National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, MS E-86, 1600 Clifton Road, Atlanta, GA 30333, USA.
Matern Child Health J. 2012 Apr;16 Suppl 1:S151-7. doi: 10.1007/s10995-012-1004-0.
The prevalence of autism spectrum disorders (ASD) from the 2007 National Survey of Children's Health (NSCH) was twice the 2003 NSCH estimate for autism. From each NSCH, we selected children born in the US from 1990 to 2000. We estimated autism prevalence within each 1-year birth cohort to hold genetic and non-genetic prenatal factors constant. Prevalence differences across surveys thus reflect survey measurement changes and/or external identification effects. In 2003, parents were asked whether their child was ever diagnosed with autism. In 2007, parents were asked whether their child was ever diagnosed with an ASD and whether s/he currently had an ASD. For the 1997-2000 birth cohorts (children aged 3-6 years in 2003 and 7-10 years in 2007), relative increases between 2003 autism estimates and 2007 ASD estimates were 200-600 %. For the 1990-1996 birth cohorts (children aged 7-13 years in 2003) increases were lower; nonetheless, differences between 2003 estimates and 2007 "ever ASD" estimates were >100 % for 6 cohorts and differences between 2003 estimates and 2007 "current ASD" estimates were >80 % for 3 cohorts. The magnitude of most birth cohort-specific differences suggests continuing diagnosis of children in the community played a sizable role in the 2003-2007 ASD prevalence increase. While some increase was expected for 1997-2000 cohorts, because some children have later diagnoses coinciding with school entry, increases were also observed for children ages ≥ 7 years in 2003. Given past ASD subtype studies, the 2003 "autism" question might have missed a modest amount (≤ 33 %) of ASDs other than autistic disorder.
自闭症谱系障碍（ASD）的患病率从 2007 年全国儿童健康调查（NSCH）的两倍，到 2003 年 NSCH 对自闭症的估计。从每个 NSCH 中，我们选择了 1990 年至 2000 年在美国出生的儿童。我们估计了每个 1 年出生队列的自闭症患病率，以保持遗传和非遗传产前因素不变。因此，调查之间的患病率差异反映了调查测量的变化和/或外部识别效应。在 2003 年，父母被问及他们的孩子是否曾经被诊断出患有自闭症。在 2007 年，父母被问及他们的孩子是否曾经被诊断出患有 ASD，以及他们目前是否患有 ASD。对于 1997-2000 年出生的队列（2003 年年龄为 3-6 岁，2007 年年龄为 7-10 岁），2003 年自闭症估计值与 2007 年 ASD 估计值之间的相对增加为 200-600%。对于 1990-1996 年出生的队列（2003 年年龄为 7-13 岁），增幅较低；尽管如此，对于 6 个队列，2003 年估计值与 2007 年“ASD 曾经”估计值之间的差异>100%，对于 3 个队列，2003 年估计值与 2007 年“当前 ASD”估计值之间的差异>80%。大多数出生队列特定差异的幅度表明，社区中儿童的持续诊断在 2003-2007 年 ASD 患病率增加中发挥了相当大的作用。虽然对于 1997-2000 年的队列预计会有一些增加，因为一些儿童的诊断较晚，正好与入学时间相符，但对于 2003 年年龄≥7 岁的儿童也观察到了增加。考虑到过去的 ASD 亚型研究，2003 年的“自闭症”问题可能错过了相当一部分（≤33%）除自闭症障碍以外的 ASD。
