National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Pediatrics. 2024 Apr 1;153(4). doi: 10.1542/peds.2023-063672.
Our objectives with this study were to describe the frequency of selected cooccurring health conditions and individualized education program (IEP) services and post-high school transition planning for adolescents with autism spectrum disorder and identify disparities by sex, intellectual ability, race or ethnicity, and geographic area.
The study sample included 1787 adolescents born in 2004 who were identified as having autism through a health and education record review through age 16 years in 2020. These adolescents were part of a longitudinal population-based surveillance birth cohort from the Autism and Developmental Disabilities Monitoring Network from 2004 to 2020 in 5 US catchment areas.
Attention deficit hyperactivity disorder (47%) and anxiety (39%) were the most common cooccurring health conditions. Anxiety was less commonly identified for those with intellectual disability than those without. It was also less commonly identified among Black adolescents compared with White or Hispanic adolescents. There was wide variation across Autism and Developmental Disabilities Monitoring Network sites in the provision of school-based IEP services. Students with intellectual disability were less likely to receive school-based mental health services and more likely to have a goal for postsecondary independent living skills compared with those without intellectual disability. A total of 37% of students did not participate in standardized testing.
We identified disparities in the identification of cooccurring conditions and school-based IEP services, practices, and transition planning. Working with pediatric health and education providers, families, and adolescents with autism will be important to identify contributing factors and to focus efforts to reduce disparities in the supports and services adolescents with autism have access to and receive.
本研究的目的是描述自闭症谱系障碍青少年共同出现的健康状况和个别化教育计划(IEP)服务的频率,以及高中毕业后的过渡规划,并确定性别、智力能力、种族或民族以及地理位置差异。
研究样本包括 1787 名青少年,他们在 2020 年通过健康和教育记录审查在 16 岁之前被确定为自闭症。这些青少年是 2004 年至 2020 年在 5 个美国监测区域的自闭症和发育障碍监测网络(Autism and Developmental Disabilities Monitoring Network)进行的纵向基于人群的监测出生队列的一部分。
注意力缺陷多动障碍(47%)和焦虑(39%)是最常见的共同出现的健康状况。与没有智力障碍的人相比,智力障碍者的焦虑症发病率较低。与白人和西班牙裔青少年相比,黑皮肤青少年的焦虑症发病率也较低。在自闭症和发育障碍监测网络各站点提供的基于学校的 IEP 服务方面存在很大差异。与没有智力障碍的学生相比,有智力障碍的学生接受基于学校的心理健康服务的可能性较小,而接受高中后独立生活技能目标的可能性较大。共有 37%的学生未参加标准化考试。
我们发现共同出现的疾病和基于学校的 IEP 服务、实践和过渡规划方面存在差异。与儿科保健和教育提供者、家庭以及自闭症青少年合作将是确定促成因素的重要途径,并将努力重点放在减少自闭症青少年获得和接受的支持和服务方面的差异上。