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Üçüncü basamak sağlık hizmeti veren bir merkezde otizm spektrum bozukluğu nedeniyle izlenen 4 yaş altındaki çocukların gelişimsel özellikleri

Year 2020, Volume: 53 Issue: 3, 148 - 154, 31.12.2020

Pelin Çelik İclal Ayranci Sucakli Gülser Şenses Dinç Halil İbrahim Yakut

https://doi.org/10.20492/aeahtd.709373

Abstract

Amaç: Çalışmanın amacı otizm spektrum bozukluğu (OSB) tanısı alan küçük çocukların klinik ve gelişimsel özelliklerini incelemek ve OSB’nun erken belirtilerini araştırmaktır.
Gereç ve yöntem: Ocak 2017-Mayıs 2019 tarihleri arasında, 4 yaş altında, yeni tanı alan, Gelişimsel Pediatri ve Çocuk ve Ergen Psikiyatrisi tarafından izlenen 134 çocuğun tıbbi kayıtları geriye dönük olarak incelendi. 24 ay ve öncesinde otizm tanısı alanlarla, sonra tanı alanların başvuru gelişimsel özellikleri karşılaştırıldı.
Bulgular: Çocukların 43'ü (%32.1) ≤24 ay, 91'i (%67.9) >24 ay tanı almıştı. Ebeveynlerin en sık başvuru yakınması konuşma gecikmesiydi(%46.2). Ebeveynlerin sadece %1.5'inin başvuru yakınmalarını “otizm” olarak bildirdikleri, %73.9'unun ise öykü derinleştirildiğinde OSB ile ilgili kaygılarını dile getirdikleri saptandı. Ebeveynlerin OSB ile ilişkili kaygı bildirmesi (p=0.031) ve ≥8 yıl anne eğitim süresi (p = 0,002) daha erken tanı ile ilişkili saptandı. ≤24 ay tanı alan çocuklarda, >24 ay tanı alan çocuklara göre komut almama (p=0.012) ve hareket gelişiminde gecikme (p=0.008) daha sıktı. Diğer OSB bulguları ve klinik özellikler ≤24 ay ve >24 ay tanı alan çocuklarda benzerdi.
Sonuç: OSB belirtileri yaşamın ilk 2 yılında ortaya çıkmaktadır. OSB tanısını ≤24 ay alan çocuklarda, daha geç yaşta tanı alanlara göre alıcı dil ve hareket işlevlerinde zorluk daha sıktır. Ebeveynler OSB düşündüren belirtileri farketmelerine rağmen, endişelerini açıkça ifade etmeyebilirler. Çocuk hekimleri ailelerin OSB'nu yansıtan kaygılarını anlamak için onları dinlemeli ve zaman ayırmalıdır.

Keywords

otizm spektrum bozukluğu otizm belirtileri gelişimsel özellikler ebeveyn kaygısı erken tanı

