关键词: 孤独症谱系障碍, 社区, 就诊原因, 确诊年龄

Abstract: Objective To summarize and analyze the treatment time and diagnosis months of children with autism spectrum disorder (ASD) registered and diagnosed in Xuhui District since the early autism screening in communities(primary health care institutions) was carried out from 2012 to 2020, so as to provide basis for identifying ASD children earlier and faster. Methods Children aged 18 to 24 months with positive results in routine screening, and children who were suspected with social interaction problems and with abnormal results of the age screening scale or Denver Ⅱ during the physical examination of 18 to 24 months with negative screening and non 18 - 24 month old children in Xuhui District Maternal and child health care center and 13 community health service centers, were referred through the green channel to the developmental behavior specialist clinic of the Child Healthcare Department of the Pediatric Hospital Affiliated to Fudan University for diagnosis. Children diagnosed with ASD were enrolled in this study, and were divided into three different reasons for consultation: Diagnosis in 18 to 24 months old with a positive screening result, diagnosis beyond 18 to 24 months old with a positive screening result, diagnosis in 18 to 24 months old with a false negative screening result. One way ANOVA was used for inter-group comparison and LSD method was used to compare the two groups when the difference was statistically significant. Results Among 121 children diagnosed with ASD, 82 cases aged 18 to 24 months with a positive screening result were diagnosed, 18 cases aged beyond 18 to 24 months with a positive screening result were diagnosed, 21 cases aged 18 to 24 months with a false negative screening result were diagnosed, with an average age of (26.34±9.08) months. The age of diagnosis was significantly different among the three groups (F=21.22, P<0.001). There was no significant difference in the age of diagnosis for the four reasons for consultation among doctor referrals and parental self-referrals in children aged 18 to 24 months with a false negative screening result, referrals for systematic medical examinations and referrals for school and nursery admissions for children beyond 18 to 24 months with a positive screening result (F=1.746, P=0.176). Conclusions The age of diagnosis is generally earlier for children managed by the child health care system and routinely screened in Xuhui District. Diagnosis is confirmed earlier for children aged 18 to 24 months with a positive screening result.

Key words: autism spectrum disorder, community, reason for visit, age of diagnosis