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自闭症谱系障碍诊断年龄的预测因素:在临床样本中使用多元回归分析和分类树。

Predictors of age at diagnosis in autism spectrum disorders: the use of multiple regression analyses and a classification tree on a clinical sample.

机构信息

Department of Child Psychiatry, Second Faculty of Medicine, Charles University, University Hospital Motol, V Uvalu 84, 15006, Prague, Czech Republic.

Institute of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic.

出版信息

Eur Child Adolesc Psychiatry. 2024 Apr;33(4):1171-1177. doi: 10.1007/s00787-023-02189-6. Epub 2023 Mar 18.

Abstract

The increasing prevalence of autism spectrum disorders (ASD) has led to worldwide interest in factors influencing the age of ASD diagnosis. Parents or caregivers of 237 ASD children (193 boys, 44 girls) diagnosed using the Autism Diagnostic Observation Schedule (ADOS) completed a simple descriptive questionnaire. The data were analyzed using the variable-centered multiple regression analysis and the person-centered classification tree method. We believed that the concurrent use of these two methods could produce robust results. The mean age at diagnosis was 5.8 ± 2.2 years (median 5.3 years). Younger ages for ASD diagnosis were predicted (using multiple regression analysis) by higher scores in the ADOS social domain, higher scores in ADOS restrictive and repetitive behaviors and interest domain, higher maternal education, and the shared household of parents. Using the classification tree method, the subgroup with the lowest mean age at diagnosis were children, in whom the summation of ADOS communication and social domain scores was ≥ 17, and paternal age at the delivery was ≥ 29 years. In contrast, the subgroup with the oldest mean age at diagnosis included children with summed ADOS communication and social domain scores < 17 and maternal education at the elementary school level. The severity of autism and maternal education played a significant role in both types of data analysis focused on age at diagnosis.

摘要

自闭症谱系障碍 (ASD) 的患病率不断上升,引起了全世界对影响 ASD 诊断年龄因素的关注。使用自闭症诊断观察量表 (ADOS) 诊断的 237 名 ASD 儿童(193 名男孩,44 名女孩)的父母或照顾者完成了一份简单的描述性问卷。使用变量中心多元回归分析和个体中心分类树方法对数据进行了分析。我们认为,同时使用这两种方法可以产生稳健的结果。诊断的平均年龄为 5.8±2.2 岁(中位数为 5.3 岁)。使用多元回归分析预测 ASD 诊断年龄较小的因素包括 ADOS 社会领域得分较高、ADOS 限制和重复行为和兴趣领域得分较高、母亲教育程度较高以及父母共同居住。使用分类树方法,最低平均诊断年龄的亚组为 ADOS 沟通和社会领域得分总和≥17 分且父亲分娩年龄≥29 岁的儿童。相比之下,平均诊断年龄最大的亚组包括 ADOS 沟通和社会领域得分总和<17 分且母亲受教育程度为小学的儿童。自闭症严重程度和母亲教育在两种类型的数据分析中都对诊断年龄起着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5047/11032267/b27b7769e447/787_2023_2189_Fig1_HTML.jpg

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