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<<   作成日時 : 2009/10/06 21:43   >>

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 2つの新たな政府の研究によれば、自閉症は以前に考えられた150人に1人より多く100人に1人であるという。
 より広く知られるようになり定義も広がり年少の子どもの診断も増えたことが増加の一因だと当局は言う。
 問題は本当の増加が埋没してしまうことにあると、国立精神衛生研究所のトーマスインセル博士は言う。フィラデルフィア小児病院のスーザンE.リーヴィ博士は、子どもの行動に基づく診断のために実数を出すのは極めて難しいという。
 新たな見積もりでは約673,000人の自閉症の子どもが米国にはいることになり、以前は約560,000人とされていたものである。
 研究の1つは2007年の子どもの健康全国調査による。アスペルガー症候群も含め、年齢が3〜17才の91人に約1人が自閉症だった。
 もう1つの政府研究はまだ公にされていないが、CDCのネットワークを用い、選ばれた都市の8才の子どもの教育健康記録を調査し、診断に適合するかを調べたところ、約100人に1人が自閉症であった。自閉症専門家によれば、より厳密な方法であるという。
(書きかけ)
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高齢出産による自閉症のリスク
http://kurie.at.webry.info/200907/article_11.html
自閉症の急激な増加/米国 カリフォルニア
http://kurie.at.webry.info/200901/article_26.html
脳内蛋白の欠如により自閉症が発症の可能性
http://kurie.at.webry.info/200802/article_24.html
----------------------------------------------------
Government Finds Higher Autism Figure: 1 in 100
2 government studies find autism disorders in 1 in 100 US children
By CARLA K. JOHNSON AP Medical Writer
CHICAGO October 5, 2009 (AP) The Associated Press
http://abcnews.go.com/Health/wireStory?id=8750846

Two new government studies indicate about 1 in 100 children have autism disorders ― higher than a previous U.S. estimate of 1 in 150.

Greater awareness, broader definitions and spotting autism in younger children may explain some of the increase, federal health officials said.

"The concern here is that buried in these numbers is a true increase," said Dr. Thomas Insel, director of the National Institute of Mental Health. "We're going to have to think very hard about what we're going to do for the 1 in 100."

Figuring out how many children have autism is extremely difficult because diagnosis is based on a child's behavior, said Dr. Susan E. Levy of the Children's Hospital of Philadelphia and a member of the American Academy of Pediatrics subcommittee on autism.

"With diabetes you can get a blood test," said Levy. "As of yet, there's no consistent biologic marker we can use to make the diagnosis of autism."

The new estimate would mean about 673,000 American children have autism. Previous estimates put the number at about 560,000.

One of the studies stems from the 2007 National Survey of Children's Health. The results were released Monday, and published in October's Pediatrics.

In that study, based on telephone surveys, parents reported about 1 in 91 children, ages 3 to 17, had autism, including milder forms such as Asperger's syndrome.

The other government estimate has not been formally released yet. But because of the new published findings, officials from the Centers for Disease Control and Prevention decided to announce Friday during an embargoed press briefing that their preliminary findings also show about 1 in 100 children have the disorders.

The CDC uses an in-depth method for its estimate, said CDC researcher Catherine Rice. An agency network reviews the education and health records of 8-year-old children in selected cities and determines whether the children meet the diagnosis. Autism experts generally consider this method more rigorous than a telephone survey.

President Barack Obama has made autism a priority for research, Insel said. Federal stimulus money has been earmarked for autism, and a 2006 law pumped millions of dollars of new federal money into autism research, screening and treatment.

The published findings, which include state-level data, will help the government plan new services, said Michael Kogan, a researcher with the federal Health Resources and Services Administration, who led the new study, which lists authors from several government agencies, including CDC.

The findings are based on the results of a national telephone survey of more than 78,000 parents of children ages 3 to 17. The survey dealt with many health issues and included two questions on autism.