References

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  • Referans2 Baio J, Wiggins L, Christensen DL et al. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ 2018;67(6):1-23.
  • Referans3 Bauman ML, Kemper TL. Neuroanatomic observations of the brain in autism: a review and future directions. Int J Dev Neurosci 2005;23(2-3):183-7.
  • Referans4 O'Reilly C, Lewis JD, Elsabbagh M. Is functional brain connectivity atypical in autism? A systematic review of EEG and MEG studies. PLoS One 2017;12(5):e0175870.
  • Referans5 Al-Qabandi M, Gorter JW, Rosenbaum P. Early autism detection: are we ready for routine screening? Pediatrics 2011;128(1):e211-7.
  • Referans6 Baghdadli A, Picot MC, Pascal C et al. Relationship between age of recognition of first disturbances and severity in young children with autism. Eur Child Adolesc Psychiatry 2003;12(3):122-7.
  • Referans7 Daley TC. From symptom recognition to diagnosis: children with autism in urban India. Soc Sci Med 2004;58(7):1323-35.
  • Referans8 Dawson M, Gernsbacher MA. Effectiveness of intensive autism programmes. Lancet 2010;375(9716):722-3; author reply 23.
  • Referans9 Schopler E, Reichler R, Rochen Renner B. The Childhood Autism Rating Scale 1988, Los Angeles, CA: Western Psychological Services.
  • Referans10 Ozturk Ertem I, Krishnamurthy V, Mulaudzi MC et al. Validation of the International Guide for Monitoring Child Development demonstrates good sensitivity and specificity in four diverse countries. Acta Paediatr 2019;108(6):1074-86.
  • Referans11 Chlebowski C, Green JA, Barton ML et al. Using the childhood autism rating scale to diagnose autism spectrum disorders. J Autism Dev Disord 2010;40(7):787-99.
  • Referans12 S. Incekas BB, Y. Demiral, and S. Miral. Cocukluk otizmini derecelendirme olcegi Turkce formunun gecerlilik ve guvenilirlik calismasi in 19. Ulusal Cocuk ve Ergen Ruh Sagligi veHastaliklari Kongresi Ozet Kitabi, Ulusal Cocuk ve Ergen Ruh Sagligi ve Hastaliklari Dernegi, 2009, Antakya, Turkey.
  • Referans13 Barger BD, Campbell JM, McDonough JD. Prevalence and onset of regression within autism spectrum disorders: a meta-analytic review. J Autism Dev Disord 2013;43(4):817-28.
  • Referans14 Malhi P, Singhi P. A retrospective study of toddlers with autism spectrum disorder: Clinical and developmental profile. Ann Indian Acad Neurol 2014;17(1):25-9.
  • Referans15 Dawson G, Rogers S, Munson J et al. Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics 2010;125(1):e17-23.
  • Referans16 Boyd BA, McDonough SG, Rupp B et al. Effects of a family-implemented treatment on the repetitive behaviors of children with autism. J Autism Dev Disord 2011;41(10):1330-41.
  • Referan 17 Lawton K, Kasari C. Brief report: longitudinal improvements in the quality of joint attention in preschool children with autism. J Autism Dev Disord 2012;42(2):307-12.
  • Referans18 Kasari C, Freeman S, Paparella T. Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. J Child Psychol Psychiatry 2006;47(6):611-20.
  • Referans19 Minjarez MB, Williams SE, Mercier EM et al. Pivotal response group treatment program for parents of children with autism. J Autism Dev Disord 2011;41(1):92-101.
  • Referans20 Landa RJ, Holman KC, O'Neill AH et al. Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: a randomized controlled trial. J Child Psychol Psychiatry 2011;52(1):13-21.
  • Referans21 Daniels AM, Mandell DS. Explaining differences in age at autism spectrum disorder diagnosis: a critical review. Autism 2014;18(5):583-97.
  • Referans22 Christensen DL, Baio J, Van Naarden Braun K et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years--Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012. MMWR Surveill Summ 2016;65(3):1-23.
  • Referans23 Brett D, Warnell F, McConachie H et al. Factors Affecting Age at ASD Diagnosis in UK: No Evidence that Diagnosis Age has Decreased Between 2004 and 2014. J Autism Dev Disord 2016;46(6):1974-84.
  • Referans24 Zwaigenbaum L, Duku E, Fombonne E et al. Developmental functioning and symptom severity influence age of diagnosis in Canadian preschool children with autism. Paediatr Child Health 2019;24(1):e57-e65.
  • Referans25 Landa R. Early communication development and intervention for children with autism. Ment Retard Dev Disabil Res Rev 2007;13(1):16-25.
  • Referans26 Johnson CP, Myers SM, American Academy of Pediatrics Council on Children With D. Identification and evaluation of children with autism spectrum disorders. Pediatrics 2007;120(5):1183-215.
  • Referans27 Herlihy L, Knoch K, Vibert B et al. Parents' first concerns about toddlers with autism spectrum disorder: effect of sibling status. Autism 2015;19(1):20-8.
  • Referans28 Richards M, Mossey J, Robins DL. Parents' Concerns as They Relate to Their Child's Development and Later Diagnosis of Autism Spectrum Disorder. J Dev Behav Pediatr 2016;37(7):532-40.
  • Referans29 Ertem IO, Atay G, Dogan DG et al. Mothers' knowledge of young child development in a developing country. Child Care Health Dev 2007;33(6):728-37.
  • Referans30 Licari MK, Alvares GA, Varcin K et al. Prevalence of Motor Difficulties in Autism Spectrum Disorder: Analysis of a Population-Based Cohort. Autism Res 2019.
  • Referans31 Harris SR. Early motor delays as diagnostic clues in autism spectrum disorder. Eur J Pediatr 2017;176(9):1259-62.
  • Referans32 West KL. Infant Motor Development in Autism Spectrum Disorder: A Synthesis and Meta-analysis. Child Dev 2018.
  • Referans33 Lord C, Shulman C, DiLavore P. Regression and word loss in autistic spectrum disorders. J Child Psychol Psychiatry 2004;45(5):936-55.
  • Referans34 Mamidala MP, Kalikiri MK, Praveen Kumar PT et al. Consanguinity in India and its association with autism spectrum disorder. Autism Res 2015;8(2):224-8.
  • Referans35 TFSS (2011) Family Structure in Turkey Survey, Ministry of Family and Social Policy (Turkey) (2011). Available from: http://www.cocukhaklariizleme.org/wp-content/uploads/turkiyenin-aile-yapisiarastirmasi-20111.pdf.
  • Referans36 Kaplan S, Pinar G, Kaplan B et al. The Prevalence of Consanguineous Marriages and Affecting Factors in Turkey: A National Survey. J Biosoc Sci 2016;48(5):616-30.
  • Referans37 Chonchaiya W, Nuntnarumit P, Pruksananonda C. Comparison of television viewing between children with autism spectrum disorder and controls. Acta Paediatr 2011;100(7):1033-7.
  • Referans38 Kilic AO, Sari E, Yucel H et al. Exposure to and use of mobile devices in children aged 1-60 months. Eur J Pediatr 2019;178(2):221-27.
  • Referans39 Council On C, Media. Media and Young Minds. Pediatrics 2016;138(5).
  • Referans40 Celik P, Sucakli IA, Yakut HI. Initial symptom of different developmental problems: Language delay. Turkish Journal of Pediatric Disease 2019;13(6):468 - 74.
  • Referans41 Krupa M, Boominathan P, Ramanan PV et al. Relationship Between Screen Time and Mother-Child Reciprocal Interaction in Typically Developing Children and Children with Autism Spectrum Disorders. Indian J Pediatr 2019;86(4):394.

