Garcia Primo Patricia, Weber Christoph, Posada de la Paz Manuel, Fellinger Johannes, Dirmhirn Anna, Holzinger Daniel
Research Institute of Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria.
Department for Inclusive Education, University of Education Upper Austria, 4020 Linz, Austria.
Brain Sci. 2020 Jul 14;10(7):448. doi: 10.3390/brainsci10070448.
This study explored (i) differences in age at Autism Spectrum Disorder (ASD) diagnosis between children with and without a migrant background in the main diagnostic centre for ASD in Upper Austria (ii) factors related to the age at diagnosis and (iii) whether specific factors differed between the two groups. A retrospective chart analysis included all children who received their first diagnosis before the age of 10 years ( = 211) between 2013 and 2018. Children with a migrant background were diagnosed 13 months earlier than those without (r = 0.278, < 0.001), and had more severe delays in language, more severe autism, no Asperger's syndrome, lower parental educational level and more frequent referrals by paediatricians. For the total sample, expressive language delay, severity of restricted and repetitive behaviours, higher nonverbal development, and paediatric referrals explained earlier diagnoses. There was a stronger effect of parental education and weaker effect of language impairment on age at ASD diagnosis in children with a migrant background. In conclusion, no delay in diagnosing ASD in children with a migrant background in a country with universal health care and an established system of paediatric developmental surveillance was found. Awareness of ASD, including Asperger's syndrome, should be raised among families and healthcare professionals.
（i）奥地利上奥地利州自闭症谱系障碍（ASD）主要诊断中心中，有移民背景和无移民背景儿童在ASD诊断年龄上的差异；（ii）与诊断年龄相关的因素；以及（iii）两组之间特定因素是否存在差异。一项回顾性病历分析纳入了2013年至2018年间所有在10岁前首次确诊的儿童（n = 211）。有移民背景的儿童比无移民背景的儿童早13个月被诊断出来（r = 0.278，p < 0.001），且语言发育延迟更严重、自闭症更严重、没有阿斯伯格综合征、父母教育水平较低以及儿科医生转诊更频繁。对于整个样本，表达性语言延迟、受限和重复行为的严重程度、较高的非语言发育水平以及儿科转诊可解释较早的诊断。在有移民背景的儿童中，父母教育对ASD诊断年龄的影响更强，而语言障碍的影响较弱。总之，在一个拥有全民医疗保健和成熟儿科发育监测系统的国家，未发现有移民背景儿童在ASD诊断上存在延迟。应提高家庭和医疗保健专业人员对包括阿斯伯格综合征在内的ASD的认识。
