences in the age of identification among the 13 sites were also discovered.
The large gap between the age at which children can be identified and when they actually are identified suggests a critical need for further research, innovation, and improvement in this area of clinical practice.
社区服务提供者在什么年龄识别出自闭症谱系障碍（ASD）儿童？哪些因素会影响儿童被识别为患有ASD的时间？本研究调查了ASD儿童被识别的时间。
数据来自参与疾病控制与预防中心2002年多地点持续自闭症监测项目“自闭症及发育障碍监测网络”的13个地点。生存分析用于研究影响基于社区的识别和诊断时间的因素。
健康和教育记录数据显示，识别的中位年龄为5.7岁（标准误0.08岁）。参数生存模型显示，几个因素与较年轻的识别年龄相关：男性、智商为70或更低以及经历过发育倒退。还发现13个地点之间在识别年龄上存在显著差异。
儿童能够被识别的年龄与实际被识别的年龄之间存在巨大差距，这表明在这一临床实践领域迫切需要进一步的研究、创新和改进。
