[autismo-biologia] Incidenza, prevalenza, costi
Stefano Palazzi
s.palazzi a ausl.fe.it
Mar 8 Feb 2011 17:20:07 CET
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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