Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and
Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and.
Pediatrics. 2020 Apr;145(Suppl 1):S99-S107. doi: 10.1542/peds.2019-1895M.
Guidelines suggest young children with autism spectrum disorder (ASD) receive intensive nonpharmacologic interventions. Additionally, associated symptoms may be treated with psychotropic medications. Actual intervention use by young children has not been well characterized. Our aim in this study was to describe interventions received by young children (3-6 years old) with ASD. The association with sociodemographic factors was also explored.
Data were analyzed from the Autism Speaks Autism Treatment Network (AS-ATN), a research registry of children with ASD from 17 sites in the United States and Canada. AS-ATN participants receive a diagnostic evaluation and treatment recommendations. Parents report intervention use at follow-up visits. At follow-up, 805 participants had data available about therapies received, and 613 had data available about medications received.
The median total hours per week of therapy was 5.5 hours (interquartile range 2.0-15.0), and only 33.4% of participants were reported to be getting behaviorally based therapies. A univariate analysis and a multiple regression model predicting total therapy time showed that a diagnosis of ASD before enrollment in the AS-ATN was a significant predictor. Additionally, 16.3% of participants were on ≥1 psychotropic medication. A univariate analysis and a multiple logistic model predicting psychotropic medication use showed site region as a significant predictor.
Relatively few young children with ASD are receiving behavioral therapies or total therapy hours at the recommended intensity. There is regional variability in psychotropic medication use. Further research is needed to improve access to evidence-based treatments for young children with ASD.
指南建议自闭症谱系障碍（ASD）的幼儿接受强化的非药物干预。此外，相关症状可以用精神药物治疗。但幼儿实际接受的干预措施尚未得到很好的描述。我们本项研究的目的是描述 ASD 幼儿（3-6 岁）接受的干预措施，并探讨与社会人口因素的相关性。
本研究的数据来自自闭症之声自闭症治疗网络（AS-ATN），这是一个来自美国和加拿大 17 个地点的自闭症儿童研究注册处。AS-ATN 参与者接受诊断评估和治疗建议。家长在随访时报告干预措施的使用情况。在随访时，805 名参与者提供了有关接受治疗的数据，613 名参与者提供了有关接受药物治疗的数据。
每周治疗的总时间中位数为 5.5 小时（四分位间距 2.0-15.0），只有 33.4%的参与者接受基于行为的治疗。单变量分析和预测总治疗时间的多元回归模型显示，在 AS-ATN 注册前被诊断为 ASD 是一个显著的预测因素。此外，16.3%的参与者正在服用≥1 种精神药物。单变量分析和预测精神药物使用的多元逻辑模型显示，地点区域是一个显著的预测因素。
相对较少的 ASD 幼儿正在接受行为治疗或达到推荐强度的总治疗时间。精神药物的使用存在区域差异。需要进一步研究，以改善 ASD 幼儿获得循证治疗的机会。
