Âge de la première identification du trouble du spectre de l'autisme: une analyse de deux enquêtes américaines

Aperçu: G.M.

Des données probantes concernant l'âge auquel le trouble du spectre autistique est identifié sont essentielles pour améliorer le dépistage précoce. L'objectif de la recherche était d'estimer la répartition par âge pour la première identification des TSA dans les enquêtes nationales auprès des parents.

Dans deux enquêtes nationales, la majorité des parents d'enfants avec un diagnostic de TSA ont déclaré avoir eu une identification après 3 ans, lorsque l'admissibilité aux services d'intervention précoce a expiré et beaucoup ont déclaré avoir eu une identification de TSA après l'âge scolaire. L'identification tardive des enfants présentant des symptômes plus légers met en évidence la nécessité d'un dépistage précoce qui est sensible à toutes les formes de TSA, quelle que soit la gravité. 

J Am Acad Child Adolesc Psychiatry. 2017 Apr;56(4):313-320. doi: 10.1016/j.jaac.2017.01.012. Epub 2017 Feb 3.

Age at First Identification of Autism Spectrum Disorder: An Analysis of Two US Surveys

Sheldrick RC¹, Maye MP², Carter AS².

Author information

1

Tufts Medical Center, Boston. Electronic address: rsheldrick@tuftsmedicalcenter.org

2

University of Massachusetts, Boston.

Abstract

OBJECTIVE:

Evidence regarding the age at which autism spectrum disorder (ASD) is identified is essential for improving early detection, yet many extant studies have not applied time-to-event analyses, which account for statistical biases that arise from sampling in cross-sectional surveys by adjusting for child age at time of parental report. Our objective was to estimate age distributions for first identification of ASD in national parent surveys using time-to-event analyses.

METHOD:

We conducted time-to-event analyses of responses to identical questions in the 2011 to 2012 National Survey of Children's Health (n = 95,677) and the 2009 to 2010 National Survey of Children with Special Health Care Needs (n = 371,617).

RESULTS:

Parents in both surveys reported that a minority of ASD cases were identified before age 3 years, and that one-third to one-half of cases were identified after 6 years. In both surveys, a majority of parents described their child's ASD severity as mild, and these parents reported the oldest age at identification (mean, 5.6 and 8.6 years). In contrast, parents who described their child's ASD as severe reported earlier age at identification (mean, 3.7 and 4.5 years). Time-to-event analyses yielded older estimates of age at identification than analyses based on raw distributions.

CONCLUSION:

In two national surveys, a majority of parents of children with ASD reported identification after 3 years, when eligibility for early intervention services expires, and many reported identification of ASD after school age. Later identification of children with milder symptoms highlights the need for early screening that is sensitive to all forms of ASD, regardless of severity.

Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

PMID: 28335875

DOI: 10.1016/j.jaac.2017.01.012