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自闭症谱系障碍儿童早期干预机会的错失

Missed Early Intervention Opportunities for Children With Autism Spectrum Disorder.

作者信息

Lidstone Daniel E

机构信息

School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, Pennsylvania, USA.

出版信息

Autism Res. 2025 May;18(5):1097-1103. doi: 10.1002/aur.70043. Epub 2025 Apr 16.

DOI:10.1002/aur.70043
PMID:40237135
Abstract

Early intervention (EI) is essential for improving developmental outcomes in children with autism spectrum disorder (ASD). However, participation during the critical neurodevelopmental (0-3 years) period remains a challenge. To identify those factors associated with the participation of preschool children with ASD in EI before age 2, this study uses recent cross-sectional data from the 2021 to 2023 National Survey of Children's Health (NSCH). Binary logistical regression analysis was conducted to identify factors associated with EI receipt before age 2, including age of ASD diagnosis, socioeconomic status (SES), race, ASD severity, biological sex, birth weight, and diagnosis of early indicators of future developmental delay (DD). The findings revealed that only 15% of preschool children with ASD received EI before age 2. Significant predictors of timely participation in Part C EI included an ASD diagnosis before age 2, higher SES, and lower birth weight. Findings also revealed that 15.5% of children who did not receive timely EI had severe ASD symptoms, highlighting the critical need to improve EI participation for these children. Potential solutions discussed include expanding the definition of DD, increasing the number of states recognizing low birth weight as a Part C EI diagnosis, reducing barriers to Part C EI participation for disadvantaged families, and developing more effective tools to detect ASD and DD earlier in development.

摘要

早期干预(EI)对于改善自闭症谱系障碍(ASD)儿童的发育结局至关重要。然而,在关键的神经发育阶段(0至3岁)参与干预仍然是一项挑战。为了确定与2岁前患有ASD的学龄前儿童参与EI相关的因素,本研究使用了2021年至2023年全国儿童健康调查(NSCH)的最新横断面数据。进行二元逻辑回归分析以确定与2岁前接受EI相关的因素,包括ASD诊断年龄、社会经济地位(SES)、种族、ASD严重程度、生物学性别、出生体重以及未来发育迟缓(DD)早期指标的诊断。研究结果显示,只有15%的患有ASD的学龄前儿童在2岁前接受了EI。及时参与C部分EI的显著预测因素包括2岁前的ASD诊断、较高的SES和较低的出生体重。研究结果还显示,15.5%未及时接受EI的儿童有严重的ASD症状,这凸显了提高这些儿童EI参与率的迫切需求。讨论的潜在解决方案包括扩大DD的定义、增加将低出生体重视为C部分EI诊断的州的数量、减少弱势家庭参与C部分EI的障碍,以及开发更有效的工具以在发育早期更早地检测ASD和DD。

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本文引用的文献

1
Disparities in Receipt of Early Intervention Services by Toddlers with Autism Diagnoses: an Intersectional Latent Class Analysis of Demographic Factors.自闭症诊断幼儿接受早期干预服务的差异:人口因素的交叉潜在类别分析
J Autism Dev Disord. 2024 Oct 28. doi: 10.1007/s10803-024-06613-x.
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Access to Part C, Early Intervention for children younger than 4 years evaluated for autism spectrum disorder.获得针对自闭症谱系障碍进行评估的 4 岁以下儿童的 C 部分(早期干预)服务。
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Autism diagnosis as a social process.自闭症的诊断过程是一个社会过程。
Autism. 2022 Feb;26(2):488-498. doi: 10.1177/13623613211030392. Epub 2021 Jul 9.
9
Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019.自闭症谱系障碍诊断年龄:2012 年至 2019 年的系统评价和荟萃分析。
Autism. 2021 May;25(4):862-873. doi: 10.1177/1362361320971107. Epub 2020 Nov 19.
10
Characteristics of toddlers with early versus later diagnosis of autism spectrum disorder.自闭症谱系障碍早期诊断与晚期诊断幼儿的特征。
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