National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
School of Medicine, University of Missouri - Kansas City, Kansas City, MO.
J Pediatr. 2021 May;232:264-271. doi: 10.1016/j.jpeds.2021.01.043. Epub 2021 Jan 22.
To explore how many pre-school aged children with autism spectrum disorder (ASD) used psychotropic medication, child and geographic factors associated with psychotropic medication use, and how many children who used psychotropic medication did or did not ever receive behavior therapy.
Children 2-5 years of age were enrolled from 2012 to 2016 in a multisite case-control study designed to investigate the development and risk factors of ASD. Children with a positive ASD screen or ASD diagnosis upon enrollment were asked to complete a comprehensive evaluation to determine ASD status and developmental level. Caregivers completed a Services and Treatments Questionnaire and multiple self-administered questionnaires to determine child use of psychotropic medication, ever receipt of behavior therapy, and presence of co-occurring symptoms.
There were 763 children who were classified as ASD and had data collected on the Services and Treatments Questionnaire. Of those, 62 (8.1%) used psychotropic medication to treat behavioral symptoms and 28 (3.7%) were ≤3 years of age when medication was first started. Attention problems (aOR, 7.65; 95% CI, 3.41-16.1; P < .001) and study site (aOR, 2.62; 95% CI, 1.04-6.56; P = .04) were significantly associated with psychotropic medication use after controlling for maternal race/ethnicity. More than one-half (59.7%) of those who used psychotropic medication did not ever receive behavior therapy.
Many preschool-aged children with ASD who use psychotropic medication do not receive behavior therapy. Pediatricians are an important resource for children and families and can help facilitate behavioral treatment for children with ASD and other disorders.
探索有多少患有自闭症谱系障碍（ASD）的学龄前儿童使用精神药物，与精神药物使用相关的儿童和地理因素，以及有多少使用精神药物的儿童曾经或从未接受过行为疗法。
本研究采用多中心病例对照设计，于 2012 年至 2016 年期间招募了 2-5 岁的儿童，旨在调查 ASD 的发展和风险因素。入组时通过阳性 ASD 筛查或 ASD 诊断的儿童被要求完成全面评估，以确定 ASD 状态和发育水平。照护者填写服务和治疗问卷以及多项自我管理问卷，以确定儿童使用精神药物、是否曾接受过行为治疗以及是否存在共患症状。
共有 763 名被归类为 ASD 并在服务和治疗问卷上收集了数据的儿童。其中，62 名（8.1%）使用精神药物治疗行为症状，28 名（3.7%）在首次开始用药时年龄≤3 岁。注意力问题（比值比，7.65；95%置信区间，3.41-16.1；P<0.001）和研究地点（比值比，2.62；95%置信区间，1.04-6.56；P=0.04）是在控制了母亲种族/民族后与精神药物使用显著相关的因素。超过一半（59.7%）使用精神药物的儿童从未接受过行为治疗。
许多使用精神药物的学龄前 ASD 儿童未接受行为治疗。儿科医生是儿童及其家庭的重要资源，可帮助为 ASD 和其他障碍儿童提供行为治疗。
