Williams Lashae N, Wieckowski Andrea Trubanova, Dieckhaus Mary F S, Dai Yael G, Zhang Fengqing, Dumont-Mathieu Thyde, Barton Marianne, Fein Deborah, Robins Diana L
A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA 19104, USA.
Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA.
Brain Sci. 2022 Dec 22;13(1):18. doi: 10.3390/brainsci13010018.
Early detection of autism provides access to early intervention and subsequently fewer lifelong challenges. However, disparities in screening have been associated with socioeconomic status (SES) and race, and disparities in surveillance have been associated with clinician knowledge and beliefs about autism identification. The present study examines associations between demographic variables and clinician beliefs, and agreement between screening results and clinician surveillance. Surveillance included activities used by the primary care clinicians (PCCs) to assess risk for autism. PCCs reported their beliefs about autism screening and identification, their sex, race, years in practice, and racial distribution of their patient population. Children's demographic information was also collected. PCCs identified children as having, or not having, an increased likelihood of autism, and parents of children completed an autism screener. Agreement between screening and surveillance results were examined across PCC, practice, and child demographics. Higher confidence in autism knowledge and screening resources, female PCC sex, and majority White practice patient demographics all predicted agreement between screening and surveillance. Female child sex and higher maternal education also predicted agreement between screening and surveillance. These findings highlight the importance of PCC screening beliefs and child and PCC demographics on the autism identification process.
早期发现自闭症能够获得早期干预，进而减少终身面临的挑战。然而，筛查方面的差异与社会经济地位（SES）和种族有关，而监测方面的差异则与临床医生对自闭症识别的知识和信念有关。本研究考察了人口统计学变量与临床医生信念之间的关联，以及筛查结果与临床医生监测之间的一致性。监测包括基层医疗临床医生（PCCs）用于评估自闭症风险的活动。PCCs报告了他们对自闭症筛查和识别的信念、性别、种族、执业年限以及患者群体的种族分布。还收集了儿童的人口统计学信息。PCCs确定儿童是否有患自闭症的可能性增加，儿童的父母完成了自闭症筛查。在PCC、执业情况和儿童人口统计学方面，对筛查和监测结果之间的一致性进行了考察。对自闭症知识和筛查资源的更高信心、女性PCC性别以及以白人为主的执业患者人口统计学特征均预测了筛查和监测之间的一致性。女童性别和母亲较高的教育水平也预测了筛查和监测之间的一致性。这些发现凸显了PCC筛查信念以及儿童和PCC人口统计学特征在自闭症识别过程中的重要性。
