1 Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
2 National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Rep. 2018 Jan/Feb;133(1):85-92. doi: 10.1177/0033354917739582. Epub 2017 Dec 19.
Although data on publicly available special education are informative and offer a glimpse of trends in autism spectrum disorder (ASD) and use of educational services, using these data for population-based public health monitoring has drawbacks. Our objective was to evaluate trends in special education eligibility among 8-year-old children with ASD identified in the Autism and Developmental Disabilities Monitoring Network.
We used data from 5 Autism and Developmental Disabilities Monitoring Network sites (Arizona, Colorado, Georgia, Maryland, and North Carolina) during 4 surveillance years (2002, 2006, 2008, and 2010) and compared trends in 12 categories of special education eligibility by sex and race/ethnicity. We used multivariable linear risk regressions to evaluate how the proportion of children with a given eligibility changed over time.
Of 6010 children with ASD, more than 36% did not receive an autism eligibility in special education in each surveillance year. From surveillance year 2002 to surveillance year 2010, autism eligibility increased by 3.6 percentage points ( P = .09), and intellectual disability eligibility decreased by 4.6 percentage points ( P < .001). A greater proportion of boys than girls had an autism eligibility in 2002 (56.3% vs 48.8%). Compared with other racial/ethnic groups, Hispanic children had the largest increase in proportion with autism eligibility from 2002 to 2010 (15.4%, P = .005) and the largest decrease in proportion with intellectual disability (-14.3%, P = .004).
Although most children with ASD had autism eligibility, many received special education services under other categories, and racial/ethnic disparities persisted. To monitor trends in ASD prevalence, public health officials need access to comprehensive data collected systematically, not just special education eligibility.
尽管公开的特殊教育数据提供了有价值的信息，可洞悉自闭症谱系障碍（ASD）的趋势和教育服务的利用情况，但将这些数据用于基于人群的公共卫生监测存在缺陷。我们的目的是评估在自闭症和发育障碍监测网络中发现的 8 岁 ASD 儿童的特殊教育资格认定趋势。
我们使用了来自自闭症和发育障碍监测网络的 5 个监测点（亚利桑那州、科罗拉多州、佐治亚州、马里兰州和北卡罗来纳州）的数据，这些数据来自 4 个监测年（2002 年、2006 年、2008 年和 2010 年），并比较了男女性别和种族/民族在 12 类特殊教育资格认定类别中的趋势。我们使用多变量线性风险回归来评估特定资格认定比例随时间的变化情况。
在 6010 名 ASD 儿童中，超过 36%的儿童在每个监测年度都没有获得特殊教育的自闭症资格认定。从 2002 年监测年到 2010 年监测年，自闭症资格认定增加了 3.6 个百分点（P=0.09），智力障碍资格认定下降了 4.6 个百分点（P<0.001）。2002 年，男孩自闭症资格认定比例（56.3%）高于女孩（48.8%）。与其他种族/民族群体相比，西班牙裔儿童在 2002 年至 2010 年期间自闭症资格认定比例的增幅最大（15.4%，P=0.005），智力障碍资格认定比例的降幅最大（-14.3%，P=0.004）。
尽管大多数 ASD 儿童有自闭症资格认定，但许多儿童仍通过其他类别获得特殊教育服务，种族/民族差异仍然存在。为了监测 ASD 流行率的趋势，公共卫生官员需要获得系统收集的全面数据，而不仅仅是特殊教育资格认定数据。
