Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 83
Filtrar
1.
Am J Epidemiol ; 190(2): 265-276, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33524118

RESUMO

Polyunsaturated fatty acids (PUFAs) are critical for brain development and have been linked with neurodevelopmental outcomes. We conducted a population-based case-control study in California to examine the association between PUFAs measured in midpregnancy serum samples and autism spectrum disorder (ASD) in offspring. ASD cases (n = 499) were identified through the California Department of Developmental Services and matched to live-birth population controls (n = 502) on birth month, year (2010 or 2011), and sex. Logistic regression models were used to examine crude and adjusted associations. In secondary analyses, we examined ASD with and without co-occurring intellectual disability (ID; n = 67 and n = 432, respectively) and effect modification by sex and ethnicity. No clear patterns emerged, though there was a modest inverse association with the top quartile of linoleic acid level (highest quartile vs. lowest: adjusted odds ratio = 0.74, 95% confidence interval: 0.49, 1.11; P for trend = 0.10). Lower levels of total and ω-3 PUFAs were associated with ASD with ID (lowest decile of total PUFAs vs. deciles 4-7: adjusted odds ratio = 2.78, 95% confidence interval: 1.13, 6.82) but not ASD without ID. We did not observe evidence of effect modification by the factors examined. These findings do not suggest a strong association between midpregnancy PUFA levels and ASD. In further work, researchers should consider associations with ASD with ID and in other time windows.


Assuntos
Transtorno do Espectro Autista/epidemiologia , Ácidos Graxos Insaturados/sangue , Deficiência Intelectual/epidemiologia , Segundo Trimestre da Gravidez/sangue , Transtorno do Espectro Autista/etnologia , Peso ao Nascer , California/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Idade Gestacional , Humanos , Deficiência Intelectual/etnologia , Masculino , Razão de Chances , Gravidez , Fatores Sexuais , Fatores Socioeconômicos
3.
Yonsei Med J ; 61(11): 909-922, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33107234

RESUMO

Through this meta-analysis, we sought to examine the prevalence of, risks for, and factors associated with bullying involvement (victimization, perpetration, perpetration-victimization) among students with autism spectrum disorder (ASD). Additionally, we attempted to examine sources of variance in the prevalence and effect sizes of bullying in students with ASD across studies. Systematic database and literature review identified 34 relevant studies (31 for Western countries, three for Eastern countries). Pooled prevalence estimates for victimization, perpetration, and perpetration-victimization in general were 67%, 29%, and 14%, respectively. The risk of victimization in students with ASD was significantly higher than that in typically developing students and students with other disabilities. Further, deficits in social interaction and communication, externalizing symptoms, internalizing symptoms, and integrated inclusive school settings were related to higher victimization, and externalizing symptoms were related to higher perpetration. Finally, moderation analyses revealed significant variations in the pooled prevalences thereof depending on culture, age, school settings, and methodological quality and in the pooled effect sizes according to publication year and methodological quality. Our results highlight needs for bullying intervention for students with ASD, especially those who are younger, are in an inclusive school setting, and have higher social difficulties and externalizing/internalizing symptoms; for intensive research of bullying experiences among students with ASD in Eastern countries; and for efforts to improve the methodological quality of such research.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Bullying/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Comparação Transcultural , Estudantes/psicologia , Adolescente , Transtorno do Espectro Autista/etnologia , Transtorno do Espectro Autista/psicologia , Bullying/psicologia , Criança , Pré-Escolar , Vítimas de Crime/psicologia , Feminino , Humanos , Relações Interpessoais , Masculino , Prevalência , Estudantes/estatística & dados numéricos , Adulto Jovem
4.
Ann Epidemiol ; 48: 1-8, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32778226

