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自闭症谱系障碍的首次预警及诊断时间。

First Alarm and Time of Diagnosis in Autism Spectrum Disorders.

作者信息

Mitroulaki Sotiria, Serdari Aspasia, Tripsianis Gregory, Gundelfinger Ronnie, Arvaniti Aikaterini, Vorvolakos Theofanis, Samakouri Maria

机构信息

Department of Child and Adolescent Psychiatry, Democritus University of Thrace, Medical School, Alexandroupolis, Greece.

Department of Child and Adolescent Psychiatry, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis, Alexandroupolis, Greece.

出版信息

Compr Child Adolesc Nurs. 2020 Oct 22;45(1):75-91. doi: 10.1080/24694193.2020.1834013.

Abstract

Early diagnosis of autism spectrum disorder (ASD) is of paramount importance as it opens the road to early intervention, which is associated with better prognosis. However, early diagnosis is often delayed until preschool or school age. The purpose of the current retrospective study was to explore the age of recognition of first alarming symptoms in boys and girls as well as the age at diagnosis of different subtypes of ASD in a small sample. A total of 128 parents' of children with ASDs were participated in the survey by completing a self-report questionnaire about early signs and symptoms that raised their concern. Parents of children with autism voiced concerns earlier and obtained diagnosis significantly earlier compared to parents of children with Asperger syndrome ( value <0.000). No significant difference ( value<0.05) has been detected between males and females in early manifestation of first signs and symptoms of ASD. The mean age at diagnosis was 3.8 years for autistic disorder, 6.2 years for children with Asperger syndrome and 6.4 years for other, e.g., PDD-NOS. The most commonly reported symptoms were speech and language problems ( value = 0.001) for children who were later diagnosed with autism, while behavior problems ( value = 0.046) as well as difficulties in education at school ( value = 0.013) for children with Asperger syndrome. The gap between early identification and diagnosis pinpoints the urgent need for national systematic early screening, the development of reliable and sensitive diagnostic instruments for infants and toddlers and heightened awareness of early signs of ASD among parents, teachers, and healthcare professionals and providers as well.

摘要

自闭症谱系障碍(ASD)的早期诊断至关重要,因为它为早期干预开辟了道路,而早期干预与更好的预后相关。然而,早期诊断往往会延迟到学龄前或学龄期。本项回顾性研究的目的是在一个小样本中探讨男孩和女孩首次出现警示症状的识别年龄以及不同亚型ASD的诊断年龄。共有128名自闭症谱系障碍儿童的家长参与了调查,他们填写了一份关于引起他们关注的早期体征和症状的自我报告问卷。与阿斯伯格综合征患儿的家长相比,自闭症患儿的家长更早表达担忧且诊断时间明显更早(值<0.000)。在ASD首次体征和症状的早期表现方面,男性和女性之间未检测到显著差异(值<0.05)。自闭症障碍的平均诊断年龄为3.8岁,阿斯伯格综合征患儿为6.2岁,其他类型如广泛性发育障碍未特定型(PDD-NOS)为6.4岁。对于后来被诊断为自闭症的儿童,最常报告的症状是言语和语言问题(值 = 0.001),而对于阿斯伯格综合征患儿,行为问题(值 = 0.046)以及在学校的学习困难(值 = 0.013)。早期识别与诊断之间的差距凸显了国家系统早期筛查的迫切需求、开发针对婴幼儿的可靠且敏感的诊断工具以及提高家长、教师和医疗保健专业人员及提供者对ASD早期体征的认识。

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