Department of Physical Medicine and Rehabilitation, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; Department of Senior Citizen Service Management, Chia Nan University of Pharmacy & Science, Tainan, Taiwan.
Res Dev Disabil. 2013 Nov;34(11):3766-72. doi: 10.1016/j.ridd.2013.08.001. Epub 2013 Sep 7.
Childhood disability is not uncommon, but data at the national level are limited, especially those on the changes in the prevalence over time. On the basis of the Disabled Welfare Act, Taiwan began to certify disabled residents and provide various services in 1980. All the cases receiving services are registered, and the registry provides a rare opportunity for studying childhood disability at the national level. Using the data from 2000 to 2011, we calculated the age-specific prevalence of all disability combined and assessed the changes over time. We also calculated the prevalence rate and the proportion in all disabilities combined for each disability category and assessed the trends. As certification before 3 years old is generally discouraged by the government, we limited analyses to children between 3 and 17 years old. We found that the registered cases ranged from 49,242 to 61,717 from 2000 to 2011 and that intellectual disability (ID), had been the leading category all through the years. The proportion of autism spectrum disorders (ASD) had been increasing rapidly and become the third leading disability in 2011. The prevalence of all disabilities combined increased constantly from 9.98/1000 to 15.41/1000 (p<0.01), and increases were generally observed every year in all age groups (p<0.01). The increase could largely be attributable to the increases in ID and ASD, while the increasing trends were also significant in "multiple disabilities," "speech or language impairment," and "other disabilities listed by the Department of Health" (p<0.01 for all the five categories). An increase with age in the prevalence of all disabilities combined could be observed all through the years (p<0.01 in all calendar years). We concluded that the prevalence of childhood disability has been increasing in Taiwan, with ID contributing the most cases and ASD as an emerging problem. However, the increase of prevalence cannot be attributed entirely to the increase in the occurrence of cases, and an increase in the proportion of cases registered was an more important factor, which may be in turn attributable to a better service of the related agencies, lower discrimination against the patients, higher awareness of the disorder, and more willingness of the guardians to register.
儿童残疾并不罕见，但全国层面的数据有限，尤其是关于随时间推移患病率变化的数据。1980 年，基于《残障福利法》，台湾开始认证残障居民并提供各种服务。所有接受服务的案例都进行了登记，该登记为研究全国层面的儿童残疾提供了难得的机会。我们使用了 2000 年至 2011 年的数据，计算了所有残疾合并的特定年龄患病率，并评估了随时间的变化。我们还计算了每种残疾类别的患病率和在所有残疾合并中的比例，并评估了趋势。由于政府普遍不鼓励 3 岁前认证，我们将分析限于 3 至 17 岁的儿童。我们发现，2000 年至 2011 年，登记案例数从 49242 例到 61717 例不等，智力残疾（ID）多年来一直是主要类别。自闭症谱系障碍（ASD）的比例迅速增加，2011 年成为第三大残疾。所有残疾合并的患病率从 9.98/1000 持续增加到 15.41/1000（p<0.01），所有年龄组每年都普遍观察到增加（p<0.01）。这种增加主要归因于 ID 和 ASD 的增加，而“多种残疾”、“言语或语言障碍”和“卫生署列出的其他残疾”（所有五个类别 p<0.01）的上升趋势也很显著。所有残疾合并的患病率多年来呈随年龄增长的趋势（所有历年 p<0.01）。我们得出结论，台湾儿童残疾的患病率一直在增加，ID 导致的病例最多，ASD 是一个新出现的问题。然而，患病率的增加不能完全归因于病例发生的增加，登记病例比例的增加是一个更重要的因素，这可能反过来归因于相关机构更好的服务、对患者的歧视减少、对障碍的认识提高以及监护人更愿意登记。