RESUMO

PURPOSE: Studies indicate an apparent sharp increasing trend in autism spectrum disorder (ASD) incidence and prevalence worldwide. This nationwide study aims at depicting ASD prevalence distribution in Israel in both space and time. METHODS: Based on data from Israel National Insurance Institute, the study population included all children born in Israel 2000-2011 (n = 1,786,194), of whom 11,699 (0.655%) were subsequently diagnosed with ASD (until December 31, 2016). Prevalence was calculated and mapped by dividing the number of ASD cases within each year of birth by the number of births during that year, for each spatial unit, and similarly for several spatiotemporal levels of aggregation. RESULTS: ASD prevalence varies substantially across different geographic areas in Israel, with considerably higher prevalence concentrated in central Israel. Strong associations were found between locality-level socioeconomic index, ethnicity, and peripherality and ASD prevalence, and even after adjustment for them, excess prevalence for ASD still persisted in certain localities. No spatial dependence of prevalence, with and without adjustment for the locality-level variables, was found (Moran's I = -0.000546, -0.00335, respectively). CONCLUSIONS: Our findings provide important insights regarding health disparities affecting ASD diagnosis, directing further health policy intervention and further research.


Assuntos
Transtorno do Espectro Autista/epidemiologia , Grupos Étnicos/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Vigilância da População/métodos , Características de Residência , Adolescente , Transtorno do Espectro Autista/etnologia , Criança , Estudos de Coortes , Feminino , Sistemas de Informação Geográfica , Humanos , Incidência , Israel/epidemiologia , Masculino , Análise Espaço-Temporal
5.
J Autism Dev Disord ; 50(1): 51-62, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31529239

RESUMO

Research on families' experiences raising children with Autism Spectrum Disorder (ASD) is limited in minority ethnic and cultural groups, such as the Arab American community. Twenty Arab American caregivers raising children with ASD completed online questionnaires regarding their experiences with stigma and acculturation. Nine participants completed follow-up phone interviews. Perceived stigma fell in the low to moderate range. Acculturation related to social interactions indicated slightly greater assimilation compared to separation, and slightly greater integration over marginalization. During interviews, participants discussed the impact of disability stigma, distancing from their communities, and parent gender roles. By better understanding Arab American families raising children with ASD professionals can work towards improving clinical services for these families.


Assuntos
Árabes , Transtorno do Espectro Autista/etnologia , Cuidadores/psicologia , Adolescente , Criança , Feminino , Humanos , Relações Interpessoais , Masculino , Pais , Estigma Social , Inquéritos e Questionários
6.
J Autism Dev Disord ; 50(9): 3263-3275, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31297644

RESUMO

Determining diagnostic stability of ASD, as well stability of functioning in early childhood, is relevant to prevalence, best practices for communicating early ASD diagnoses to caregivers, families' experiences, and developmental trajectories. Generalizability of findings from prior research has been limited by small and homogenous samples, short follow-up time intervals, and inconsistent diagnostic procedures. This report presents follow-up evaluations of 60 children (86.7% male, mean age: 51.3 months) with diverse backgrounds (79.7% racial/ethnic minorities) who received initial ASD diagnoses before 36 months of age (mean age: 27 months). Fifty-three children (88.3%) met diagnostic criteria for ASD at follow-up, a proportion consistent with previous studies. On average, children demonstrated significant cognitive gains and ASD symptom improvement. Clinical implications of findings are discussed.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/etnologia , Grupos Étnicos , Grupos Minoritários , Transtorno do Espectro Autista/psicologia , Criança , Pré-Escolar , Diagnóstico Precoce , Grupos Étnicos/psicologia , Feminino , Seguimentos , Humanos , Masculino , Grupos Minoritários/psicologia , Prevalência , Fatores Socioeconômicos
7.
J Autism Dev Disord ; 50(7): 2360-2374, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29948527

RESUMO

To address the limited research on diverse families of children with ASD, we examined the impact of ASD on 46 Latina and 56 non-Latina White mothers from a resiliency perspective. We explored perceptions of family problems, optimism and pessimism among mothers of child with ASD between 1 and 22 years old. Mothers were recruited through support groups and listservs. Univariate and multivariate analyses were conducted. Results indicated fewer perceived family problems and less pessimism about the child's future among Latina mothers. We found maternal optimism and family cohesion were associated with perceived family problems and mother's pessimism about the child's future. Understanding the impact of ASD among diverse families will aid in developing appropriate services that enhances family strengths.


