Öz
Aims: Since the first medical contact of children and families is mostly with paediatricians, the knowledge and experience of paediatricians on Autism Spectrum Disorder (ASD) is extremely significant. It was aimed to investigate paediatricians’ general knowledge on ASD, daily practices in the outpatient clinic and ability to recognize warning signs.
Methods: A 40-item questionnaire prepared by the researchers was completed with 116 specialists or subspecialties working in public and private hospitals of two cities in Türkiye.
Results: While 41.7% of paediatricians received rotation training in residency, 32.8 % reported they have enough experience. While 87% considered ASD screening among their duties, only 12.8% stated they have enough time. The number of patients referred for formal assessment of ASD was low. Gender, type of expertise, duration of experience, and sense of competence were not associated with referral frequency. It’s been determined paediatricians have a lack of knowledge about ASD. While not responding to name and difficulty following the instructions were seen as most warning symptoms, other diagnostic criteria and accompanying symptoms were recognized insufficiently.
Conclusions: In addition to increasing the duration and quality of child psychiatry education during residency, regulating the outpatient clinic conditions can overcome an important obstacle in the early diagnosis of ASD.
Anahtar Kelimeler
paediatricians awareness autistic disorder early diagnosis knowledge
Kaynakça
- American Psychiatric Association 2013, Diagnostic and statistical manual of mental disorders 5th ed., American Psychiatric Association, Washington DC.
- CDC, 2020. [online] (updated April 2023) Available at: https://www.cdc.gov/ncbddd/autism/data.html [Accessed 4 June 2023].
- Johnson CP, Myers SM. American Academy of Pediatrics Council on Children With Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215.
- Turkish Ministry of Health. Recommended periodic health examinations and screening tests in family medicine practice. Ministry of Health, Republic of Turkey, 2015.
- MacDonald R, Parry-Cruwys D, Dupere S, Ahearn W. Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism. Res Dev Disabil. 2014;35(12):3632-3644.
- Brignell A, Harwood RC, May T, et al. Overall prognosis of preschool autism spectrum disorder diagnoses. Cochrane Database Syst Rev. 2022;9(9):CD012749.
- Mukhamedshina YO, Fayzullina RA, Nigmatullina IA, Rutland CS, Vasina VV. Health care providers’ awareness on medical management of children with autism spectrum disorder: cross-sectional study in Russia. BMC Med Educ. 2022;22(1):29.
- Song C, Wu L, Hong Y, Chen X, Zhu Z. Factors affecting knowledge of autism spectrum disorder among pediatric residents in eastern China: a cross-sectional study. BMC Med Educ. 2022;22(1):699.
- Mao S, Fan X, Ma Y, Chen Y, Lv J, Yang R. Knowledge and beliefs about autism spectrum disorders among physicians: a cross-sectional survey from China. BMJ Paediatr Open. 2022;6(1):e001696.
- Çitil G, Çöp E, Açıkel SB, Sarı E, Karacan CD, Şenel S. Assessment of the knowledge and awareness of pediatric residents and pediatricians about autism spectrum disorder at a single center in Turkey. J Community Psychol. 2021;49(7):2264-2275.
- Kılınçel Ş, Baki F. Analysis of pediatricians’ knowledge about autism. J Surg Med. 2021;5:153-157.
- Ozcelik A, Soysal Acar A, Arhan E, Demir E, Gücüyener K, Serdaroğlu A. Autism spectrum disorder management practices and level of knowledge among general pediatricians. Gazi Med J. 2015;26:158-162.
- Monteiro SA, Dempsey J, Berry LN, Voigt RG, Goin-Kochel RP. Screening and referral practices for autism spectrum disorder in primary pediatric care. Pediatrics. 2019;144(4):e20183326.
- Wallis KE, Guthrie W, Bennett AE, et al. Adherence to screening and referral guidelines for autism spectrum disorder in toddlers in pediatric primary care. PLoS One. 2020;15(5):e0232335.
- Erden G, Akçakın M, Doğan DG, Ertem İÖ. Çocuk hekimleri ve otizm: Tanıda zorluklar. Turkiye Klinikleri J Pediatrics. 2010;19:9-15.
- Austriaco K, Aban I, Willig J, Kong M. Contemporary trainee knowledge of autism: how prepared are our future providers? Front Pediatr. 2019;7:165.
- Belzer K, Flake E, Kiger M. Enhancing resident education in autism diagnosis: Training on the screening tool for autism in toddlers. J Dev Behav Pediatr. 2023;44(5):e358-e364.
- Akdag B. Investigation of knowledge about autism spectrum disorder among healthcare professionals in a district. JEUNF. 2023;39(2):243-249.
- Zwaigenbaum L, Brian JA, Ip A. Early detection for autism spectrum disorder in young children. Paediatr Child Health. 2019;24(7):424-443.
- Dosreis S, Weiner CL, Johnson L, Newschaffer CJ. Autism spectrum disorder screening and management practices among general pediatric providers. J Dev Behav Pediatr. 2006;27(2):88-94.
- Gabrielsen TP, Farley M, Speer L, Villalobos M, Baker CN, Miller J. Identifying autism in a brief observation. Pediatrics. 2015;135(2):e330-338.
