Leach Madison, Mazefsky Carla A, Northrup Jessie B
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
J Autism Dev Disord. 2025 Jan 4. doi: 10.1007/s10803-024-06699-3.
There is a substantial time gap between when parents develop concerns about their child (ages 1-2) and when they receive a diagnosis of autism (ages 3-5), delaying the onset of critical interventions. Few studies have examined how the timing, type, and quantity of early parental concerns are associated with age of diagnosis. The aims of this study were to describe characteristics of parents' concerns in a large community-based sample and explore how characteristics of concerns relate to age of diagnosis. This study included 853 parents of 2- to 5-year-old children with an autism diagnosis. Parents completed an online survey including questions regarding their child's age when they first became concerned about their development, what their first concern was, all concerns they have had about their child, and age of diagnosis. An earlier age at first concern and the presence of several specific types of concerns (i.e., delayed/absence response to name, reduced eye contact, developmental regression, delayed gesture development, limited emotional response) were found to be significant predictors of earlier age at diagnosis. In addition, when accounting for age of first concern and the presence of specific types of concerns, a higher number of concerns was associated with a later age of diagnosis. Several specific types of concerns significantly predict the age at diagnosis, although several of these specific types are not commonly reported by parents. Educating parents and pediatricians about these concerns may improve early detection and intervention, ultimately improving long-term outcomes for children and families.
从父母开始担心自己1至2岁的孩子，到孩子被诊断为自闭症（3至5岁）之间，存在着相当长的时间间隔，这延误了关键干预措施的启动。很少有研究探讨早期父母担忧的时间、类型和数量与诊断年龄之间的关联。本研究的目的是描述一个大型社区样本中父母担忧的特征，并探讨这些担忧的特征与诊断年龄之间的关系。本研究纳入了853名2至5岁被诊断为自闭症儿童的父母。父母们完成了一项在线调查，其中包括关于他们首次开始担心孩子发育时孩子的年龄、他们最初的担忧是什么、他们对孩子的所有担忧以及诊断年龄的问题。首次担忧的年龄较早以及存在几种特定类型的担忧（即对名字的反应延迟/没有反应、眼神接触减少、发育倒退、手势发育延迟、情感反应有限）被发现是诊断年龄较早的重要预测因素。此外，在考虑首次担忧的年龄和特定类型担忧的存在时，担忧数量较多与诊断年龄较晚相关。几种特定类型的担忧显著预测诊断年龄，尽管其中一些特定类型的担忧父母并不常报告。让父母和儿科医生了解这些担忧可能会改善早期发现和干预，最终改善儿童及其家庭的长期结局。