Developmental profile of toddlers with autism spectrum disorder at a tertiary centre in Turkey

Year 2020, Volume: 53 Issue: 3, 148 - 154, 31.12.2020

Pelin Çelik İclal Ayranci Sucakli Gülser Şenses Dinç Halil İbrahim Yakut

https://doi.org/10.20492/aeahtd.709373

Abstract

Purpose: The aim of the study was to examine the clinical and developmental characteristics of toddlers with autism spectrum disorder (ASD); and find out early manifestations.
Material and method: Medical records of 134 newly diagnosed children under 4 years of age and followed by both developmental-behavioral pediatrics, and child and adolescent psychiatry between January 2017 and May 2019 were retrospectively reviewed. Developmental features of children who diagnosed ≤24 months of age and later were compared.
Results: ASD diagnosis was performed at ≤24 and >24 months of age in 43 (32.1%) and 91 (67.9%) children, respectively. The most common concern expressed by parents at admission was language delay (46.2%). While only 1.5% of parents named “autism” spontaneously as a concern, 73.9% of parents expressed concerns about ASD when the history was deepened. Parental concern about ASD (p=0.031) and mother’s education level ≥8 years (p=0.002) were associated with earlier diagnosis. Children diagnosed at ≤24 months of age were more likely to have inability to follow verbal commands (p=0.012) and delayed motor milestones (p=0.008). Other ASD signs and clinical characteristics were similar between children who diagnosed at ≤24 and >24 months of age.
Conclusion: The signs of ASD emerge over the first 2 years of life. Children who diagnosed ASD ≤24 months of age have poorer receptive language and motor skills. Whereas parents were recognising warming signs of ASD, they may not express their concerns clearly. Pediatricians should take time to listen to parents and realize their concerns reflecting ASD.

