[autismo-biologia] Incidenza, prevalenza, costi

[Stefano Palazzi]

Vorrei condividere una riflessione che emerge dall'abstract allegato  
che si interroga sulla sostenibilità dei programmi d'intervento  
tempestivo nell'autismo negli USA a fronte delle prevalenze osservate.  
A pari incidenza teorica, da questo punto di vista l'Italia si  
avvantaggia della bassa natalità, nonostante una maggior morbilità  
autistica per l'incrementata sopravvivenza dei grandi prematuri.  
D'altro canto ci si trova a gestire una prevalenza record di persone  
adulte sempre più anziane che non furono diagnosticate né precocemente  
né mai.
Visti i tempi, prima che si facciano scelte incongrue di politica  
socio-sanitaria, forse è il caso di pensarci.
L'intervento tempestivo è quello della scuola d'infanzia e dei servizi  
di neuropsichiatria infantile...
Niente di nuovo, ma da ricordare.
Stefano Palazzi

J Dev Behav Pediatr. 2010 Jul-Aug;31(6):469-76.

Can state early intervention programs meet the increased demand of  
children suspected of having autism spectrum disorders?

Wise MD, Little AA, Holliman JB, Wise PH, Wang CJ.

Department of Pediatrics, Boston Medical Center, Boston, MA 02118, USA.

OBJECTIVE: To determine whether Early Intervention programs have the  
capacity to accommodate the expected increase in referrals following  
the American Academy of Pediatrics' 2007 recommendation for universal  
screening of 18- and 24-month-old children for Autism Spectrum  
Disorders (ASD). METHOD: We conducted a telephone survey of all state  
and territory early. Intervention coordinators about the demand for  
ASD evaluations, services, and program capacity. We used multivariate  
models to examine state-level factors associated with the capacity to  
serve children with ASD. RESULTS: Fifty-two of the 57 coordinators  
(91%) responded to the survey. Most states reported an increase in  
demand for ASD-related evaluations (65%) and services (58%) since  
2007. In addition, 46% reported that their current capacity poses a  
challenge to meeting the 45-day time limit for creating the  
Individualized Family Service Plan. Many states reported that they  
have shortages of ASD-related personnel, including behavioral  
therapists (89%), speech-language pathologists (82%), and occupational  
therapists (79%). Among states that reported the number of service  
hours (n = 34) 44% indicated that children with ASD receive 5 or fewer  
weekly service hours. Multivariate models showed that states with a  
higher percentage of African-American and Latino children were more  
likely to have provider shortages whereas states with higher  
population densities were more likely to offer a greater number of  
service hours. CONCLUSION: Many Early Intervention programs may not  
have the capability to address the expected increase in demand for ASD  
services. Early Intervention programs will likely need enhanced  
resources to provide all children with suspected ASD with appropriate  
evaluations and services.

  PMID: 20585267 [PubMed - indexed for MEDLINE]

  
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