圣地亚哥县胎儿酒精谱系障碍与区域中心服务的获取
Fetal alcohol spectrum disorders and access to regional center services in San Diego County.
机构信息
Department of Pediatrics, University of California San Diego, La Jolla, California, USA.
Department of Psychiatry, University of California San Diego, La Jolla, California, USA.
出版信息
Alcohol Clin Exp Res. 2022 Oct;46(10):1857-1864. doi: 10.1111/acer.14934. Epub 2022 Sep 14.
BACKGROUND
Fetal alcohol spectrum disorders (FASD) are developmental disabilities that are estimated to occur in 2-5% of elementary school children and that negatively impact a child's ability to function without support. Timely diagnosis-informed interventions are crucial to optimizing the developmental trajectory of children with FASD. The true prevalence of FASD among children receiving services for developmental disabilities is unknown.
METHODS
An FASD prevalence study was carried out between 2011 and 2014 among a sample of 5- to 7-year-old children who were receiving services provided by the California State Regional Center for Developmental Disabilities in San Diego County. Children whose parent or caregiver consented were evaluated using the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence study assessment protocol and classification criteria.
RESULTS
Among 216 eligible caregiver-child dyads, 44 completed assessments that were sufficient to obtain a classification for FASD, including fetal alcohol syndrome (FAS), partial FAS, alcohol-related neurodevelopmental disorder, or no fetal alcohol spectrum disorder. Fifteen children were classified as meeting the criteria for an FASD. A minimum FASD prevalence rate of 69.4 per 1000 (6.9%) among all eligible children was estimated. None of the children classified as FASD were receiving services because of an FASD diagnosis, and none had previously been diagnosed with FASD. Autism was the most common qualifying diagnosis for which children classified as FASD were receiving services.
CONCLUSIONS
The 6.9% prevalence estimate among Regional Center clients was higher than the prevalence estimate of 2.3% in the same community among 5- to 7-year-old children in the general population, though the estimate was based on only 20% of eligible dyads. All children in the sample were receiving Regional Center services for another diagnosis. Barriers to eligibility for services for children with FASD may lead to less than optimum care for these children. Study findings support the facilitation of access to developmental services for children with FASD.
背景
胎儿酒精谱系障碍（FASD）是一种发育障碍，据估计，在小学儿童中发生率为 2-5%，会对儿童在没有支持的情况下的功能产生负面影响。及时进行诊断干预对于优化 FASD 儿童的发育轨迹至关重要。在接受发育障碍服务的儿童中，FASD 的真实患病率尚不清楚。
方法
2011 年至 2014 年，在圣地亚哥县加利福尼亚州区域发育障碍中心接受服务的 5 至 7 岁儿童中进行了一项 FASD 患病率研究。获得父母或照顾者同意的儿童使用合作胎儿酒精谱系障碍患病率研究评估方案和分类标准进行评估。
结果
在 216 名符合条件的照顾者-儿童对中，有 44 对完成了评估，足以获得 FASD 的分类，包括胎儿酒精综合征（FAS）、部分 FAS、酒精相关神经发育障碍或无胎儿酒精谱系障碍。15 名儿童被归类为符合 FASD 标准。估计所有符合条件的儿童中最小 FASD 患病率为 69.4/1000（6.9%）。没有被归类为 FASD 的儿童因 FASD 诊断而接受服务，也没有儿童以前被诊断为 FASD。自闭症是被归类为 FASD 的儿童接受服务的最常见的合格诊断。
结论
区域中心客户的 6.9%患病率估计高于同一社区普通人群中 5-7 岁儿童的 2.3%患病率估计，但该估计仅基于 20%的符合条件的对子。样本中的所有儿童都因其他诊断而接受区域中心的服务。FASD 儿童获得服务的资格障碍可能导致这些儿童得不到最佳护理。研究结果支持为 FASD 儿童提供获得发育服务的便利。
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