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家长报告的自闭症诊断稳定性和澳大利亚儿童纵向研究中的轨迹。

Parent-reported Autism Diagnostic Stability and Trajectories in the Longitudinal Study of Australian Children.

机构信息

Department of Paediatrics, Monash University, Clayton, Victoria, Australia.

Murdoch Children's Research Institute, Parkville, Victoria, Australia.

出版信息

Autism Res. 2021 Apr;14(4):773-786. doi: 10.1002/aur.2470. Epub 2021 Jan 14.

Abstract

This study aimed to explore the stability of parent-reported diagnosis of Autism Spectrum Disorder (ASD) and factors influencing the trajectories in two cohorts from the prospective Longitudinal Study of Australian Children (LSAC). Parent-reported ASD diagnosis was collected for children from 6 years of age in a Birth cohort and 10 years of age in a Kinder cohort; allowing for exploration of diagnostic stability at age 6, 8, 10, and 12 years (Birth cohort) and 10, 12, 14, 16 years (Kinder cohort). Children were grouped based on persisting, desisting, inconsistent and late (diagnosis after 6 years-Birth cohort; after 10 years-Kinder) subgroups over four timepoints. Multinomial logistic regression explored predictors of diagnostic trajectories; generalized estimating equations examined trajectories of emotional and behavioral problems. Of 66 Birth cohort children parent-reported to have ASD at age 6, with data at all four time points, 14% did not at 12 years; of 73 Kinder cohort children at age 10 years, 26% no longer had parent-reported ASD at 16 years. Children with late diagnoses showed increasing trajectories of emotional and behavioral problems, while children with persisting or desisting diagnoses showed decreasing trajectories. Between 86% and 74% had a reported ASD diagnosis after 6 years. Findings indicate that children with ASD need services and supports that can adapt to their changing needs, which may be increasing, decreasing or different. This has implications for the provision of services and funding. LAY SUMMARY: This study explored how consistent parent-reported ASD diagnosis is over time in two groups of children from the Longitudinal Study of Australian Children (LSAC). Although up to 26% of children no longer had parent-reported ASD after 6-years follow up, persisting or late trajectories were more common. The outcome of late onset trajectories requires ongoing review. Autism Res 2021, 14: 773-786. © 2021 International Society for Autism Research and Wiley Periodicals LLC.

摘要

本研究旨在探索前瞻性澳大利亚儿童纵向研究(LSAC)两个队列中父母报告的自闭症谱系障碍(ASD)诊断的稳定性,以及影响轨迹的因素。从出生队列的 6 岁儿童和儿童队列的 10 岁儿童中收集父母报告的 ASD 诊断;允许在 6 岁、8 岁、10 岁和 12 岁(出生队列)和 10 岁、12 岁、14 岁、16 岁(儿童队列)时探索诊断稳定性。根据在四个时间点上持续、消退、不一致和延迟(出生队列 6 年后;儿童队列 10 年后)亚组,将儿童分为不同的组别。多项逻辑回归探索了诊断轨迹的预测因素;广义估计方程研究了情绪和行为问题的轨迹。在 6 岁时父母报告患有 ASD 的 66 名出生队列儿童中,有数据显示,在所有四个时间点上,有 14%的儿童在 12 岁时没有被诊断出患有 ASD;在 10 岁时父母报告患有 ASD 的 73 名儿童中,有 26%的儿童在 16 岁时不再被父母报告患有 ASD。诊断较晚的儿童表现出情绪和行为问题的轨迹增加,而持续或消退诊断的儿童表现出轨迹减少。6 岁后,有 86%至 74%的儿童被报告患有 ASD。研究结果表明,患有 ASD 的儿童需要能够适应其不断变化需求的服务和支持,这些需求可能会增加、减少或不同。这对服务和资金的提供有影响。

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