Assuntos
Transtorno do Espectro Autista/psicologia , Relações Familiares , Mães/psicologia , Pessimismo , Adolescente , Adulto , Transtorno do Espectro Autista/etnologia , Criança , Pré-Escolar , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Hispano-Americanos/psicologia , Humanos , Lactente , Masculino
8.
Asian J Psychiatr ; 46: 54-61, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31614268

RESUMO

Several studies have investigated association of MTHFR 677C > T and 1298A > C polymorphisms with risk of autism, but they have reported controversial and inconclusive results. The present meta-analysis was designed to evaluate association of MTHFR 677C > T and 1298A > C polymorphisms with risk of autism. A comprehensive literature search was done in PubMed, EMBASE, and CNKI databases to identify all eligible publications up to April 01, 2019. Finally, 25 case-control studies including 18 studies on MTHFR 677C > T and 7 studies on MTHFR 1298A > C polymorphism were selected. Overall, a significant association was found between MTHFR 677C > T and an increased risk of autism under all five genetic models (T vs. C: OR = 1.483, 95% CI 1.188-1.850, p ≤ 0.001; TT vs. CC: OR = 1.834, 95% CI 1.155-2.913, p = 0.010; TC vs. CC: OR = 1.512, 95% CI 1.101-2.078, p = 0.011; TT + TC vs. CC: OR = 1.632, 95% CI 1.261-2.113, p ≤ 0.001; and TT vs. TC + CC: OR = 1.427, 95% CI 1.002-2.032, p = 0.049). However, no significant association was found between MTHFR 1298A > C and autism risk. Stratified analyses showed that MTHFR 677C > T and 1298A > C polymorphisms are involved in genetic susceptibility of autism by ethnicity. Results of this meta-analysis indicated that MTHFR 677C > T polymorphism may be associated with increased risk of autism in overall and by ethnicity, while MTHFR 1298A > C was reported to be significantly associated with the risk of autism only in Caucasians. MTHFR polymorphisms could be used as a diagnostic marker for autism with respect to ethnicity background.


Assuntos
Transtorno do Espectro Autista/etnologia , Transtorno do Espectro Autista/genética , Predisposição Genética para Doença/etnologia , Predisposição Genética para Doença/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Humanos
9.
J Autism Dev Disord ; 49(12): 4721-4730, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31435818

RESUMO

Race-specific time trends in Autism Spectrum Disorder prevalence are tracked among 3-5 year-olds and 8 year-olds identified by the U.S. Individuals with Disabilities Education Act (IDEA) and the Autism and Developmental Disabilities Monitoring (ADDM) Network, respectively. White ASD prevalence historically has been higher than other racial groups but plateaued for IDEA birth cohorts from ~ 2004 to 2007 before resuming its increase. Black and Hispanic IDEA prevalence increased continuously and caught up to whites by birth year ~ 2008 and ~ 2013, respectively, with black prevalence subsequently exceeding white prevalence in the majority of states. Plateaus in white prevalence occurred in some ADDM states for birth years 2002-2006, but IDEA trends suggest prevalence will increase across all racial groups in ADDM's birth year 2008 report.


Assuntos
Transtorno do Espectro Autista/etnologia , Centers for Disease Control and Prevention, U.S./tendências , Deficiências do Desenvolvimento/etnologia , Pessoas com Deficiência , Vigilância da População , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Centers for Disease Control and Prevention, U.S./legislação & jurisprudência , Criança , Pré-Escolar , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/psicologia , Pessoas com Deficiência/legislação & jurisprudência , Pessoas com Deficiência/psicologia , Grupos Étnicos/psicologia , Feminino , Humanos , Masculino , Vigilância da População/métodos , Prevalência , Estados Unidos/etnologia
10.
J Dev Behav Pediatr ; 40(7): 501-510, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31318777

RESUMO

OBJECTIVE: The objective of this study is to measure racial and ethnic disparities in autism-related services among U.S. children with parent-reported autism spectrum disorder (ASD). METHODS: Using the 2011 Survey of Pathways to Diagnosis and Services, we analyzed parent-reported data on 1420 children with current ASD in the nationally representative sample. An estimation method consistent with the Institute of Medicine's definition of health care disparities is used to measure racial and ethnic disparities. RESULTS: The findings revealed Latino-white disparities in the percentage of children currently using school-based occupational and physical therapy and Latino-white and "other race"-white disparities in the percentage of children using physical therapy outside of school. There were no statistically significant black-white disparities. Instead, the study found that the percentage of black children with ASD receiving school-based services was 8 points higher than that of white children (p < 0.04). Factors unrelated to the need for autism services were largely unassociated with the receipt of services. CONCLUSION: The findings provide a partial baseline and identify a need for further examination of the source of existing disparities and the lack of disparities found for specific services and minority groups.