Keywords

autism spectrum disorder signs of autism developmental profile parental concern early diagnosis

References

  • Referans1 Diagnostic and statistical manual of mental disorders. American Psychiatric Association. 5th ed 2013, Arlington, VA.
  • Referans2 Baio J, Wiggins L, Christensen DL et al. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ 2018;67(6):1-23.
  • Referans3 Bauman ML, Kemper TL. Neuroanatomic observations of the brain in autism: a review and future directions. Int J Dev Neurosci 2005;23(2-3):183-7.
  • Referans4 O'Reilly C, Lewis JD, Elsabbagh M. Is functional brain connectivity atypical in autism? A systematic review of EEG and MEG studies. PLoS One 2017;12(5):e0175870.
  • Referans5 Al-Qabandi M, Gorter JW, Rosenbaum P. Early autism detection: are we ready for routine screening? Pediatrics 2011;128(1):e211-7.
  • Referans6 Baghdadli A, Picot MC, Pascal C et al. Relationship between age of recognition of first disturbances and severity in young children with autism. Eur Child Adolesc Psychiatry 2003;12(3):122-7.
  • Referans7 Daley TC. From symptom recognition to diagnosis: children with autism in urban India. Soc Sci Med 2004;58(7):1323-35.
  • Referans8 Dawson M, Gernsbacher MA. Effectiveness of intensive autism programmes. Lancet 2010;375(9716):722-3; author reply 23.
  • Referans9 Schopler E, Reichler R, Rochen Renner B. The Childhood Autism Rating Scale 1988, Los Angeles, CA: Western Psychological Services.
  • Referans10 Ozturk Ertem I, Krishnamurthy V, Mulaudzi MC et al. Validation of the International Guide for Monitoring Child Development demonstrates good sensitivity and specificity in four diverse countries. Acta Paediatr 2019;108(6):1074-86.
  • Referans11 Chlebowski C, Green JA, Barton ML et al. Using the childhood autism rating scale to diagnose autism spectrum disorders. J Autism Dev Disord 2010;40(7):787-99.
  • Referans12 S. Incekas BB, Y. Demiral, and S. Miral. Cocukluk otizmini derecelendirme olcegi Turkce formunun gecerlilik ve guvenilirlik calismasi in 19. Ulusal Cocuk ve Ergen Ruh Sagligi veHastaliklari Kongresi Ozet Kitabi, Ulusal Cocuk ve Ergen Ruh Sagligi ve Hastaliklari Dernegi, 2009, Antakya, Turkey.
  • Referans13 Barger BD, Campbell JM, McDonough JD. Prevalence and onset of regression within autism spectrum disorders: a meta-analytic review. J Autism Dev Disord 2013;43(4):817-28.
  • Referans14 Malhi P, Singhi P. A retrospective study of toddlers with autism spectrum disorder: Clinical and developmental profile. Ann Indian Acad Neurol 2014;17(1):25-9.
  • Referans15 Dawson G, Rogers S, Munson J et al. Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics 2010;125(1):e17-23.
  • Referans16 Boyd BA, McDonough SG, Rupp B et al. Effects of a family-implemented treatment on the repetitive behaviors of children with autism. J Autism Dev Disord 2011;41(10):1330-41.
  • Referan 17 Lawton K, Kasari C. Brief report: longitudinal improvements in the quality of joint attention in preschool children with autism. J Autism Dev Disord 2012;42(2):307-12.
  • Referans18 Kasari C, Freeman S, Paparella T. Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. J Child Psychol Psychiatry 2006;47(6):611-20.
  • Referans19 Minjarez MB, Williams SE, Mercier EM et al. Pivotal response group treatment program for parents of children with autism. J Autism Dev Disord 2011;41(1):92-101.
  • Referans20 Landa RJ, Holman KC, O'Neill AH et al. Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: a randomized controlled trial. J Child Psychol Psychiatry 2011;52(1):13-21.
  • Referans21 Daniels AM, Mandell DS. Explaining differences in age at autism spectrum disorder diagnosis: a critical review. Autism 2014;18(5):583-97.
  • Referans22 Christensen DL, Baio J, Van Naarden Braun K et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years--Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012. MMWR Surveill Summ 2016;65(3):1-23.
