Zablotsky Benjamin, Pringle Beverly A, Colpe Lisa J, Kogan Michael D, Rice Catherine, Blumberg Stephen J
*National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD; †Office for Research on Disparities and Global Mental Health, National Institute of Mental Health, Bethesda, MD; ‡Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, MD; §Office of Epidemiology and Research, Maternal and Child Health Bureau, Rockville, MD; ¶National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
J Dev Behav Pediatr. 2015 Feb-Mar;36(2):98-105. doi: 10.1097/DBP.0000000000000127.
Children diagnosed with autism spectrum disorder (ASD) require substantial support to address not only core ASD symptoms but also a range of co-occurring conditions. This study explores treatment and service use among children with ASD with and without intellectual disability (ID) and parents' perception of unmet needs from these treatments.
Data were retrieved from a probability-based national sample of 2077 children diagnosed with ASD, ID, or both (ASD and ID). Weighted multivariate logistic regressions examined differences between diagnostic groups for current medication and service utilization with a subanalysis exploring differences among those with co-occurring psychiatric conditions. Additional modeling examined parents' perception of unmet needs.
Children diagnosed with ASD and ID were significantly more likely to be receiving current medication and services when compared with children with ID only or ASD only. Children with a co-occurring psychiatric diagnosis, from all 3 diagnostic groups, were more likely to be receiving a current medication, but not more likely to be receiving a current service when compared with children without a co-occurring psychiatric diagnosis. Children with ASD and a co-occurring psychiatric diagnosis were significantly more likely to have parents who reported unmet needs when compared with parents of children with ASD without a co-occurring psychiatric diagnosis.
Children diagnosed with ASD and ID, especially those with a comorbid psychiatric condition, represent a vulnerable population with substantial rates of current service (98%) and medication (67%) usage, but despite these high rates, approximately 30% of parents report that their child's developmental needs are still not being met by their current treatment and services.
被诊断为自闭症谱系障碍（ASD）的儿童不仅需要大量支持来解决核心ASD症状，还需要应对一系列共病情况。本研究探讨了有无智力障碍（ID）的ASD儿童的治疗和服务使用情况，以及家长对这些治疗未满足需求的看法。
数据取自一个基于概率的全国性样本，该样本包含2077名被诊断为患有ASD、ID或两者皆有的儿童（ASD和ID）。加权多变量逻辑回归分析了诊断组之间当前药物治疗和服务利用情况的差异，并进行了一项子分析，探讨共病精神疾病儿童之间的差异。额外的模型分析考察了家长对未满足需求的看法。
与仅患有ID或仅患有ASD的儿童相比，被诊断为ASD和ID的儿童接受当前药物治疗和服务的可能性显著更高。来自所有三个诊断组的共病精神疾病诊断的儿童，与没有共病精神疾病诊断的儿童相比，更有可能接受当前药物治疗，但接受当前服务的可能性并不更高。与没有共病精神疾病诊断的ASD儿童的家长相比，患有ASD且共病精神疾病诊断的儿童的家长报告未满足需求的可能性显著更高。
被诊断为ASD和ID的儿童，尤其是那些患有共病精神疾病的儿童，是一个弱势群体，当前服务使用率（98%）和药物使用率（67%）都很高，但尽管使用率很高，仍有大约30%的家长报告说，他们孩子的发育需求目前的治疗和服务仍未得到满足。