Assuntos
Afro-Americanos/estatística & dados numéricos , Transtorno do Espectro Autista/reabilitação , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Hispano-Americanos/estatística & dados numéricos , Serviços de Saúde Escolar/estatística & dados numéricos , Adolescente , Transtorno do Espectro Autista/etnologia , Criança , Deficiências do Desenvolvimento/etnologia , Deficiências do Desenvolvimento/reabilitação , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Deficiência Intelectual/etnologia , Deficiência Intelectual/reabilitação , Masculino , Terapia Ocupacional/estatística & dados numéricos , Psicoterapia/estatística & dados numéricos , Fonoterapia/estatística & dados numéricos , Estados Unidos/etnologia
11.
J Dev Behav Pediatr ; 40(7): 493-500, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31318780

RESUMO

OBJECTIVE: Autism spectrum disorder (ASD) screening completion rates are often low despite their validity and influence on earlier intervention and positive treatment outcomes. This study sought to examine the use of one ASD screening tool, the Modified Checklist for Autism in Toddlers-Revised (MCHAT-R), in a racially and ethnically diverse urban pediatric clinic to review potential disparities within screening rates and referral practices. METHODS: A retrospective chart review was conducted for children (N = 999) within the ages of 17 to 34 months seen for a well-child appointment at one of 3 pediatric clinics: a general pediatric clinic, resident pediatric clinic, and Hispanic pediatric clinic. RESULTS: MCHAT-R screening completion rates were low for all clinics. There were no significant differences in MCHAT-R screening completion based on ethnicity; however, the percentage of children screening positive on the MCHAT-R was significantly higher for Hispanic versus non-Hispanic children. Referral practices were highly variable across positive screenings, and few children received the appropriate combination of referrals. CONCLUSION: Ethnic disparities in ASD positive screening rates and inconsistent referrals represent a critical issue in current pediatric practice. There is a great need for the development of more culturally sensitive ASD screening instruments. Additionally, to help increase ASD screening rate and accuracy, as well as consistency in referrals, greater emphasis is needed on professional training, parental education, and technology use within pediatric clinics.


Assuntos
Centros Médicos Acadêmicos/estatística & dados numéricos , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Transtorno do Espectro Autista/diagnóstico , Serviços de Saúde da Criança/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Pediatras/estatística & dados numéricos , Transtorno do Espectro Autista/etnologia , Transtorno do Espectro Autista/terapia , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Programas de Rastreamento , Meio-Oeste dos Estados Unidos/etnologia , Encaminhamento e Consulta , Estudos Retrospectivos , População Urbana/estatística & dados numéricos
12.
J Racial Ethn Health Disparities ; 6(6): 1107-1121, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31292923

RESUMO

OBJECTIVES: Hispanic/Latino (H/L) children have lower prevalence of neurodevelopmental disabilities (NDD) than other groups. The explanations for this are complex, but may be related to nativity, language barriers, and lack of access to and utilization of healthcare. Previous research focused on how these factors affect children with NDD, but little research has jointly examined whether these factors predict NDD. This study examines whether social and environmental factors explain low prevalence of NDD in this population. METHODS: This study uses nationally representative Integrated Public Use Microdata Series National Health Interview Survey data (N = 200,622) and multivariate logistic regression analysis to compare NDD prevalence in white and H/L children (average age of 10.2), and examines whether nativity, healthcare access, healthcare utilization, and language barriers explain this disability disparity. RESULTS: Findings reveal that the H/L NDD disparity is not explained by differences in access to or utilization of healthcare, or as a result of language differences that may create barriers to NDD diagnosis. While H/L children whose sampled adult was born in the USA have lower rates of NDD than whites, H/Ls whose sampled adult were not born in the USA have even lower probability of NDD than H/Ls who were born in the USA. CONCLUSIONS: These findings may be a result of cultural differences in knowledge or understanding of what constitutes a disability or the result of differential treatment within the healthcare system among H/Ls. The findings underscore the importance of accessible and culturally appropriate health and clinical care interventions among H/L communities.