  • Referans23 Brett D, Warnell F, McConachie H et al. Factors Affecting Age at ASD Diagnosis in UK: No Evidence that Diagnosis Age has Decreased Between 2004 and 2014. J Autism Dev Disord 2016;46(6):1974-84.
  • Referans24 Zwaigenbaum L, Duku E, Fombonne E et al. Developmental functioning and symptom severity influence age of diagnosis in Canadian preschool children with autism. Paediatr Child Health 2019;24(1):e57-e65.
  • Referans25 Landa R. Early communication development and intervention for children with autism. Ment Retard Dev Disabil Res Rev 2007;13(1):16-25.
  • Referans26 Johnson CP, Myers SM, American Academy of Pediatrics Council on Children With D. Identification and evaluation of children with autism spectrum disorders. Pediatrics 2007;120(5):1183-215.
  • Referans27 Herlihy L, Knoch K, Vibert B et al. Parents' first concerns about toddlers with autism spectrum disorder: effect of sibling status. Autism 2015;19(1):20-8.
  • Referans28 Richards M, Mossey J, Robins DL. Parents' Concerns as They Relate to Their Child's Development and Later Diagnosis of Autism Spectrum Disorder. J Dev Behav Pediatr 2016;37(7):532-40.
  • Referans29 Ertem IO, Atay G, Dogan DG et al. Mothers' knowledge of young child development in a developing country. Child Care Health Dev 2007;33(6):728-37.
  • Referans30 Licari MK, Alvares GA, Varcin K et al. Prevalence of Motor Difficulties in Autism Spectrum Disorder: Analysis of a Population-Based Cohort. Autism Res 2019.
  • Referans31 Harris SR. Early motor delays as diagnostic clues in autism spectrum disorder. Eur J Pediatr 2017;176(9):1259-62.
  • Referans32 West KL. Infant Motor Development in Autism Spectrum Disorder: A Synthesis and Meta-analysis. Child Dev 2018.
  • Referans33 Lord C, Shulman C, DiLavore P. Regression and word loss in autistic spectrum disorders. J Child Psychol Psychiatry 2004;45(5):936-55.
  • Referans34 Mamidala MP, Kalikiri MK, Praveen Kumar PT et al. Consanguinity in India and its association with autism spectrum disorder. Autism Res 2015;8(2):224-8.
  • Referans35 TFSS (2011) Family Structure in Turkey Survey, Ministry of Family and Social Policy (Turkey) (2011). Available from: http://www.cocukhaklariizleme.org/wp-content/uploads/turkiyenin-aile-yapisiarastirmasi-20111.pdf.
  • Referans36 Kaplan S, Pinar G, Kaplan B et al. The Prevalence of Consanguineous Marriages and Affecting Factors in Turkey: A National Survey. J Biosoc Sci 2016;48(5):616-30.
  • Referans37 Chonchaiya W, Nuntnarumit P, Pruksananonda C. Comparison of television viewing between children with autism spectrum disorder and controls. Acta Paediatr 2011;100(7):1033-7.
  • Referans38 Kilic AO, Sari E, Yucel H et al. Exposure to and use of mobile devices in children aged 1-60 months. Eur J Pediatr 2019;178(2):221-27.
  • Referans39 Council On C, Media. Media and Young Minds. Pediatrics 2016;138(5).
  • Referans40 Celik P, Sucakli IA, Yakut HI. Initial symptom of different developmental problems: Language delay. Turkish Journal of Pediatric Disease 2019;13(6):468 - 74.
  • Referans41 Krupa M, Boominathan P, Ramanan PV et al. Relationship Between Screen Time and Mother-Child Reciprocal Interaction in Typically Developing Children and Children with Autism Spectrum Disorders. Indian J Pediatr 2019;86(4):394.
There are 41 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original research article
Authors

Pelin Çelik

İclal Ayranci Sucakli This is me 0000-0002-0995-2636

Gülser Şenses Dinç

Halil İbrahim Yakut

Publication Date December 31, 2020
Submission Date March 25, 2020
Published in Issue Year 2020 Volume: 53 Issue: 3

Cite

AMA Çelik P, Ayranci Sucakli İ, Şenses Dinç G, Yakut Hİ. Developmental profile of toddlers with autism spectrum disorder at a tertiary centre in Turkey. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. December 2020;53(3):148-154. doi:10.20492/aeahtd.709373
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