Lin Sue C, Yu Stella M
Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, 2242 Valley Drive, College Park, Maryland 20742, USA.
Center for Global Health and Health Policy, Global Health and Education Projects, Inc., P. O. Box 234, Riverdale, Maryland, 20738 USA.
Int J MCH AIDS. 2015;3(2):159-67.
The prevalence of autism spectrum disorder (ASD) in United State (US) has surged from 1 in 150 children in 2007 to 1 in 88 children in 2012 with substantial increase in immigrant minority groups including Hispanic and Somali children. Our study objective is to examine the associations between household language among children with ASD and national health quality indicators attainment.
We conducted bivariate and multivariate logistic regression analyses using cross-sectional data from the publicly-available 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) to investigate the association between household language use and quality indicators of medical home, adequate insurance, and early and continuous screening.
Approximately, 28% of parents of children with ASD from non-English primary language (NEPL) households reported their child having severe ASD as compared with 13% of parents from English primary language (EPL) households. Older children were more likely to have care that met the early and continuous screening quality indicator, while lower income children and uninsured children were less likely to have met this indicator.
Despite the lack of differences in the attainment of quality indicators by household language, the higher severity found in children in NEPL households suggests that they are exceptionally vulnerable. Enhanced early screening and identification for these children and supporting their parents in navigating the complex US health care delivery system would increase their participation in early intervention services. Immigration of children with special health care needs from around the world to the US has been increasing from countries with diverse healthcare systems. Our findings will help to inform policies and interventions to reduce health disparities for children with ASD from immigrant populations. As the prevalence of ASD has increased worldwide, understanding of the condition and care-seeking behavior in migrant populations is especially valuable.
美国自闭症谱系障碍（ASD）的患病率已从2007年的每150名儿童中有1例激增至2012年的每88名儿童中有1例，包括西班牙裔和索马里儿童在内的少数族裔移民群体患病率大幅上升。我们的研究目的是探讨ASD儿童的家庭语言与国家健康质量指标达成情况之间的关联。
我们使用公开可得的2009 - 2010年全国特殊医疗需求儿童调查（NS - CSHCN）的横断面数据进行双变量和多变量逻辑回归分析，以研究家庭语言使用与医疗之家、充足保险以及早期和持续筛查的质量指标之间的关联。
来自非英语主要语言（NEPL）家庭的ASD儿童中，约28%的家长报告其孩子患有重度ASD，而来自英语主要语言（EPL）家庭的家长这一比例为13%。年龄较大的儿童更有可能接受符合早期和持续筛查质量指标的护理，而低收入儿童和未参保儿童不太可能达到该指标。
尽管在质量指标达成情况上家庭语言没有差异，但NEPL家庭儿童中发现的更高严重程度表明他们格外脆弱。加强对这些儿童的早期筛查和识别，并支持他们的父母应对复杂的美国医疗保健系统，将增加他们参与早期干预服务的机会。有特殊医疗需求的儿童从世界各地不同医疗体系的国家移民到美国的情况一直在增加。我们的研究结果将有助于为减少移民人口中ASD儿童的健康差距的政策和干预措施提供信息。由于ASD在全球的患病率都有所上升，了解移民群体中的病情和就医行为尤其有价值。
