Rice Catherine E, Rosanoff Michael, Dawson Geraldine, Durkin Maureen S, Croen Lisa A, Singer Alison, Yeargin-Allsopp Marshalyn
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, USA.
Autism Speaks, USA.
Public Health Rev. 2012;34(2):1-22. doi: 10.1007/BF03391685.
Autism spectrum disorders (ASDs) are estimated to occur among about one percent of children in the United States. This estimate is in line with estimates from other industrialized countries. However, the identified prevalence of ASDs has increased significantly in a short time period based on data from multiple studies including the U.S. Centers for Disease Control and Prevention's (CDC) Autism and Developmental Disabilities Monitoring (ADDM) Network. Whether increases in ASD prevalence are partly attributable to a true increase in the risk of developing ASD or solely to changes in community awareness and identification patterns is not known. It is clear that more children are identified with an ASD now than in the past and the impact on individuals, families, and communities is significant. However, disentangling the many potential reasons for ASD prevalence increases has been challenging. Understanding the relative contribution of multiple factors such as variation in study methods, changes in diagnostic and community identification, and potential changes in risk factors is an important priority for the ADDM Network and for CDC. This article summarizes the discussion from a workshop that was co-sponsored by CDC and Autism Speaks as a forum for sharing knowledge and opinions of a diverse range of stakeholders about changes in ASD prevalence. Panelists discussed recommendations for building on existing infrastructure and developing new initiatives to better understand ASD trends. The information, research, and opinions shared during this workshop add to the knowledge base about ASD prevalence in an effort to stimulate further work to understand the multiple reasons behind increasing ASD prevalence.
据估计,美国约1%的儿童患有自闭症谱系障碍(ASD)。这一估计与其他工业化国家的估计一致。然而,根据包括美国疾病控制与预防中心(CDC)的自闭症及发育障碍监测(ADDM)网络在内的多项研究数据,ASD的确诊患病率在短时间内显著上升。目前尚不清楚ASD患病率的上升部分是由于患ASD风险的真正增加,还是仅仅由于社区意识和识别模式的变化。显然,现在被确诊患有ASD的儿童比过去更多,这对个人、家庭和社区的影响重大。然而,梳理ASD患病率上升的诸多潜在原因一直具有挑战性。了解多种因素的相对贡献,如研究方法的差异、诊断和社区识别的变化以及风险因素的潜在变化,是ADDM网络和CDC的一项重要优先事项。本文总结了由CDC和自闭症之声共同主办的一次研讨会的讨论内容,该研讨会是一个论坛,旨在分享不同利益相关者关于ASD患病率变化的知识和观点。小组成员讨论了在现有基础设施基础上进一步发展以及开展新举措以更好地了解ASD趋势的建议。本次研讨会期间分享的信息、研究和观点丰富了关于ASD患病率的知识库,以期推动进一步的工作,以了解ASD患病率上升背后的多重原因。