Barnard-Brak Lucy, Richman David, Ellerbeck Kathryn, Moreno Rosario
Department of Educational Psychology, Texas Tech University, P.O. Box 41071, Lubbock, TX, 79409, USA.
University of Kansas School of Medicine, Kansas City, KS, USA.
Child Adolesc Ment Health. 2017 Feb;22(1):30-35. doi: 10.1111/camh.12194. Epub 2016 Nov 7.
Health care provider (HCP) responses to initial parental report of autism spectrum disorder (ASD) symptoms were examined in relation to latency to diagnosis and child chronological age at diagnosis.
Secondary data analyses were conducted for a sample of 1384 parents of children with ASD utilizing data from the National Survey of Children with Special Health Care Needs (NS-CSHCN, 2009-2010 National Survey of Children with Special Health Care Needs, 2009) and the Centers for Disease Control and Prevention Pathways to Diagnosis and Services (CDC PDS, Survey of pathways to diagnosis and services, 2011).
Approximately 44% of the sample experienced predominantly delayed HCP responses, 38% experienced predominantly proactive responses, while the remaining 18% experienced a relatively even mix of delayed and proactive responses across HCPs. With regard to outcomes correlated with the type of HCP response, individuals exposed to proactive HCPs were diagnosed with ASD almost a year earlier for child chronological age than individuals exposed to mixed HCPs. This difference increased beyond a year between individuals receiving proactive HCPs versus individuals experiencing delayed HCPs. Finally, after controlling for socioeconomic status, parent-reported severity of ASD symptoms, and age at time of referral, proactive HCP was correlated with decreased time to diagnosis from parental first report of ASD symptoms.
Results are discussed with regard to increasing proactive HCP responses to parental first concerns of ASD symptomology versus a mix or delayed responses.
研究了医疗服务提供者(HCP)对家长首次报告的自闭症谱系障碍(ASD)症状的反应与诊断延迟时间以及诊断时儿童实足年龄之间的关系。
利用来自全国特殊医疗需求儿童调查(NS-CSHCN,2009 - 2010年全国特殊医疗需求儿童调查)和疾病控制与预防中心诊断与服务途径调查(CDC PDS,2011年诊断与服务途径调查)的数据,对1384名自闭症谱系障碍儿童的家长样本进行了二次数据分析。
大约44%的样本主要经历了医疗服务提供者的延迟反应,38%主要经历了积极主动的反应,而其余18%在不同医疗服务提供者中经历了延迟反应和积极主动反应的相对均衡混合。关于与医疗服务提供者反应类型相关的结果,接触积极主动医疗服务提供者的个体在儿童实足年龄方面被诊断为自闭症谱系障碍的时间比接触混合反应医疗服务提供者的个体早近一年。在接受积极主动医疗服务提供者的个体与经历延迟反应医疗服务提供者的个体之间,这种差异增加到一年以上。最后,在控制了社会经济地位、家长报告的自闭症谱系障碍症状严重程度以及转诊时的年龄后,积极主动的医疗服务提供者与从家长首次报告自闭症谱系障碍症状到诊断的时间缩短相关。
讨论了关于增加医疗服务提供者对家长首次对自闭症谱系障碍症状担忧的积极主动反应,相对于混合或延迟反应的结果。