在初级保健人群中与自闭症谱系障碍诊断年龄相关的儿童和家庭特征。

IF 2.2 3区 医学 Q3 BEHAVIORAL SCIENCES
Corinna J Rea, Kayla Lesch, Barbara Hernandez, Eli Sprecher, Marissa Hauptman, Alexandra Epee-Bounya, Kimberly Wilson, Snehal N Shah
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引用次数: 0

摘要

目的:比较诊断为自闭症谱系障碍(ASD)的儿科初级保健患者与普通临床人群的样本,以及儿童和照顾者特征与诊断年龄的关系。方法:从2018年3月1日至2022年2月28日期间2个大型城市初级保健诊所诊断为ASD的患者的病历中收集横截面数据,通过提取和图表复习。采用χ2分析将样本与初级保健总人群进行比较。采用未调整的双变量线性回归和多变量线性回归评价各变量与诊断年龄的相关性。结果:与普通门诊人群相比,诊断为ASD的患者更可能是男性、西班牙裔、公共保险和医疗复杂的人群。自闭症组的母亲受教育程度也更高。在未经调整的线性回归分析中,语言延迟、与早期干预(EI)的联系、父母关注的较早年龄、转诊的较早年龄、完成了M-CHAT测试、较高的M-CHAT评分以及有一级亲属患有ASD与早期诊断年龄相关。在多元线性回归分析中,与EI联系,更好的护理连续性,更高的M-CHAT评分和有商业保险与早期诊断相关。种族/民族、语言和社会脆弱性指数≥90%与ASD诊断年龄无显著相关性。结论:本研究反映了ASD患病率模式的变化,但在公共保险儿童中诊断年龄的持续差异。它强调了发育监测,连续性护理和导航支持的重要性,以帮助家庭及时获得ASD诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Child and Family Characteristics Associated With Age of Autism Spectrum Disorder Diagnosis in a Primary Care Population.

Objective: To compare a sample of pediatric primary care patients diagnosed with autism spectrum disorder (ASD) with the general clinic population, as well as associations of child and caregiver characteristics with age of diagnosis.

Method: Cross-sectional data for patients from 2 large, urban primary care practices diagnosed with ASD between March 1, 2018, and February 28, 2022, were collected from the medical record through extraction and chart review. The sample was compared with the total primary care population using χ2 analysis. Unadjusted bivariate linear regression and multivariate linear regression were used to evaluate associations of each variable with age of diagnosis.

Results: Patients diagnosed with ASD were more likely to be male, Hispanic, publicly insured and medically complex than the general clinic population. There was also a higher maternal education level in the autism group. In unadjusted linear regression analyses, language delay, connection with Early Intervention (EI), earlier age of parental concern, earlier age of referral, having an M-CHAT completed, higher M-CHAT scores, and having a first-degree relative with ASD were associated with earlier age of diagnosis. In multivariate linear regression analysis, connection with EI, better continuity of care, higher M-CHAT scores and having commercial insurance were associated with earlier diagnosis. Race/ethnicity, language, and Social Vulnerability Index ≥ 90%ile were not significantly associated with age of ASD diagnosis.

Conclusion: This study reflects shifting prevalence patterns of ASD, but a persistent disparity in age of diagnosis among publicly insured children. It highlights the importance of developmental monitoring, continuity of care, and navigation support to help families obtain ASD diagnoses promptly.

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来源期刊
CiteScore
3.10
自引率
8.30%
发文量
155
审稿时长
6-12 weeks
期刊介绍: Journal of Developmental & Behavioral Pediatrics (JDBP) is a leading resource for clinicians, teachers, and researchers involved in pediatric healthcare and child development. This important journal covers some of the most challenging issues affecting child development and behavior.
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