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

Öz

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.

Anahtar Kelimeler

• otizm spektrum bozukluğu,otizm belirtileri,gelişimsel özellikler,ebeveyn kaygısı,erken tanı

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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