Kaplan-Kahn Elizabeth A, Rando Juliette, Ames Jennifer L, Bekelman Traci A, Camargo Carlos A, Croen Lisa A, Dager Stephen R, Dickerson Aisha S, Dunlop Anne L, Elliott Amy J, Giardino Angelo P, Hazlett Heather Cody, Hertz-Picciotto Irva, Hirtz Deborah, Joseph Robert M, Landa Rebecca J, McEvoy Cindy T, Messinger Daniel S, Koinis-Mitchell Daphne, Neiderhiser Jenae M, Newschaffer Craig J, Northrup Jessie B, Ozonoff Sally, Schmidt Rebecca J, Volk Heather E, Lyall Kristen
Center for Autism Research at Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
A.J. Drexel Autism Institute at Drexel University, Philadelphia, Pennsylvania.
JAACAP Open. 2024 Aug 28;3(3):618-633. doi: 10.1016/j.jaacop.2024.05.005. eCollection 2025 Sep.
The goal of this study is to characterize health outcomes across 3 domains-overall well-being, behavioral health, and physical health-in a large sample of autistic and non-autistic children and adolescents in the Environmental influences on Child Health Outcomes (ECHO) program.
First, we examined differences in health outcomes between autistic (N = 286) and non-autistic (N = 4,225) children and adolescents in the ECHO Program. Using a subsample of 1,809 participants (116 autistic participants) with complete outcome data, we conducted latent profile analyses (LPAs) to define profiles of health outcomes for autistic children and adolescents and for the combined sample of autistic and non-autistic participants. Finally, we examined demographic factors in relation to the health outcome profiles.
Autistic participants demonstrated poorer health outcomes than non-autistic participants for most outcome measures across the domains of overall well-being, behavioral health, and physical health. In the combined sample LPA, 3 profiles, representing more positive health (n = 566, 31.3%), poorer health (n = 462, 25.5%), and mixed health (n = 781, 43.2%), were identified. The profile with the poorer health outcomes had the highest proportion of autistic participants (n = 64, 13.9%). However, within the autistic group, LPA revealed 2 profiles of autistic participants, with 1 profile (n = 70, 60.3%) having more positive health outcomes across all domains.
Although autistic participants demonstrated poorer health outcomes than non-autistic participants on most measures, examining latent profiles within the group of autistic participants highlighted variability in the health outcomes among autistic youth. Results emphasize the importance of examining variability within autistic samples to better understand multidimensional health influences and outcomes of individuals on the autism spectrum.
DIVERSITY & INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science.
本研究的目的是在“环境对儿童健康结果的影响”(ECHO)项目中,对大量自闭症和非自闭症儿童及青少年在三个领域——总体幸福感、行为健康和身体健康——的健康结果进行特征描述。
首先,我们研究了ECHO项目中自闭症儿童(N = 286)和非自闭症儿童(青少年)(N = 4225)在健康结果方面的差异。我们使用了1809名参与者(116名自闭症参与者)的子样本,这些参与者有完整的结果数据,进行潜在类别分析(LPA),以确定自闭症儿童及青少年以及自闭症和非自闭症参与者的综合样本的健康结果类别。最后,我们研究了与健康结果类别相关的人口统计学因素。
在总体幸福感、行为健康和身体健康领域的大多数结果测量中,自闭症参与者的健康结果比非自闭症参与者差。在综合样本LPA中,确定了3种类别,分别代表更积极的健康状况(n = 566,31.3%)、较差的健康状况(n = 462,25.5%)和混合健康状况(n = 781,43.2%)。健康结果较差的类别中自闭症参与者的比例最高(n = 64,13.9%)。然而,在自闭症组中,LPA揭示了自闭症参与者的2种类别,其中1种类别(n = 70,60.3%)在所有领域的健康结果更积极。
尽管在大多数测量中,自闭症参与者的健康结果比非自闭症参与者差,但对自闭症参与者群体内部潜在类别的研究突出了自闭症青少年健康结果的变异性。结果强调了研究自闭症样本内部变异性对于更好地理解自闭症谱系个体的多维度健康影响和结果的重要性。
本文的一位或多位作者自我认定为科学领域中一个或多个历史上代表性不足的性取向和/或性别群体的成员。