(SALT LAKE CITY)—Children suspected of having 自闭症谱系障碍（自闭症谱系障碍） appear to be getting earlier evaluations to identify the condition, a study of 4-year-olds in Utah and four other states has found. The research suggests that a national effort to have kids looked at when they are younger is working.
Early intervention is critical to help those with 自闭症谱系障碍 lead fuller lives. The drive to identify children with 自闭症谱系障碍 or developmental disabilities at younger ages gained momentum after a landmark 2007 study estimated that one in 152 U.S. 孩子们 自闭症谱系障碍，较前几年明显增加. 在研究之后, the American Academy of Pediatrics recommended every child be evaluated for 自闭症 at 18 and 24 months.
Led by researchers from the Centers for Disease Control and Prevention (CDC), five states in the Early Autism and Developmental Disabilities Network (Early ADDM)–Utah, 亚利桑那州, 威斯康辛州, New Jersey and Missouri–examined health and education records of 4- and 8-year-old children in 2010 who had 自闭症谱系障碍 characteristics. Among 4-year-old children with a previous 自闭症谱系障碍 diagnosis by a community provider, researchers found that the median age of their first evaluation was five months earlier for children born in 2006 compared to children born in 2002, 分别是27个月和32个月, 分别.
The reduction in the median age of first comprehensive evaluation demonstrates significant progress toward the goal of improving early screening and identification of children with 自闭症谱系障碍, 根据 Deborah Bilder， M.D., University of Utah associate professor of child psychiatry and the study's second author.
The numbers also showed that on average across the five states, a much larger percentage of the 4-year-olds than 8-year-olds identified with 自闭症谱系障碍 by Early ADDM (71.3%对42%.6%)在3岁前接受评估. 犹他州的ADDM也显示出类似的趋势：70.4 percent of 4-year-olds identified with 自闭症谱系障碍 compared with 32.6 percent of 8-year-olds identified with 自闭症谱系障碍 had a comprehensive evaluation by age 3.
"This study was the first opportunity to see how well we are doing at identifying kids who show signs of 自闭症 or developmental disabilities at an earlier age,比尔德说. "Our findings should give policy makers the feedback they need to continue the effort to identify kids with 自闭症谱系障碍 earlier and also to make adjustments in funding allotments, service planning and public policy where needed."
这项研究发表在网上 Journal of Developmental and Behavioral Pediatrics 12月. 9, 2015.
Along with looking at the median age of when children were first evaluated, the study estimated that across the Early ADDM sites one in 75 4-year-olds and one in 48 8-year-olds had 自闭症谱系障碍. The higher prevalence among 8-year-olds is likely explained, 在某种程度上, by the under-identification of 自闭症谱系障碍 among preschool children, 据比尔德说. "Some children are not recognized as having 自闭症谱系障碍 until they enter the public school system or reach an age where their social deficits become more apparent when compared to their peers,她说. "This is also the first year we measured 自闭症谱系障碍 prevalence among 4-year-olds and estimate that previously we missed at least 10 percent of children with 自闭症谱系障碍."
Early ADDM looked at de-identified health and education records of 58,467个4岁和56岁,五州网络的727名8岁儿童. The study found a total of 783 4-year-olds and 1,091 8-year-olds with 自闭症谱系障碍.
在犹他州, the ADDM surveys rely on data from the Utah Registry of Autism and Developmental Disabilities (URADD), 由犹他州卫生部资助.
对于目前的研究, URADD researchers surveyed the records of 4-year-olds with 自闭症谱系障碍 in Tooele County and part of Salt Lake County and identified 132 children with 自闭症谱系障碍. Prevalence of the disorder in Utah was estimated at one in 83 4-year-olds. The numbers also showed that male 4-year-olds in Utah were three times more likely to be diagnosed with 自闭症谱系障碍 than females. The reason for the almost triple prevalence of 自闭症谱系障碍 among males compared to females is not yet known. The 自闭症谱系障碍 prevalence in Utah among Non-Hispanic whites was nearly 1½ times that of Hispanic children, which may be reflect differences in access to health and education services.
"This is the first study of 4-year-old children in Utah using ADDM methodology,比尔德说. "We look forward to reviewing data from our subsequent 2012 study year so that we may have a clear sense of trends in national and local 自闭症谱系障碍 prevalence and evaluation practices."
Utah and the other states in 2010 Early ADDM are part of the larger Autism and Developmental Disabilities Monitoring Network (ADDM), an 11-site CDC consortium that tracks 自闭症 prevalence among the nation's 8-year-olds. 阿曼达·巴基安博士.D., URADD导演, co-investigator of Utah ADDM and assistant professor of psychiatry (biostatistics) also contributed to 2010 Early ADDM. Bilder also serves as co-investigator at URADD.