AWARENESS ABOUT CHILDHOOD AUTISM AMONG RESIDENT PHYSICIANS OF SURGICAL, NONSURGICAL AND FIRSTCONTACT DISCIPLINES (FAMILY MEDICINE+ PEDIATRICS+ OTORHINOLARYNGOLOGY) OF A RESEARCH AND TRAINING HOSPITAL IN ISTANBUL, TURKEY

Öz

Objective: The objective of this descriptive study was to assess the awareness of childhood autism among 275 physicians undergoing their residency training in several disciplines which were classified as surgical, nonsurgical and first-contact disciplines (Family medicine + Pediatrics + Otorhinolaryngology) of a Research and Training Hospital in Istanbul, Turkey. Material and Method: Data were collected through a self-administered questionnaire. Residents scoring below 20 were considered as “low scoring”; and residents scoring 20 and above were considered as “high scoring”; Chi-square test and Fisher’s chi-square test were applied for finding association between categorical variables. Results: The characteristics of childhood autism emerging with statistically significant differences between the disciplines (p<0.05) were ‘‘A child with autism frequently has repetitive and stereotypical behaviours’’ and ‘‘about the outstanding talents a child with autism might have’’. Around 94.1% of the first-contact disciplines and 93.3% of the nonsurgical disciplines were in the high-scoring group; whereas 82.6% of the surgical disciplines could be placed in the high-scoring group. This difference was statistically significant (p<0.05).Conclusion: In this study, the physicians undergoing their residency training in the first-contact disciplines, namely Family Medicine + Pediatrics + Otorhinolaryngology, were found to be more knowledgeable on childhood autism as compared to the ones undergoing residency training in the surgical disciplines. This was considered as a pleasing finding since the first-contact disciplines are most likely to be in an initial position to detect a child with autism in the community, refer him/her to the health authorities and continue monitoring him/her from thereon.

Anahtar Kelimeler

• Childhood autism
• awareness
• resident physicians
• non-surgical disciplines

İSTANBUL’DA BİR EĞİTİM VE ARAŞTIRMA HASTANESİNİN CERRAHİ, CERRAHİ DIŞI VE İLK-BAŞVURU DİSİPLİNLERİ (AİLE HEKİMLİĞİ + PEDİATRİ + KULAK BURUN BOĞAZ) ASİSTAN HEKİMLERİNİN ÇOCUKLUK ÇAĞI OTİZMİ HAKKINDA FARKINDALIKLARININ DEĞERLENDİRİLMESİ

Öz

Amaç: Bu tanımlayıcı çalışmanın amacı, İstanbul’da bir Eğitim Araştırma Hastanesi’nde cerrahi, cerrahi dışı ve ilk -başvuru disiplinlerinde (Aile hekimliği + Pediatri + Kulak Burun Boğaz) Tıpta Uzmanlık Eğitimi almakta olan 275 asistan hekimin çocukluk otizmi farkındalığını değerlendirmektir. Gereç ve Yöntem: Veriler asistan hekimlerin kendilerinin doldurduğu anket aracılığıyla toplandı. Yirmi’nin altında puan alan hekimler “düşük puan” almış olarak kabul edildi; 20 ve üzeri puan alanlar “yüksek puan” almış olarak kabul edildi; Kategorik değişkenler arasındaki ilişkiyi bulmak için ki-kare testi ve Fisher’in ki-kare testi uygulanmıştır. Bulgular: Otizmli bir çocuk tekrarlayıcı ve stereotipik davranışlara sahiptir” ve “otizmi olan bir çocuğun üstün yeteneklere sahip olabileceği” disiplinler arasında istatistiksel olarak anlamlı farklarla ortaya çıkan çocukluk otizminin özellikleridir. İlk -başvuru disiplinlerinin yaklaşık %94,1’i ve cerrahi dışı disiplinlerin %93,3’ü yüksek puan grubunda yer almıştır; oysa cerrahi disiplinlerin daha azı (%82,6’sı) yüksek puan grubunda yer almıştır. Bu fark istatistiksel olarak anlamlıydı (p<0,05). Sonuç: Bu çalışmada ilk-başvuru disiplinlerinde eğtim almakta olan asistan hekimlerin çocukluk otizmi hakkında daha fazla bilgi sahibi oldukları görülmüştür. İlk-başvuru disiplinlerinin, toplumda olası otizmi olan bir çocuğu fark etmek, ilk adımı atacak disiplinler olmaları nedeniyle, bu sonuç yüz güldürücü bir bulgu olarak kabul edildi.

