与被证实和未被证实的自闭症谱系障碍诊断在儿童志愿者研究相关的因素
Susanne W Duvall1, Rachel K Greene2, Randi Phelps3,4
1Departments of Pediatrics and Psychiatry, Institute on Development and Disability, Center for Development and Child Rehabilitation, Oregon Health & Science University, 707 SW Gaines St, Portland, OR, 98239, USA. duvall@ohsu.edu.
Journal of autism and developmental disorders
|April 12, 2024
概括
在社区中,许多被诊断患有自闭症谱系障碍 (ASD) 的儿童在专家审查后不符合诊断标准. 与护理人员报告不同的是,临床医师的评估有效地区分了确定的和不准确的ASD诊断.
科学领域:
- 儿童心理学 儿童心理学
- 神经发育障碍 神经发育障碍
- 诊断的准确性 诊断的准确性
背景情况:
- 准确诊断自闭症谱系障碍 (ASD) 对于有效的干预和研究至关重要.
- 诊断不足,诊断过多和诊断错误的普遍问题阻碍了ASD患者的最佳护理.
研究的目的:
- 评估基于社区的自闭症谱系障碍 (ASD) 诊断的诊断准确性.
- 确定诊断错误的个体与确诊的ASD病例区分的临床特征.
主要方法:
- 一组232名社区诊断的自闭症儿童接受了严格的研究评估.
- 参与者被分为确认的ASD (ASD+) 和未确认/不准确的诊断 (ASD-) 组.
- 分析了临床数据,包括发育史,认知评估和标准化诊断工具.
主要成果:
- 近一半 (47%) 的社区ASD诊断的儿童不符合专家确认的ASD标准.
- 确诊的ASD+组显示早期语言延迟的发病率较高,但目前的语言缺陷没有.
- 临床医生管理的工具,如ADI-R和ADOS-2,在ASD+和ASD-组之间显著区分.
- 自闭症组的智商得分更高,精神病相关疾病 (焦虑,情绪,破坏性行为障碍) 的患病率更高.
- 护理人员报告的问卷 (SRS-2,CCC-2) 没有有效地区分这些组.
结论:
- 错误诊断组中精神疾病的高发病率表明复杂性可能导致ASD过度诊断.
- 专家主导的诊断工具在准确识别自闭症方面比护理人员问卷更有效.
- 在社区环境中提高诊断准确度至关重要,以确保对神经发育状况的儿童提供适当的支持.
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