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Therapy and Psychotropic Medication Use in Young Children With Autism Spectrum Disorder.
自闭症谱系障碍幼儿的治疗和精神药物使用。
- 影响因子:5.00
- DOI:10.1542/peds.2019-1895M
- 作者列表:"Ziskind D","Bennett A","Jawad A","Blum N
- 发表时间:2020-04-01
Abstract
BACKGROUND AND OBJECTIVES:Guidelines suggest young children with autism spectrum disorder (ASD) receive intensive nonpharmacologic interventions. Additionally, associated symptoms may be treated with psychotropic medications. Actual intervention use by young children has not been well characterized. Our aim in this study was to describe interventions received by young children (3-6 years old) with ASD. The association with sociodemographic factors was also explored. METHODS:Data were analyzed from the Autism Speaks Autism Treatment Network (AS-ATN), a research registry of children with ASD from 17 sites in the United States and Canada. AS-ATN participants receive a diagnostic evaluation and treatment recommendations. Parents report intervention use at follow-up visits. At follow-up, 805 participants had data available about therapies received, and 613 had data available about medications received. RESULTS:The median total hours per week of therapy was 5.5 hours (interquartile range 2.0-15.0), and only 33.4% of participants were reported to be getting behaviorally based therapies. A univariate analysis and a multiple regression model predicting total therapy time showed that a diagnosis of ASD before enrollment in the AS-ATN was a significant predictor. Additionally, 16.3% of participants were on ≥1 psychotropic medication. A univariate analysis and a multiple logistic model predicting psychotropic medication use showed site region as a significant predictor. CONCLUSIONS:Relatively few young children with ASD are receiving behavioral therapies or total therapy hours at the recommended intensity. There is regional variability in psychotropic medication use. Further research is needed to improve access to evidence-based treatments for young children with ASD.
摘要
背景和目的: 指南建议患有自闭症谱系障碍 (ASD) 的幼儿接受强化的非药物干预。此外,相关症状可以用精神药物治疗。幼儿的实际干预使用尚未得到很好的表征。我们在本研究中的目的是描述患有 ASD 的幼儿 (3-6 岁) 接受的干预措施。还探讨了与社会人口学因素的相关性。 方法: 数据来自自闭症说话自闭症治疗网络 (AS-ATN),这是一个来自美国和加拿大 17 个研究中心的 ASD 儿童研究登记处。AS-ATN 参与者接受诊断评估和治疗建议。家长在随访访视时报告干预使用情况。随访时,805 名参与者有接受治疗的数据,613 的参与者有接受药物治疗的数据。 结果: 每周治疗的总小时数中位数为 5.5 小时 (四分位距 2.0-15.0),据报道只有 33.4% 的参与者接受了基于行为的治疗。单变量分析和预测总治疗时间的多元回归模型表明,在 AS-ATN 入组前诊断 ASD 是一个显著的预测因子。此外,16.3% 的参与者服用 ≥ 1 种精神药物。单变量分析和预测精神药物使用的多变量 logistic 模型显示站点区域是一个显著的预测因子。 结论: 在推荐强度下,接受行为治疗或总治疗时间相对较少的 ASD 幼儿。精神药物使用存在区域变异性。需要进一步的研究来改善 ASD 幼儿获得循证治疗的机会。
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