Gudmundsdottir Emilia, Frigge Helen M, Saemundsen Evald, Jensinudottir Kolbrun B, Njardvik Urdur
Counseling and Diagnostic Center of Iceland, Hafnarfjordur, Iceland.
Children's Mental Health Center, Primary Health Care of the Capital Area, Reykjavik, Iceland.
Eur Child Adolesc Psychiatry. 2025 May 27. doi: 10.1007/s00787-025-02744-3.
Children of migrants have been reported to have increased likelihood of various neurodevelopmental disorders (NDDs), but little is known about differences in referral patterns for diagnostic assessment. This retrospective cohort study aimed to examine differences in referral rates and subsequent diagnostic outcomes between children with native (Icelandic parents) and migrant (at least one parent foreign-born) backgrounds in Iceland in five referral-year cohorts (2014-2018) using a nationwide database. Among 1,367 new referrals, children with migrant backgrounds (31.6%) were consistently referred at a significantly higher rate for assessment due to suspected autism spectrum disorder (ASD), intellectual disability (ID), or motor disorders such as cerebral palsy (CP), particularly children who were under 6 years old, male and second-generation immigrants (born in Iceland to two foreign-born parents). At follow-up, diagnostic outcomes most consistently differed for speech and language disorders (SLD), with significantly higher rates among children with migrant backgrounds across all cohorts. They also had significantly elevated rates of ASD diagnosis in three of the five cohorts, but no difference was found when co-occurring ID and SLD were excluded. Rates of ID (significantly elevated in one cohort) and CP (no difference in any cohort) were similar to those of children with native backgrounds. While it is positive that children with NDDs are not being overlooked due to their migrant backgrounds, the elevated rates of suspected NDDs in this population suggests a need for improved primary-level support with the aim of enhancing their well-being while reducing the demand for specialized diagnostic assessment and long-term support.
据报道，移民子女患各种神经发育障碍（NDDs）的可能性增加，但对于诊断评估的转诊模式差异知之甚少。这项回顾性队列研究旨在利用全国性数据库，调查冰岛五个转诊年份队列（2014 - 2018年）中，具有本土背景（冰岛父母）和移民背景（至少一位父母为外国出生）的儿童在转诊率和后续诊断结果方面的差异。在1367例新转诊病例中，具有移民背景的儿童（31.6%）因疑似自闭症谱系障碍（ASD）、智力残疾（ID）或运动障碍如脑瘫（CP）而被转诊进行评估的比例一直显著更高，尤其是6岁以下、男性和第二代移民（在冰岛出生，父母均为外国出生）的儿童。在随访中，言语和语言障碍（SLD）的诊断结果差异最为一致，所有队列中具有移民背景的儿童患病率显著更高。在五个队列中的三个队列中，他们被诊断为ASD的比例也显著升高，但排除同时存在的ID和SLD后未发现差异。ID（在一个队列中显著升高）和CP（在任何队列中均无差异）的患病率与具有本土背景的儿童相似。虽然患有NDDs的儿童没有因其移民背景而被忽视是一件好事，但该人群中疑似NDDs的高发病率表明，需要改善初级水平的支持，以提高他们的幸福感，同时减少对专门诊断评估和长期支持的需求。
