The Route to Autism Spectrum Diagnosis in Pediatric Practice in Bulgaria
| Autor: | Ivan Ivanov, Elena Timova, Fani Galabova, Lauren Franz, Ralitsa Iordanova, Aneliya Petkova, Margarita V. Panova, Iliyana Pacheva, Katerina Gaberova, Nikolay Tonchev, Vasil Kotetarov |
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| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Joint attention age of diagnosis pediatrics Clinical Biochemistry autism Physical examination Affect (psychology) Article 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine 0501 psychology and cognitive sciences lcsh:R5-920 Facial expression medicine.diagnostic_test neurodevelopment business.industry 05 social sciences medicine.disease Autism spectrum disorder Speech delay Autism medicine.symptom lcsh:Medicine (General) business Developmental regression 050104 developmental & child psychology |
| Zdroj: | Diagnostics Diagnostics, Vol 11, Iss 106, p 106 (2021) Volume 11 Issue 1 |
| ISSN: | 2075-4418 |
| Popis: | Diagnosis of autism spectrum disorder (ASD) before the age of three years is a challenge. Analyzing the present practice may help reaching that goal. Aim: To investigate developmental abnormalities and diagnostic pathway of ASD patients in pediatric practice. Methods: Retrospective cross-sectional study of 192 children aged 13 months to 17 years 11 months (average 4 years 9 months), investigated in an outpatient and hospital setting from January 2015 to June 2018 by a semi-structured history and clinical examination, and diagnosed with ASD by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Results: Behavioral peculiarities were detected in the history of the first two years of life in 74.8% of the subjects. The first developmental abnormalities were noticed by the parents at ages from 8 to 36 months (mean 15.6 months) and were predominantly in speech (in 94.6%) and non-verbal communication (11.3%). Developmental regression was reported in 42.1% of the patients occurring between the ages of 6 and 50 months (mean 17.9 months), affecting most commonly speech (88.4% of cases), non-verbal communication (29.2%), and behavior (12.8%). By history, the first manifestations of ASD were noticed at ages from 8 months to 84 months (mean 18.5 months), and were disorders of expressive speech (in 66.7% of cases), receptive speech (in 45.8%), non-verbal communication (35.4%), behavior (27.6%), play (8.9%), socialization (5.7%), and joint attention (2.1%). The most common motive for specialized consultation was delay in language development&mdash in 84.6% of children. The age of ASD diagnosis varied between 12 and 132 months (mean 39.7 months), and the time period between first ASD manifestations and diagnosis was in the range of 0 to 79 months (mean 23.3 months). Many symptoms of abnormal social communication, unnoticed by parents, were detected objectively in more than 95% of the cases&mdash absent or rare spontaneous or reciprocal smile lack of sharing of interest or affect abnormal eye contact lack of finger pointing lack of gaze to a pointed object poor facial expressions lack of imaginary play, etc. Conclusions: Almost two years are needed for diagnosing abnormal development in other domains besides speech in ASD patients. Diagnosis before the age of three years can be achieved by focusing parents&rsquo and pediatricians&rsquo attention on social communication and behavior in patients with speech delay or developmental regression. |
| Databáze: | OpenAIRE |
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