National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
Autism Res. 2020 Mar;13(3):464-473. doi: 10.1002/aur.2255. Epub 2019 Dec 23.
The objectives of our study were to (a) report how many children met an autism spectrum disorder (ASD) surveillance definition but had no clinical diagnosis of ASD in health or education records and (b) evaluate differences in demographic, individual, and service factors between children with and without a documented ASD diagnosis. ASD surveillance was conducted in selected areas of Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin. Children were defined as having ASD if sufficient social and behavioral deficits and/or an ASD diagnosis were noted in health and/or education records. Among 4,498 children, 1,135 (25%) had ASD indicators without having an ASD diagnosis. Of those 1,135 children without a documented ASD diagnosis, 628 (55%) were not known to receive ASD services in public school. Factors associated with not having a clinical diagnosis of ASD were non-White race, no intellectual disability, older age at first developmental concern, older age at first developmental evaluation, special education eligibility other than ASD, and need for fewer supports. These results highlight the importance of reducing disparities in the diagnosis of children with ASD characteristics so that appropriate interventions can be promoted across communities. Autism Res 2020, 13: 464-473. © 2019 International Society for AutismResearch,Wiley Periodicals, Inc. LAY SUMMARY: Children who did not have a clinical diagnosis of autism spectrum disorder (ASD) documented in health or education records were more likely to be non-White and have fewer developmental problems than children with a clinical diagnosis of ASD. They were brought to the attention of healthcare providers at older ages and needed fewer supports than children with a clinical diagnosis of ASD. All children with ASD symptoms who meet diagnostic criteria should be given a clinical diagnosis so they can receive treatment specific to their needs.
(a)报告在健康或教育记录中，有多少儿童符合自闭症谱系障碍 (ASD) 监测定义但没有临床 ASD 诊断；(b)评估在有或没有记录的 ASD 诊断的儿童之间，在人口统计学、个体和服务因素方面的差异。ASD 监测在亚利桑那州、阿肯色州、科罗拉多州、佐治亚州、马里兰州、明尼苏达州、密苏里州、新泽西州、北卡罗来纳州、田纳西州和威斯康星州的选定地区进行。如果在健康和/或教育记录中注意到足够的社交和行为缺陷和/或 ASD 诊断，则将儿童定义为患有 ASD。在 4498 名儿童中，有 1135 名（25%）具有 ASD 指标但没有 ASD 诊断。在这 1135 名没有记录的 ASD 诊断的儿童中，有 628 名（55%）在公立学校没有接受 ASD 服务。与没有临床 ASD 诊断相关的因素是非白种人、没有智力残疾、首次出现发育问题的年龄较大、首次进行发育评估的年龄较大、特殊教育资格不是 ASD，以及需要较少的支持。这些结果强调了减少具有 ASD 特征的儿童诊断差异的重要性，以便能够在各个社区推广适当的干预措施。自闭症研究 2020，13：464-473。©2019 自闭症国际研究协会，威利期刊，公司。要点总结：在健康或教育记录中没有记录自闭症谱系障碍 (ASD) 临床诊断的儿童，与具有临床 ASD 诊断的儿童相比，他们更有可能是非白种人，且发育问题较少。与具有临床 ASD 诊断的儿童相比，他们被医疗保健提供者注意到的年龄更大，且需要的支持也比具有临床 ASD 诊断的儿童少。所有符合诊断标准的有 ASD 症状的儿童都应进行临床诊断，以便他们能够接受针对其需求的治疗。