Parents were asked whether they'd ever been told by a doctor or other health care provider that their child had autism, Asperger's syndrome, pervasive developmental disorder or other autism spectrum disorder.

If the parent said yes, they were asked if their child currently has autism or an autism spectrum disorder. "Yes" to both questions was counted as a child with an autism disorder.

The survey questions were flawed, said autism researcher Irva Hertz-Picciotto of the University of California, Davis. A broad definition, read to some parents who asked for clarification, didn't include "repetitive behaviors," Hertz-Picciotto said. And parents weren't asked about a professional diagnosis in the second question.

Children with autism can have trouble communicating and interacting socially. They may have poor eye contact and engage in repetitive behavior such as rocking or hand-flapping.

"The wording and definition invited much broader interpretation," Hertz-Picciotto said, and researchers didn't check what parents said against medical records.

In another finding, nearly 40 percent of the children ever diagnosed with autism disorders didn't currently have autism, the parents reported. That rate is much higher than ever found by autism recovery researchers. Outside experts said they doubt it reflects a true rate of recoveries. Autism could have been suspected and later ruled out for some of the children, the authors wrote.

One of the new study's authors was supported in part by a grant from Autism Speaks. The others work for federal agencies.

"Autism is a highly prevalent disorder," said Geraldine Dawson, chief science officer of the advocacy group Autism Speaks. "We're looking at a major public health challenge."

―――
On the Net:
American Academy of Pediatrics: http://www.aap.org
CDC: http://www.cdc.gov/ncbddd/autism/
HRSA: http://www.hrsa.gov/
Autism Speaks: http://www.autismspeaks.org/
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

-------------------------------------------------------
Published online October 5, 2009
PEDIATRICS (doi:10.1542/peds.2009-1522)

画像Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007

Michael D. Kogan, PhDa, Stephen J. Blumberg, PhDb, Laura A. Schieve, PhDc, Coleen A. Boyle, PhDc, James M. Perrin, MDd, Reem M. Ghandour, DrPHa, Gopal K. Singh, PhDa, Bonnie B. Strickland, PhDa, Edwin Trevathan, MD, MPHc and Peter C. van Dyck, MD, MPHa

aMaternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland;
bNational Center for Health Statistics, Centers for Disease Control and Prevention, US Department of Health and Human Services, Hyattsville, Maryland;
cNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, Georgia; and
dCenter for Child and Adolescent Health Policy, Mass General Hospital for Children, Harvard Medical School, Boston, Massachusetts

Objectives The reported increasing prevalence of autism spectrum disorder (ASD) and attendant health and family impact make monitoring of ASD prevalence a public health priority.

Methods The prevalence of parent-reported diagnosis of ASD among US children aged 3 to 17 years was estimated from the 2007 National Survey of Children's Health (sample size: 78037). A child was considered to have ASD if a parent/guardian reported that a doctor or other health care provider had ever said that the child had ASD and that the child currently had the condition. The point-prevalence for ASD was calculated for those children meeting both criteria. We examined sociodemographic factors associated with current ASD and with a past (but not current) ASD diagnosis. The health care experiences for children in both ASD groups were explored.

Results The weighted current ASD point-prevalence was 110 per 10,000. We estimate that 673,000 US children have ASD. Odds of having ASD were 4 times as large for boys than girls. Non-Hispanic (NH) black and multiracial children had lower odds of ASD than NH white children. Nearly 40% of those ever diagnosed with ASD did not currently have the condition; NH black children were more likely than NH white children to not have current ASD. Children in both ASD groups were less likely than children without ASD to receive care within a medical home.

Conclusions The observed point-prevalence is higher than previous US estimates. More inclusive survey questions, increased population awareness, and improved screening and identification by providers may partly explain this finding.

Key Words: autism spectrum disorder . prevalence . children with special health care needs . disability . national estimates . access to health care

Abbreviations: CI, confidence interval

Accepted Aug 3, 2009.


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