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Saturday, May 9, 2009
Northwest Hall (Chicago Hilton)
10:00 AM
Background: Autism Spectrum Disorders (ASDs) are complex neurodevelopmental disorders that manifest in early childhood but their etiology is not fully understood. The prevalence of ASD appears to be on the rise in developed countries, and has become a serious public health concern. In the developing world, however, reliable epidemiologic data on ASDs are rare. Research in developing countries, where the environment may be very different from developed countries, will broaden epidemiological understanding of autism and allow for a better understanding of the etiology of ASD.
Objectives: The initial goal of this research was to use existing data to characterize ASD in Jamaican children. The long term goal is to develop collaboration among teams at the University of Texas Health Science Center at Houston, Autism Speaks and the University of West Indies in order to build capacity for conducting genetic and epidemiologic research on ASD in Jamaica. We will also present the concept behind the Epidemiological Research on Autism in Jamaica planning project; the first project designed to develop capacity for conducting population-based ASD studies in an Afro-Caribbean population.
Methods: Existing epidemiologic data were of children with ASD who attended the public Child and Family Clinic for Developmental and Behavioral Disorders of Childhood and the only private developmental and behavioral pediatric practice, both at the University Hospital of the West Indies (UHWI); a recognized referral centre for children with ASD. Diagnosis of ASD was based on developmental history, assessment of mental development using the Griffiths Mental Development Scales, and assessment of behavior. Children were evaluated from 1995 through 2006, however standardized assessment and diagnostic procedures for behavior based on the Childhood Autism Rating Scale (CARS), which is currently used for ASD assessment in Jamaica, was only conducted at both private and public diagnostic facilities for the years since 1999.
Results: A total of 168 children with ASD were identified during the study period, of which 79 (47%) were seen at the public diagnostic facility. The average age at the first appointment was 4.7 years, the youngest being 1.5 years old and the oldest, 15.8 years old. Of note, 140 (83.3%) were male and the remaining 28 (16.7%) were female representing a 5:1 ratio. Diagnoses were distributed as follows: Autism, 86%, PDD, 6% PDD-NOS, 5%, and Asperger Syndrome, 3%.
Conclusions: This study provides an important first look at the characteristics of ASD in an Afro-Caribbean population. The reported male-to-female ratio of 5:1 is within range of previous population-based studies (2.8:1–5.5:1). In order to have a better understanding of the etiology of ASD, we will conduct pilot studies to compare ASD case-finding and case-ascertainment approaches that will be used in future studies. Specifically, we will re-evaluate all suspected ASD cases from the existing Jamaica Autism Database using Autism Diagnostic Interview-Revised (ADI-R) and Diagnostic Observation Schedule (ADOS) assessment tools. The agreement between Childhood Autism Rating Scale (CARS) which is currently used for ASD assessment in Jamaica and ADI-R & ADOS will be determined.
Objectives: The initial goal of this research was to use existing data to characterize ASD in Jamaican children. The long term goal is to develop collaboration among teams at the University of Texas Health Science Center at Houston, Autism Speaks and the University of West Indies in order to build capacity for conducting genetic and epidemiologic research on ASD in Jamaica. We will also present the concept behind the Epidemiological Research on Autism in Jamaica planning project; the first project designed to develop capacity for conducting population-based ASD studies in an Afro-Caribbean population.
Methods: Existing epidemiologic data were of children with ASD who attended the public Child and Family Clinic for Developmental and Behavioral Disorders of Childhood and the only private developmental and behavioral pediatric practice, both at the University Hospital of the West Indies (UHWI); a recognized referral centre for children with ASD. Diagnosis of ASD was based on developmental history, assessment of mental development using the Griffiths Mental Development Scales, and assessment of behavior. Children were evaluated from 1995 through 2006, however standardized assessment and diagnostic procedures for behavior based on the Childhood Autism Rating Scale (CARS), which is currently used for ASD assessment in Jamaica, was only conducted at both private and public diagnostic facilities for the years since 1999.
Results: A total of 168 children with ASD were identified during the study period, of which 79 (47%) were seen at the public diagnostic facility. The average age at the first appointment was 4.7 years, the youngest being 1.5 years old and the oldest, 15.8 years old. Of note, 140 (83.3%) were male and the remaining 28 (16.7%) were female representing a 5:1 ratio. Diagnoses were distributed as follows: Autism, 86%, PDD, 6% PDD-NOS, 5%, and Asperger Syndrome, 3%.
Conclusions: This study provides an important first look at the characteristics of ASD in an Afro-Caribbean population. The reported male-to-female ratio of 5:1 is within range of previous population-based studies (2.8:1–5.5:1). In order to have a better understanding of the etiology of ASD, we will conduct pilot studies to compare ASD case-finding and case-ascertainment approaches that will be used in future studies. Specifically, we will re-evaluate all suspected ASD cases from the existing Jamaica Autism Database using Autism Diagnostic Interview-Revised (ADI-R) and Diagnostic Observation Schedule (ADOS) assessment tools. The agreement between Childhood Autism Rating Scale (CARS) which is currently used for ASD assessment in Jamaica and ADI-R & ADOS will be determined.