Assuntos
Barreiras de Comunicação , Emigrantes e Imigrantes/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Hispano-Americanos/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Idioma , Transtornos do Neurodesenvolvimento/etnologia , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/etnologia , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/etnologia , Criança , Pré-Escolar , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Disparidades nos Níveis de Saúde , Humanos , Lactente , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/etnologia , Deficiências da Aprendizagem/epidemiologia , Deficiências da Aprendizagem/etnologia , Modelos Logísticos , Masculino , Análise Multivariada , Transtornos do Neurodesenvolvimento/epidemiologia , Pais , Prevalência , Estados Unidos/epidemiologia
13.
J Autism Dev Disord ; 49(9): 3611-3624, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31124024

RESUMO

An increased prevalence of autism spectrum disorder (ASD) among children of immigrant backgrounds has been observed but clinical profiles are rarely compared. Diagnostic data from children with ASD notified to the Western Australian Register for Autism Spectrum Disorders were analysed according to maternal-race ethnicity and country of birth. A total of 4776 children aged between 0 and 18 years diagnosed with ASD from 1999 to 2017 were included. Those born to immigrant mothers from lower income countries were younger at the time of diagnosis, had an increased risk of intellectual disability and poorer presentations in the social and communication domains. Further work is required to understand environmental influences that may affect children born to immigrant mothers and to improve monitoring and assessments.


Assuntos
Transtorno do Espectro Autista/epidemiologia , Grupos de Populações Continentais/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Mães/estatística & dados numéricos , Adolescente , Transtorno do Espectro Autista/etnologia , Criança , Pré-Escolar , Grupos de Populações Continentais/etnologia , Grupos de Populações Continentais/psicologia , Emigrantes e Imigrantes/psicologia , Grupos Étnicos/psicologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pobreza/etnologia , Pobreza/psicologia , Pobreza/estatística & dados numéricos , Prevalência , Sistema de Registros , Austrália Ocidental/epidemiologia
14.
J Dev Behav Pediatr ; 40(4): 257-265, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30908425

RESUMO

OBJECTIVE: Minority families experience disparities in the diagnosis and management of autism spectrum disorder (hereafter "autism"). To date, the experiences of Chinese immigrant families in the United States have not been explored. Utilizing parent and provider perspectives, this research sought to identify barriers and facilitators to the diagnosis and management of autism among Chinese immigrant children. METHODS: We conducted semistructured qualitative interviews with 16 parents of Chinese children diagnosed with autism and 16 providers who assist in the diagnosis and management of autism. Participant characteristics were analyzed utilizing descriptive statistics. Interviews were audiorecorded, transcribed, translated, and independently coded by 2 researchers until consensus was reached. Coded data were analyzed using a modified grounded therapy approach. RESULTS: Parents and providers both identified cultural beliefs as an influence on the understanding and acceptance of autism as a diagnosis. There was a high degree of alignment in themes related to barriers to health care access and parent-provider communication. Recommendations to improve the system of care include (1) supporting communication, (2) cultural sensitivity, and (3) care coordination programming. CONCLUSION: Findings reinforce that diagnosis and treatment of autism should take into account culturally specific beliefs about child developmental norms and should address systems-, provider-, and family-level barriers.