Anahtar Kelimeler

• Çocukluk çağı otizmi
• farkındalık
• asistan hekimler
• cerrahi olmayan disiplinler

Kaynakça

1. 1. Udhya J, Varadharaja MM, Parthiban J, Srinivasan I. Autism disorder (AD) an updated review for paediatric dentists. J Clin Diagn Res 2014;8:275-9.
2. 2. Elsabbagh M, Divan G, Koh YJ, Kim YS, Kauchali S, Marcin C, et al. Global prevalence of autism and other pervasive developmental disorders. Autism Res 2012;5:160-79.
3. 3. Hartley-McAndrew M, Doody KR, Mertz J. Knowledge of autism spectrum disorders in potential first-contact professionals. N Am J Med Sci 2014;7:97-102.
4. 4. Rahbar MH, İbrahim K, Assassi P. Knowledge and attitude of general practitioners regarding autism in Karachi, Pakistan. J Autism Dev Disord 2011;41:465-74.
5. 5. Dillenburger K, Jordan JA, McKerr L. Autism spectrum disorder: public awareness and attitudes. Research Update 2013 May (cited 2015 May 2): 84: (4 screens). Available from: http://www.ark.ac.uk/publications/updates/update84.pdf.
6. 6. Shamsuddin S, Rahman AS. A preliminary study: awareness, knowledge and attitude of people towards children with autism. Proceeding of the Social Sciences Research ICSSR, June 2014, Kota Kinabalu, Sabah, MALAYSIA. Available from: https://pdfs.semanticscholar. org/58e7/156be290ddaa5628d6961307f39c3bd833a3. pdf?_ga=2.41330146.1504951613.1574930609-2125218310. 1574930609
7. 7. Hartley-McAndrew M, Doody KR, Mertz J. Knowledge of Autism Spectrum Disorders in Potential First-Contact Professionals. N Am J Med Sci 2014;7:97-102.
8. 8. Bakare MO, Ebigbo PO, Agomoh AO, Eaton J, Onyeama GM, Okonkwo KO, et al. Knowledge about childhood autism and opinion among health care workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders in Nigeria. BMC Pediatr 2009;9:1-13.

