Factors Affecting The Early Diagnosis Of Autism Spectrum Disorders And The Analysis Of Early Intervention Effects

Objective:To indentify factors affecting the early diagnosis of autism spectrum disorders(ASD),which may explore the favorable factor for early diagnosis.And also analysis the very early intervention effects after early diagnosis.Method:Part A:We selected the case who had diagnosed at Shenzhen Maternity and Child Healthcare Hospital from January of 2015 to January of 2017 with the criterion.A self making caregiver's questionnaire was used to collect the information.The data of case from January of 2015 to October of 2016 was collected through phone call,while the case from November of 2016 to January of 2017 was collected with a face to face investigation.According to the diagnostic months,participants were divided into two groups,the early diagnosis group who was diagnosed at?24 months(median 21 months,range 13-23 months,while the control group was diagnosis at>24 months age(median 36 months,range 25-61 months).We compared the two groups with the social factors,the family factors,and the individual factors which included the results of Gesell Development Diagnosis Scales(GDDS),Baby-junior high school students ability of social life scale(S-M),Childhood Autism Rating Scale(CARS).Statistical method of t test,crosstab test,Wilcoxon test was used for single factor analysis.Then stepwise Logistic regression model was established with the significant factor.Part B:We selected the cases that got an ASD diagnosis from January of 2014 to January of 2017 according to the inclusion criteria and exclusion criteria.Participants were divided into two groups as part A.T test was used to compare two groups of GDDS development pursuit speed,while Wilcoxon test was used to compare the difference value of before and after the intervention for each CARS item.Result:Part A.207 cases were collected,48(23.19%)were in early diagnosed group,while 159 were in the control group.According to the results of single factor analysis,having an early screening of ASD,the main caregiver,the one who was aware of child's abnormality,the amount of place which they had consult before diagnosed was significant different between two groups.The disabled degree of ability for social life,gross motor skill,fine motor skill,personal and social skill,emotional reaction,adapting to change,listening response,shallow sensory responses,verbal communication,level and consistency of intelligent response was significant different between the two groups(P<0.05),The result of Logistic regression analyze shows that having an early screening of ASD(OR=4.017,95%CI:1.672?9.649)and the other caregiver(OR=6.374,95%CI:1.512?26.866)are beneficial factors.was an unfavorable factor while compare to other caregivers.The disabled degree of ability for social life(OR=0.377,95%CI:0.189?0.750),gross motor skill(OR=0.276,95%CI:0.144?0.528),emotional reaction(OR=0.277,95%CI:0.095?0.810),level and consistency of intelligent response(OR=0.155,95%CI:0.059?0.406)are unfavorable factors and correlate to early diagnosis negatively.In 117 early concerned case,having an early screening of ASD(OR=9.085,95%CI:3.002?27.494)is a beneficial factor.The disabled degree of ability for social life(OR=0.245,95%CI:0.100?0.600),adaptive behavior(OR=0.427,95%CI:0.206?0.885),level and consistency of intelligent response(OR=0.103,95%CI:0.030?0.361)are unfavorable factors and correlates with early diagnosis negatively.Part B.39 cases were collected,16(41.03%)were in the early diagnosis group,while 23(58.97%)were in the control group.The language development pursuit speed of early diagnosis group is 0.91 and is faster than the control group who is 0.83(P=0.006).The intervention effect of early diagnosis group in speech communication,the level of intelligent response and consistency are worse than the control group(P=0.004).Conclusion:Since the early screening plays a crucial role at early diagnosis,the process of early screening for ASD should be improved.The parent's concert is important to the early diagnosis.Parents need to indentify the child's atypical development more correctly and see a doctor in time.Early diagnosis of intervention is helpful to language development pursued,but attention should be given to the development of the abnormal verbal communication.