Dataset Information

Age of diagnosis for autism: individual and community factors across 10 birth cohorts.

ABSTRACT: The incidence of autism rose dramatically between 1992 and 2001, while the age at which children were first diagnosed declined. During this period the size and composition of the autism caseload has changed, but little is known about whether the factors associated with the timing of diagnosis may also have shifted. Using a multilevel analysis strategy, the individual and community-level factors associated with age of diagnosis were modelled across 10 birth cohorts of California children.Linked birth and administrative records on 17,185 children with diagnoses of autistic disorder born in California between 1992 and 2001 and enrolled with the California Department of Developmental Services (DDS) were analysed. Information on cases, their parents and their residential location were extracted from birth and DDS records. Zip codes of residence were matched to census data to create community-level measures. Multilevel linear models were estimated for each birth cohort, with individual-level effects for sex, race, parental characteristics, poverty status, birth order and symptom expression. At the community level measures of educational and economic composition, local autism prevalence and the presence of a child psychiatrist were included.Children with highly educated parents are diagnosed earlier, and this effect has strengthened over time. There is a persistent gap in the age of diagnosis between high and low socioeconomic status (SES) children that has shrunk but not disappeared over time.Routine screening for autism in early childhood for all children, particularly those of low SES, is necessary to eliminate disparities in early intervention.

SUBMITTER: Fountain C

PROVIDER: S-EPMC3039707 | biostudies-literature | 2011 Jun

REPOSITORIES: biostudies-literature

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Age of diagnosis for autism: individual and community factors across 10 birth cohorts.

Fountain Christine C King Marissa D MD Bearman Peter S PS

Journal of epidemiology and community health 20101025 6

<h4>Background</h4>The incidence of autism rose dramatically between 1992 and 2001, while the age at which children were first diagnosed declined. During this period the size and composition of the autism caseload has changed, but little is known about whether the factors associated with the timing of diagnosis may also have shifted. Using a multilevel analysis strategy, the individual and community-level factors associated with age of diagnosis were modelled across 10 birth cohorts of Californi ...[more]

PMID: 20974836

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Project description:BackgroundThere is a paucity of information on secular trends in the age-related process by which people develop overweight or obesity. Utilizing longitudinal data in the United Kingdom birth cohort studies, we investigated shifts over the past nearly 70 years in the distribution of body mass index (BMI) and development of overweight or obesity across childhood and adulthood.Methods and findingsThe sample comprised 56,632 participants with 273,843 BMI observations in the 1946 Medical Research Council National Survey of Health and Development (NSHD; ages 2-64 years), 1958 National Child Development Study (NCDS; 7-50), 1970 British Cohort Study (BCS; 10-42), 1991 Avon Longitudinal Study of Parents and Children (ALSPAC; 7-18), or 2001 Millennium Cohort Study (MCS; 3-11). Growth references showed a secular trend toward positive skewing of the BMI distribution at younger ages. During childhood, the 50th centiles for all studies lay in the middle of the International Obesity Task Force normal weight range, but during adulthood, the age when a 50th centile first entered the overweight range (i.e., 25-29.9 kg/m2) decreased across NSHD, NCDS, and BCS from 41 to 33 to 30 years in males and 48 to 44 to 41 years in females. Trajectories of overweight or obesity showed that more recently born cohorts developed greater probabilities of overweight or obesity at younger ages. Overweight or obesity became more probable in NCDS than NSHD in early adulthood, but more probable in BCS than NCDS and NSHD in adolescence, for example. By age 10 years, the estimated probabilities of overweight or obesity in cohorts born after the 1980s were 2-3 times greater than those born before the 1980s (e.g., 0.229 [95% CI 0.219-0.240] in MCS males; 0.071 [0.065-0.078] in NSHD males). It was not possible to (1) model separate trajectories for overweight and obesity, because there were few obesity cases at young ages in the earliest-born cohorts, or (2) consider ethnic minority groups. The end date for analyses was August 2014.ConclusionsOur results demonstrate how younger generations are likely to accumulate greater exposure to overweight or obesity throughout their lives and, thus, increased risk for chronic health conditions such as coronary heart disease and type 2 diabetes mellitus. In the absence of effective intervention, overweight and obesity will have severe public health consequences in decades to come.

Project description:BackgroundHome birth is a common contributor to maternal and neonatal deaths particularly in low and middle-income countries (LMICs). We generally refer to home births as all births that occurred at the home setting. In Benin, home birth is phenomenal among some category of women. We therefore analysed individual and community-level factors influencing home birth in Benin.MethodsData was extracted from the 2017-2018 Benin Demographic and Health Survey females' file. The survey used stratified sampling technique to recruit 15,928 women aged 15-49. This study was restricted to 7758 women in their reproductive age who had complete data. The outcome variable was home birth among women. A mixed effect regression analysis was performed using 18 individual and community level explanatory variables. Alpha threshold was fixed at 0.05 confidence interval (CI). All analyses were done using STATA (v14.0). The results were presented in adjusted odds ratios (AORs).ResultsWe found that 14% (n = 1099) of the respondents delivered at home. The odds of home births was high among cohabiting women compared with the married [AOR = 1.57, CI = 1.21-2.04] and women at parity 5 or more compared with those at parity 1-2 [AOR = 1.29, CI = 1.01-1.66]. The odds declined among the richest [AOR = 0.07, CI = 0.02-0.24], and those with formal education compared with those without formal education [AOR = 0.71, CI = 0.54-0.93]. Similarly, it was less probable for women whose partners had formal education relative to those whose partners had no formal education [AOR = 0.62, CI = 0.49-0.79]. The tendency of home birth was low for women who did not have problem in getting permission to seek medical care [AOR = 0.62, CI = 0.50-0.77], had access to mass media [AOR = 0.78, CI = 0.60-0.99], attained the recommended ANC visits [AOR = 0.33, CI = 0.18-0.63], belonged to a community of high literacy level [AOR = 0.24, CI = 0.14-0.41], and those from communities of high socio-economic status (SES) [AOR = 0.25, CI = 0.14-0.46].ConclusionThe significant predictors of home birth are wealth status, education, marital status, parity, partner's education, access to mass media, getting permission to go for medical care, ANC visit, community literacy level and community SES. To achieve maternal and child health related goals including SDG 3 and 10, the government of Benin and all stakeholders must prioritise these factors in their quest to promote facility-based delivery.

Dataset Information

Age of diagnosis for autism: individual and community factors across 10 birth cohorts.

Publications

Age of diagnosis for autism: individual and community factors across 10 birth cohorts.

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