9. 9. Sices L ,Feudtner C, McLaughlin J, Drotar D,Micelle W.How Do Primary Care Physicians Identify Young Children With Developmental Delays? A National Survey. J Dev Behav Pediatr 2003;24:409-17.
10. 10. Heidgerken AD, Gffken G, Modi A, Frakey L. A Survey of Autism Knowledge in a Health Care Setting. J Autism Dev Disord 2005;35:323-30.
11. 11. Bakare MO, Agomoh AO, Ebigbo PO, Eaton J, Okonkwo KO, Onwukwe JU, et al. Etiological explanation, treatability and preventability of childhood autism: a survey of Nigerian healthcare workers’ opinion. Ann Gen Psychiatry 2009;8:18.
12. 12. Siegel B, Pliner C, Eschler J, Elliott GR. How children with autism are diagnosed: difficulties in identification of children with multiple developmental delays. J Dev Behav Pediatr 1988;9:199-204.
13. 13. De Ocampo AC, Jacobs JM. Medical management of autism. JSC Med Assoc 2006;102:274-6.
14. 14. Ryan S, Salisbury H. ‘You know what boys are like’: prediagnosis experiences of parents of children with autism spectrum conditions. Br J Gen Pract 2012;62:378-83.
15. 15. American Academy of Pediatrics Committee on Children with Disabilities.The pediatrician’s role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics 2001;107:1221-26.
16. 16. Shaukat F, Fatima A, Zehra N, Hussein MAG, Ismail O. Assessment of knowledge about childhood autism among medical students from private and public universities in Karachi. J Pak Med Assoc 2014;64:1331-4.
17. 17. Igwe MN, Bakare MO, Agomoh AO, Onyeama GM, Okonkwo KO. Factors influencing knowledge about childhood autism among final year undergraduate medical, nursing and psychology students of University of Nigeria, Enugu State, Nigeria. Ital J Pediatr 2010;36:44.
18. 18. Kara B, Mukaddes NM, Altınkaya I, et al. Using the modified checklist for autism in toddlers in a wellchild clinic in Turkey: Adapting the screening method based on culture and setting. Autism 2014;18:331-8.
19. 19. Öner P, Öner Ö, Çöp E, Munir KM. Sosyal iletişim ölçeğinin okul öncesi çocuklardaki geçerlik ve güvenirliği. Klinik Psikofarmakol Bulteni 2012;22:43-50.
20. 20. Imran N, Chaudry MR, Azeem MW, Bhatti MR, Choudhary ZI, Cheema MA. A survey of Autism knowledge and attitudes among the healthcare professionals in Lahore, Pakistan. BMC Pediatr 2011;11:107.
21. 21. Daley TC, Sigman MD. Diagnostic conceptualization of autism among Indian psychiatrists, psychologists, and pediatricians. J Autism Dev Disord 2002;32:13-23. 22. Mishaal RA, Itzchak EB, Zachor DA. Age of autism spectrum disorder diagnosis is associated with child’s variables and parental experience. Res Autism Spectr Disord 2014;8(7):873-80.
22. 23. Meilleur AA, Jelenic P, Mottron L. Prevalence of clinically and empirically defined talents and strenghts in autism. J Autism Dev Disord 2015;45:1354-67.
23. 24. Dubischar-Krivec AM, Neumann N, Poustka F, Braun C, Birbaumer N, Bölte S. Calendar calculating in savants with autism and healthy calendar calculators. Psychol Med 2009;39:1355-63.
24. 25. Cohen SB, Wheelwright S, Skinner R, Martin J, Clubley E. The Autism-Spectrum Quotient (AQ): Evidence from Asperger Syndrome/High-Functioning Autism, Males and Females, Scientists and Mathematicians. J Autism Dev Disord 2001;31:5-17.
25. 26. Eseigbe EE, Nuhu FT, Sheikh TL, Eseigbe P, Sanni KA, Olisah VO. Knowledge of Childhood Autism and Challenges of Management among Medical Doctors in Kaduna State, Northwest Nigeria. Autism Res Treat 2015;2015:Article ID 892301.
26. 27. Erden G , Akçakın M, Doğan DG, Ertem İÖ. Çocuk Hekimleri ve Otizm: Tanıda Zorluklar. Turkiye Klinikleri J Pediatr 2010;19:9-15.
27. 28. Lian WB, Ho SK, Yeo CL, Ho LY. General practitioners’ knowledge on childhood developmental and behavioural disorders. Singapore Med J 2003;44:397-403.
28. 29. Sabuncuoğlu M, Cebeci S, Rahbar MH, Hessabi M. Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder: Knowledge and Attitude of Family Medicine Residents in Turkey. TJFMPC 2015;9:46-53.
29. 30. Golnik A, Ireland M, Borowsky IW. Medical homes for children with autism: a physician survey. Pediatrics 2009;123:966-71.
30. 31. Zuckerman KE, Sinche B, Mejia A, Cobian M, Becker T, Nicolaidis C . Latino parents’ perspectives on barriers to autism diagnosis. Acad Pediatr 2014;14 :301-8.
31. 32. Harrington JW, Patrick PA, Edwards KS, Brand DA. Parental beliefs about autism: implications for the treating physician. Autism 2006;10:452-62.
32. 33. Wing L. The History of Ideas on Autism: Legends, Myths and Reality. Autism 1997;1:13-23.