Assuntos
Americanos Asiáticos , Transtorno do Espectro Autista , Emigrantes e Imigrantes , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Acesso aos Serviços de Saúde , Pais , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Relações Profissional-Família , Adolescente , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/etnologia , Transtorno do Espectro Autista/terapia , Criança , Pré-Escolar , China/etnologia , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Estados Unidos/etnologia
15.
J Coll Physicians Surg Pak ; 29(4): 390-391, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30925970

RESUMO

In this cross-sectional study, 76 consecutive children with autism spectrum disorder (ASD) were studied for the clinical and demographic parameters at Autism Resource Centre in Pakistan. The median age at first consultation was 30 months, 36 months at diagnosis, and 42 months at referral to a specialised centre. Clinical psychologists, therapists and paediatricians were the most frequently involved people in diagnosis. There was an average delay of one year between the first consultation and referral to the specialised centre. The male to female ratio was 4.4:1. Consanguinity was observed in 33 (43.4%) children. Three children had another affected sibling. Half of the children were from the affluent class, while two-thirds of the parents were professionals having good education. The severity of ASD showed that 13 (17%) children had borderline features, 50 (66%) had mild to moderate ASD, while 13 (17%) had severe ASD.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/etnologia , Transtorno do Espectro Autista/epidemiologia , Pré-Escolar , Consanguinidade , Estudos Transversais , Feminino , Humanos , Masculino , Paquistão/epidemiologia , Distribuição por Sexo , Irmãos , Fatores Socioeconômicos , Inquéritos e Questionários
16.
Autism ; 23(8): 1927-1935, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-30892923

RESUMO

This study assessed potential under-ascertainment of autism spectrum disorder due to missing administrative information for Hispanic and non-Hispanic Black children within the Autism and Developmental Disabilities Monitoring Network. We analyzed data from two Network sites (Colorado and Wisconsin) for surveillance years 2012 and 2014 to determine whether children excluded from autism spectrum disorder prevalence estimates due to missing residency and other information differed from those included by race and ethnicity. We used multiple approaches to impute missing information to evaluate impacts on racial and ethnic disparities in autism spectrum disorder prevalence. Compared with confirmed autism spectrum disorder cases, those excluded due to missing residency were more than twice as likely to be Hispanic (19% vs 44%; p < 0.002), yet the number of cases excluded due to missing residency information was too small to account for prevalence differences. Confirmation of autism spectrum disorder case status was more likely for children with relevant health records than for those with school records only. Moreover, relevant health records were more likely to be missing for Black and Hispanic children than for White children. Observed disparities in autism spectrum disorder prevalence were not accounted for by missing demographic data, but may reflect disparities in healthcare access for developmental evaluations.


Assuntos
Afro-Americanos/estatística & dados numéricos , Transtorno do Espectro Autista/etnologia , Viés , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Hispano-Americanos/estatística & dados numéricos , Racismo , Americanos Asiáticos/estatística & dados numéricos , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Criança , Colorado/epidemiologia , Monitoramento Epidemiológico , Feminino , Acesso aos Serviços de Saúde , Humanos , Masculino , Prevalência , Estados Unidos/epidemiologia , Wisconsin/epidemiologia
17.
J Racial Ethn Health Disparities ; 6(4): 752-773, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30859514

RESUMO

Decades of research have established that racial ethnic minority, low-income, and/or non-English speaking children with autism spectrum disorder (ASD) are diagnosed later than white children, and their families experience greater difficulty accessing services in the USA. Delayed access to timely diagnosis and early intervention may impact child outcomes and family quality of life. Despite their cognition of these disparities and their significant impact on the lives of those affected, explanations for the barriers experienced by underserved families are elusive, likely due to the complex interaction between structural and family factors. This study used qualitative methods to gather family and provider perspectives of perceived barriers and facilitators to obtaining an ASD diagnosis and accessing ASD-related services for underserved families. Themes from focus groups and interviews with families from three cultural groups (black, Hispanic/Latino, and Korean) and three primary languages (English, Korean, and Spanish) highlight specific barriers related to family, community, and systemic challenges as well as facilitators to accessing care for these populations. Family experiences are expanded upon with viewpoints from the providers who work with them. Recommendations are made for reducing disparities in the existing ASD service system including increasing professional, family, and community education; increasing culturally responsive care; improving provider-family partnerships; and addressing practical challenges to service access.


