Pokoski Olivia M, Furnier Sarah M, Gangnon Ronald E, Howerton Ellen M, Kirby Anne V, Protho Tyra, Schweizer Marin L, Travers Brittany G, Durkin Maureen S
Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison.
Waisman Center, University of Wisconsin-Madison.
JAMA Pediatr. 2025 Apr 14. doi: 10.1001/jamapediatrics.2025.0216.
Prior literature has explored the prevalence of motor impairments in autistic individuals, but estimates come from clinical, convenience, or small samples, limiting generalizability. Better understanding of the frequency of motor milestone delays in autistic individuals could improve early identification and subsequently lead to earlier intervention and better developmental outcomes.
To determine the prevalence of motor milestone delays in a population-based sample of 8-year-old autistic children and to evaluate if having motor milestone delays is associated with an earlier age at autism evaluation or diagnosis.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study of autistic 8-year-old children was conducted using Autism and Developmental Disabilities Monitoring (ADDM) Network data between surveillance years 2000 and 2016. ADDM Network data are population based and are drawn from 17 sites across the US. Data were analyzed from October 2023 to August 2024.
Binary indicator of motor milestone delays documented in health or educational records.
The primary outcome was the prevalence of motor milestone delays among autistic 8-year-old children. Associations between motor milestone delays and age at autism evaluation or diagnosis were evaluated using linear regression. Covariates included study site, surveillance year, the number of autism discriminators, intellectual disability, child sex, and child race and ethnicity.
Among 32 850 children aged 8 years identified with autism by active surveillance, 23 481 children (71.5%) met criteria for motor milestone delays. A total of 5973 children (18.2%) were female. In linear regression models, children with motor milestone delays were evaluated for autism significantly earlier (mean age, 43.65 months; 95% CI, 43.38-43.91) than children without motor milestone delays (mean age, 51.64 months; 95% CI, 51.22-52.06). After stratifying by the co-occurrence of intellectual disability (ID), children with motor milestone delays were evaluated for autism earlier than those without motor milestone delays, regardless of ID.
This cross-sectional study estimates the prevalence of motor milestone delays among autistic 8-year-old children and highlights the association between these delays and an earlier autism evaluation, even in children without co-occurring ID. Early identification of autism is a public health priority, and assessing motor milestone delays, particularly in children with an increased likelihood of being autistic, may facilitate an earlier autism evaluation, leading to more timely interventions and better developmental outcomes.
既往文献探讨了自闭症个体中运动障碍的患病率，但估计值来自临床、便利样本或小样本，限制了其普遍性。更好地了解自闭症个体运动发育里程碑延迟的频率，可改善早期识别，进而实现更早干预并带来更好的发育结果。
确定以人群为基础的8岁自闭症儿童样本中运动发育里程碑延迟的患病率，并评估运动发育里程碑延迟是否与自闭症评估或诊断的较早年龄相关。
设计、背景和参与者：这项针对8岁自闭症儿童的横断面研究使用了2000年至2016年监测年度的自闭症和发育障碍监测（ADDM）网络数据。ADDM网络数据以人群为基础，取自美国17个地点。数据于2023年10月至2024年8月进行分析。
健康或教育记录中记录的运动发育里程碑延迟的二元指标。
主要结局是8岁自闭症儿童中运动发育里程碑延迟的患病率。使用线性回归评估运动发育里程碑延迟与自闭症评估或诊断年龄之间的关联。协变量包括研究地点、监测年份、自闭症鉴别指标数量、智力残疾、儿童性别以及儿童种族和族裔。
在通过主动监测确定的32850名8岁自闭症儿童中，23481名儿童（71.5%）符合运动发育里程碑延迟的标准。共有5973名儿童（18.2%）为女性。在线性回归模型中，有运动发育里程碑延迟的儿童自闭症评估的年龄显著早于无运动发育里程碑延迟的儿童（平均年龄43.65个月；95%置信区间，43.38 - 43.91）（平均年龄51.64个月；95%置信区间，51.22 - 52.06）。在按智力残疾（ID）共病情况分层后，无论是否存在ID，有运动发育里程碑延迟的儿童自闭症评估时间均早于无运动发育里程碑延迟的儿童。
这项横断面研究估计了8岁自闭症儿童中运动发育里程碑延迟的患病率，并强调了这些延迟与较早自闭症评估之间的关联，即使在无共病ID的儿童中也是如此。自闭症的早期识别是一项公共卫生重点，评估运动发育里程碑延迟，特别是在自闭症可能性增加的儿童中，可能有助于更早进行自闭症评估，从而实现更及时的干预和更好的发育结果。
