Hull York medical School and Department of Health Sciences, University of York, York, UK.
Leeds and York Partnership NHS Foundation Trust, Leeds, UK.
BMJ Open. 2021 Jan 17;11(1):e041960. doi: 10.1136/bmjopen-2020-041960.
This was a pilot study to explore whether the Early Years Foundation Stage Profile (EYFSP) carried out by UK teachers within the 'reception' year, combined with the Social Communication Questionnaire (SCQ), can lead to early identification of children with autism spectrum disorders (ASD) and early access to intervention and can reduce inequity in access to assessment and intervention.
Pragmatic prospective cohort.
Ten primary schools from the SHINE project in Bradford.
587 pupils from 10 schools who transitioned from reception to year 1 in July 2017 and had the EYFSP completed were included in the final study.
The assessment involved a multidisciplinary team of three staff who completed Autism Diagnostic Interview-Revised, Autism Diagnostic Observation Schedule Version 2, classroom observations with an ASD checklist, a teacher-based ASD questionnaire and a final consensus meeting.
National Institute for Health and Care Excellence guideline-compliant clinical diagnosis of ASD.
Age of diagnosis, demographic data and feasibility parameters.
Children with low scores on the EYFSP were more likely to score above the SCQ threshold of 12, indicating potential autism (50% compared with 19% of children with high scores on the EYFSP (p<0.001)). All children scoring above the SCQ threshold received a full autism assessment; children who scored low on the EYFSP were more likely to be diagnosed with autism (and other developmental issues) compared with those who did not.
We identified nine new children with a diagnosis of ASD, all from ethnic minorities, suggesting that this process may be addressing the inequalities in early diagnosis found in previous studies. All children who scored above the SCQ threshold required support (ie, had a neurodevelopmental disorder), indicating the EYFSP questionnaire captured 'at-risk' children.
本研究旨在探索英国教师在“接待”年进行的早期基础阶段概况（EYFSP），结合社交沟通问卷（SCQ），是否能有助于早期识别自闭症谱系障碍（ASD）儿童，并及早获得干预，从而减少获得评估和干预机会的不平等。
实用前瞻性队列研究。
布拉德福德 SHINE 项目的 10 所小学。
2017 年 7 月从幼儿园升入一年级且 EYFSP 完成的 10 所学校的 587 名学生被纳入最终研究。
评估涉及一个由 3 名工作人员组成的多学科团队，他们完成了自闭症诊断访谈修订版、自闭症诊断观察量表第 2 版、使用自闭症检查表进行课堂观察、基于教师的 ASD 问卷以及最终的共识会议。
符合国家卫生与保健卓越研究所（NICE）指南的 ASD 临床诊断。
诊断年龄、人口统计学数据和可行性参数。
EYFSP 得分较低的儿童更有可能在 SCQ 阈值（12 分）以上得分，表明存在潜在的自闭症（50%的儿童得分高于 EYFSP 得分较高的儿童（19%）（p<0.001））。所有 SCQ 阈值以上得分的儿童均接受了全面的自闭症评估；与未得分低的儿童相比，EYFSP 得分较低的儿童更有可能被诊断为自闭症（和其他发育问题）。
我们发现了 9 名新的自闭症儿童，均来自少数民族，这表明该过程可能正在解决先前研究中发现的早期诊断中的不平等问题。所有 SCQ 阈值以上得分的儿童都需要支持（即，患有神经发育障碍），这表明 EYFSP 问卷捕捉到了“高危”儿童。