Assuntos
Transtorno do Espectro Autista/etnologia , Cuidadores/psicologia , Grupos Étnicos/estatística & dados numéricos , Acesso aos Serviços de Saúde/organização & administração , Disparidades em Assistência à Saúde/etnologia , Adulto , Idoso , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/terapia , Criança , Pré-Escolar , Assistência à Saúde Culturalmente Competente/organização & administração , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Pobreza , Pesquisa Qualitativa , Qualidade de Vida , Fatores Socioeconômicos
18.
J Autism Dev Disord ; 49(6): 2258-2267, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30701436

RESUMO

The current study investigated the age of diagnosis (AoD) of autism spectrum disorder (ASD) in Nepal by using de-identified data on 246 children with a diagnosis of ASD registered at AutismCare Nepal Society from 2010 to 2015. The mean AoD in children was 58 months (range 14-187 months). Majority of children were male (76%), lived in the Kathmandu valley (75%), and were from upper caste groups (62%). The mean diagnostic age of ASD in Nepal is much later than the age at which a reliable diagnosis is possible, indicating the need to reduce the gap between the age at which it is possible to diagnose ASD, and the average age at which ASD is currently diagnosed.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/etnologia , Classe Social , Idade de Início , Transtorno do Espectro Autista/psicologia , Criança , Pré-Escolar , Coleta de Dados/tendências , Feminino , Humanos , Lactente , Masculino , Nepal/etnologia , Sistema de Registros
19.
Cultur Divers Ethnic Minor Psychol ; 25(1): 113-122, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30714773

RESUMO

OBJECTIVE: Autism spectrum disorder (ASD) is underidentified and misidentified in the Latino community, and numerous barriers limit this community's ability to access quality health care for ASD. Appreciative inquiry/boot camp translation (AI/BCT) is a novel method of community engagement that can be used within community-based participatory research partnerships. AI/BCT uses qualitative methods to uncover strategies that the community is already successfully using and develops actionable messages to increase the use of those strategies throughout the community. We describe this method and outline how it is likely to be more effective at reducing disparities related to ASDs in the Latino community than traditional methods. CONCLUSION: AI/BCT is a promising method of community engagement that is responsive to cultural differences. It is a strength-based approach focused on increasing the use of strategies that already work within the community. Therefore, it has the potential to reduce health disparities in the Latino community who have loved ones with autism ASD much more rapidly than traditional methods of inquiry. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtorno do Espectro Autista/etnologia , Disparidades em Assistência à Saúde/etnologia , Hispano-Americanos/psicologia , Transtorno do Espectro Autista/diagnóstico , Pesquisa Participativa Baseada na Comunidade/métodos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Atenção Primária à Saúde/estatística & dados numéricos , Fatores de Risco
20.
Autism ; 23(6): 1554-1562, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30612447

RESUMO

In an evaluation of Anglo and Latina mothers and their children at risk of autism, this study compared mother-reported child behavioral concerns to staff-observed symptoms of autism. Within Latina mothers, the impact of primary language (English/Spanish), mothers' education, and child age on ratings of developmental concerns was examined. Participants were 218 mothers (Anglo = 85; Latina = 133) of children referred to a no-cost autism screening clinic. Mothers reported on behavioral concerns, autism symptomology, and services received; children were administered the Autism Diagnostic Observation Schedule by certified staff. Results revealed that Anglo and Latino children did not differ by autism symptoms or classification. However, Anglo mothers reported significantly more concerns than Latina mothers. Within the Latina group, analyses revealed significant interaction effects of language and child age; Spanish-speaking mothers of preschoolers endorsed fewer concerns, while Spanish-speaking mothers of school-aged children endorsed more concerns. Despite these reports, Anglo children with a classification of autism spectrum disorder were receiving significantly more services than Latino children with autism spectrum disorder, suggesting early beginnings of a service divide as well as the need for improved parent education on child development and advocacy for Latino families.


Assuntos
Transtorno do Espectro Autista/etnologia , Transtorno do Espectro Autista/terapia , Conscientização , Disparidades em Assistência à Saúde , Hispano-Americanos/psicologia , Pais/psicologia , Pobreza/psicologia , Aculturação , Criança , Diagnóstico Diferencial , Educação Especial , Hispano-Americanos/educação , Humanos , Pais/educação , Relações Profissional-Família , Fatores de Risco , Meio Social
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...