Rutgers School of Public Health, Piscataway, New Jersey.
Rutgers New Jersey Medical School, Newark, New Jersey.
Pediatrics. 2023 Feb 1;151(2). doi: 10.1542/peds.2022-056594.
Intellectual ability predicts functional outcomes for children with autism spectrum disorder (ASD). It is essential to classify ASD children with and without intellectual disability (ID) to aid etiological research, provide services, and inform evidence-based educational and health planning.
Using a cross-sectional study design, data from 2000 to 2016 active ASD surveillance among 8-year-olds residing in the New York-New Jersey Metropolitan Area were analyzed to determine ASD prevalence with and without ID. Multivariable Poisson regression models were used to identify trends for ASD with ID (ASD-I) and without ID (ASD-N).
Overall, 4661 8-year-olds were identified with ASD. Those that were ASI-I were 1505 (32.3%) and 2764 (59.3%) were ASD-N. Males were 3794 (81.4%), 946 (20.3%) were non-Hispanic Black (Black), 1230 (26.4%) were Hispanic, and 2114 (45.4%) were non-Hispanic white (white). We observed 2-fold and 5-fold increases in the prevalence of ASD-I and ASD-N, respectively, from 2000-2016. Black children were 30% less likely to be identified with ASD-N compared with white children. Children residing in affluent areas were 80% more likely to be identified with ASD-N compared with children in underserved areas. A greater proportion of children with ASD-I resided in vulnerable areas compared with children with ASD-N. Males had higher prevalence compared with females regardless of ID status; however, male-to-female ratios were slightly lower among ASD-I compared with ASD-N cases.
One-in-3 children with ASD had ID. Disparities in the identification of ASD without ID were observed among Black and Hispanic children as well as among children residing in underserved areas.
智力能力可预测自闭症谱系障碍（ASD）儿童的功能结果。对有智力障碍（ID）和无智力障碍（ID）的 ASD 儿童进行分类对于帮助病因研究、提供服务以及告知基于证据的教育和健康规划至关重要。
使用横断面研究设计，分析了 2000 年至 2016 年期间居住在纽约-新泽西大都市区的 8 岁儿童的 ASD 主动监测数据，以确定有无 ID 的 ASD 患病率。多变量泊松回归模型用于确定有 ID 的 ASD（ASD-I）和无 ID 的 ASD（ASD-N）的趋势。
总体而言，共确定了 4661 名 8 岁 ASD 儿童。ASD-I 为 1505 人（32.3%），ASD-N 为 2764 人（59.3%）。男性为 3794 人（81.4%），946 人（20.3%）是非西班牙裔黑人（黑人），1230 人（26.4%）是西班牙裔，2114 人（45.4%）是非西班牙裔白人（白人）。我们观察到，从 2000 年到 2016 年，ASD-I 和 ASD-N 的患病率分别增加了 2 倍和 5 倍。与白人儿童相比，黑人儿童被诊断为 ASD-N 的可能性低 30%。与服务不足地区的儿童相比，居住在富裕地区的儿童被诊断为 ASD-N 的可能性高 80%。与 ASD-N 患者相比，更多的 ASD-I 患者居住在脆弱地区。无论 ID 状态如何，男性的患病率都高于女性；然而，与 ASD-N 病例相比，ASD-I 病例的男女比例略低。
每 3 名 ASD 儿童中就有 1 名患有 ID。在黑人儿童和西班牙裔儿童以及服务不足地区的儿童中，发现了 ASD 无 ID 识别方面的差异。
