Center for Autism and Developmental Disabilities Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Pediatrics. 2012 Feb;129(2):e305-16. doi: 10.1542/peds.2011-1717. Epub 2012 Jan 23.
This study aimed to investigate descriptive characteristics and co-occurring neurodevelopmental and psychiatric conditions in young children, children, and adolescents with a current and consistent or past but not current (PBNC) diagnosis of autism spectrum disorder (ASD) and how such characteristics and conditions may engender a change in diagnosis of an ASD.
Cross-sectional data of 1366 children with a parent-reported current or PBNC ASD diagnosis were obtained from the National Survey of Children's Health 2007 data set across 3 developmental stages: young children (aged 3-5 years), children (aged 6-11 years), and adolescents (aged 12-17 years). Multinomial logistic regression was used to examine demographic characteristics and co-occurring conditions that differentiate the groups with a current ASD from groups with a PBNC ASD.
Results indicated the co-occurring conditions that distinguish groups currently diagnosed with an ASD from groups with a PBNC ASD diagnosis. In young children, current moderate/severe learning disability, and current moderate/severe developmental delay; in children, past speech problem, current moderate/severe anxiety, and past hearing problem; and in adolescents, current moderate/severe speech problem, current mild seizure/epilepsy, and past hearing problem.
These findings suggest that the presence of co-occurring psychiatric and neurodevelopmental conditions are associated with a change in ASD diagnosis. Questions remain as to whether changes in diagnosis of an ASD are due to true etiologic differences or shifts in diagnostic determination.
本研究旨在调查当前和持续存在或过去但不存在(PBNC)自闭症谱系障碍(ASD)诊断的幼儿、儿童和青少年的描述性特征以及并发的神经发育和精神疾病状况,并探讨这些特征和状况如何导致 ASD 诊断的变化。
从全国儿童健康调查 2007 年数据集的 3 个发育阶段(幼儿期[3-5 岁]、儿童期[6-11 岁]和青少年期[12-17 岁])获得了 1366 名父母报告当前或 PBNC ASD 诊断的儿童的横断面数据。采用多项逻辑回归分析来检查区分当前 ASD 组和 PBNC ASD 组的人口统计学特征和并发情况。
结果表明了区分当前 ASD 组和 PBNC ASD 组的并发情况。在幼儿期,当前中重度学习障碍和当前中重度发育迟缓;在儿童期,过去的言语问题、当前的中重度焦虑和过去的听力问题;在青少年期,当前中重度言语问题、当前轻度癫痫/癫痫和过去的听力问题。
这些发现表明并发精神和神经发育疾病与 ASD 诊断的变化有关。目前仍存在疑问的是,ASD 诊断的变化是由于真正的病因差异还是诊断确定的转变所致。