Bourke Jenny, Sanders Richard, Jones Jocelyn, Ranjan Maathumai, Wong Kingsley, Leonard Helen
Child Disability, Telethon Kids Institute, Nedlands, WA, Australia.
Sanders Consulting WA, Education Consultancy, Perth, WA, Australia.
Front Psychiatry. 2024 May 20;15:1359505. doi: 10.3389/fpsyt.2024.1359505. eCollection 2024.
Estimates of the prevalence of intellectual disability or autism spectrum disorder (ASD) may vary depending on the methodology, geographical location, and sources of ascertainment. The National Disability Insurance Scheme (NDIS) in Australia was introduced progressively from 2016 to provide individualized funding for eligible people with a significant and permanent disability.
Its recent inclusion as a source of ascertainment in the population-based Intellectual Disability Exploring Answers (IDEA) database in Western Australia has allowed comparisons of the prevalence of intellectual disability and ASD before and after its introduction.
Prevalence of intellectual disability in 2020 was 22.5 per 1,000 (/1,000) live births compared with previous estimates in 2010 of 17/1,000, and for ASD, the estimate was 20.7/1,000 in 2020 compared with 5.1 /1,000 in 2010. Whilst the prevalence of ASD in Aboriginal individuals was about two-thirds that of non-Aboriginals, there was an increased prevalence of ASD in Aboriginal children under 10 years compared with non-Aboriginal children.
The concurrent relaxation of ASD diagnostic practice standards in Western Australia associated with the administration of access to the NDIS and the release of the National Guidelines empowering single diagnosticians to determine the appropriateness of engaging additional diagnosticians to form a multidisciplinary team on ASD diagnosis, appear to be important factors associated with the increase in ASD diagnoses both with and without intellectual disability.
智力残疾或自闭症谱系障碍(ASD)患病率的估计可能因方法、地理位置和确定来源而异。澳大利亚的国家残疾保险计划(NDIS)于2016年开始逐步推行,为符合条件的严重和永久性残疾人士提供个性化资金。
最近,它作为西澳大利亚州基于人群的智力残疾探索答案(IDEA)数据库的确定来源被纳入,这使得能够比较其推行前后智力残疾和ASD的患病率。
2020年智力残疾的患病率为每1000例活产22.5例(/1000),而2010年之前的估计为每1000例17例;对于ASD,2020年的估计为每1000例20.7例,而2010年为每1000例5.1例。虽然原住民个体中ASD的患病率约为非原住民的三分之二,但10岁以下原住民儿童中ASD的患病率高于非原住民儿童。
西澳大利亚州ASD诊断实践标准的同时放宽,与NDIS的准入管理以及国家指南的发布有关,该指南授权单一诊断医生确定聘请额外诊断医生以组成ASD诊断多学科团队的适宜性,这似乎是与有或无智力残疾的ASD诊断增加相关的重要因素。