Ezell Jordan, Shui Amy, Sanders Kevin, Veenstra-VanderWeele Jeremy
Department of Psychiatry, Vanderbilt University, Nashville, Tennessee;
Massachussetts General Hospital, Boston, Massachusetts; and.
Pediatrics. 2016 Feb;137 Suppl 2:S90-7. doi: 10.1542/peds.2015-2851G.
To determine whether adopted children with autism spectrum disorder (ASD) differ from the general ASD population in terms of diagnosis, internalizing and externalizing behaviors, sleep problems, and medications.
We studied 163 adoptees in the Autism Speaks Autism Treatment Network (ATN) in comparison with 5624 nonadopted ATN participants (aged 1.5-17.6 years; mean [SD] = 6.2 [3.4] years). Gender, age, race, ethnicity, IQ, and categorical Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, ASD diagnosis were tested for differences by group (adopted versus nonadopted) by using independent-samples t tests for continuous variables and Fisher's exact tests for categorical variables. Logistic or linear regression models were used to examine the association between adoption status and several outcome variables, after controlling for covariates.
After controlling for demographics and diagnosis, there were significant differences in group characteristics, including greater propensity for externalizing behavior (P < .001), internalizing behavior (P = .001), and sleep problems (P < .001) in the adopted population. Adoptees were also prescribed psychotropic medications (P < .001) more often than the nonadoptees. Adoptees received a diagnosis of pervasive developmental disorder-not otherwise specified significantly more frequently than controls (odds ratio = 1.8; CI = 1.3-2.5; P < .001), despite no significant difference in symptoms on standardized measures.
These results suggest that the population of adopted children with ASD differs from the general ASD population both with regard to diagnostic subtype and co-occurring behavioral problems. Future research should evaluate the contributions of specific factors associated with adoption such as biological family history, pregnancy history, early childhood experience, and age at adoption.
确定患有自闭症谱系障碍（ASD）的领养儿童在诊断、内化和外化行为、睡眠问题及用药方面是否与一般ASD人群存在差异。
我们对自闭症之声自闭症治疗网络（ATN）中的163名领养儿童与5624名非领养ATN参与者（年龄1.5 - 17.6岁；平均[标准差]=6.2[3.4]岁）进行了研究。通过对连续变量使用独立样本t检验，对分类变量使用Fisher精确检验，对组间（领养与非领养）的性别、年龄、种族、民族、智商以及《精神疾病诊断与统计手册》第四版（DSM-IV）的ASD分类诊断差异进行了检验。在控制协变量后，使用逻辑回归或线性回归模型来检验领养状态与几个结果变量之间的关联。
在控制人口统计学和诊断因素后，两组特征存在显著差异，包括领养人群中外化行为（P <.001）、内化行为（P =.001）和睡眠问题（P <.001）的倾向更高。领养儿童也比非领养儿童更常被开具精神药物（P <.001）。尽管在标准化测量的症状上没有显著差异，但领养儿童被诊断为广泛性发育障碍未特定型的频率显著高于对照组（优势比=1.8；可信区间=1.3 - 2.5；P <.001）。
这些结果表明，患有ASD的领养儿童群体在诊断亚型和并发行为问题方面与一般ASD人群不同。未来的研究应评估与领养相关的特定因素的作用，如生物学家族史、妊娠史、幼儿期经历和领养年龄。