- Moore C, Zamora I, Patel Gera M, Williams ME. Developmental screening and referrals: assessing the influence of provider specialty, training, and interagency communication. Clin Pediatr (Phila). 2017;56(11):1040-1047.
- Schelly D, González PJ, Solís PJ. Barriers to an information effect on diagnostic disparities of autism spectrum disorder in young children. Health Serv Res Manag Epidemiol. 2019;6:2333392819853058.
- Posar A, Visconti P. Is it autism? Some suggestions for pediatricians. Turk Pediatri Ars. 2020;55(3):229-235.
- Kütük MÖ, Tufan AE, Kılıçaslan F, et al. High depression symptoms and burnout levels among parents of children with autism spectrum disorders: a multi-center, cross-sectional, case-control study. J Autism Dev Disord. 2021;51(11):4086-4099.
- Lindly O, Thorburn S, Zuckerman K. Use and nondisclosure of complementary health approaches among us children with developmental disabilities. J Dev Behav Pediatr. 2018;39(3):217-227.
- Dini G, Toletone A, Sticchi L, Orsi A, Bragazzi NL, Durando P. Influenza vaccination in healthcare workers: a comprehensive critical appraisal of the literature. Hum Vaccin Immunother. 2018;14(3):772-789.
- Soke GN, Maenner M, Windham G, et al. Association between breastfeeding initiation and duration and autism spectrum disorder in preschool children enrolled in the study to explore early development. Autism Res. 2019;12(5):816-829.
- Sharp WG, Burrell TL, Berry RC, et al. The Autism managing eating aversions and limited variety plan vs parent education: A randomized clinical trial. J Pediatr. 2019;211:185-192.
- Ostrolenk A, Forgeot d’Arc B, Jelenic P, Samson F, Mottron L. Hyperlexia: systematic review, neurocognitive modelling, and outcome. Neurosci Biobehav Rev. 2017;79:134-149.
Öz
Giriş ve Amaç: Çocukların ve ailelerin ilk tıbbi teması çoğunlukla pediatristler ile olduğundan pediatristlerin Otizm Spektrum Bozukluğu (OSB) konusundaki bilgi ve deneyimi son derece önemlidir. Pediatristlerin OSB ile ilgili genel bilgilerinin, poliklinikteki günlük uygulamalarının ve uyarı işaretlerini tanıma becerilerinin incelenmesi amaçlandı.
Yöntemler: Araştırmacılar tarafından hazırlanan 40 maddelik anket, Türkiye'deki iki ildeki kamu ve özel hastanelerde çalışan 116 uzman veya yan dal uzmanına uygulandı.
Bulgular: Pediatristlerin %41,7'si uzmanlık alanında rotasyon eğitimi alırken, %32,8'i yeterli tecrübeye sahip olduğunu bildirdi. %87'si OSB taramasını görevleri arasında görürken, yalnızca %12,8'i yeterli zamanının olduğunu belirtti. OSB'nin resmi değerlendirmesi için yönlendirilen hasta sayısı düşüktü. Cinsiyet, uzmanlık türü, deneyim süresi ve yeterlilik duygusu sevk sıklığı ile ilişkili değildi. Pediatristlerin OSB konusunda bilgi eksikliği olduğu belirlendi. İsme yanıt vermeme ve talimatlara uymada zorluk en çok uyarıcı belirti olarak görülürken, diğer tanı ölçütleri ve eşlik eden belirtiler yeterince tanınamadı.
Sonuç: Uzmanlık döneminde çocuk psikiyatrisi eğitiminin süresinin ve kalitesinin artırılmasının yanı sıra poliklinik koşullarının düzenlenmesi OSB'nin erken tanısında önemli bir engelin aşılmasına yardımcı olabilir.
Anahtar Kelimeler
Kaynakça
- American Psychiatric Association 2013, Diagnostic and statistical manual of mental disorders 5th ed., American Psychiatric Association, Washington DC.
- CDC, 2020. [online] (updated April 2023) Available at: https://www.cdc.gov/ncbddd/autism/data.html [Accessed 4 June 2023].
- Johnson CP, Myers SM. American Academy of Pediatrics Council on Children With Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215.
- Turkish Ministry of Health. Recommended periodic health examinations and screening tests in family medicine practice. Ministry of Health, Republic of Turkey, 2015.
- MacDonald R, Parry-Cruwys D, Dupere S, Ahearn W. Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism. Res Dev Disabil. 2014;35(12):3632-3644.
- Brignell A, Harwood RC, May T, et al. Overall prognosis of preschool autism spectrum disorder diagnoses. Cochrane Database Syst Rev. 2022;9(9):CD012749.
- Mukhamedshina YO, Fayzullina RA, Nigmatullina IA, Rutland CS, Vasina VV. Health care providers’ awareness on medical management of children with autism spectrum disorder: cross-sectional study in Russia. BMC Med Educ. 2022;22(1):29.
- Song C, Wu L, Hong Y, Chen X, Zhu Z. Factors affecting knowledge of autism spectrum disorder among pediatric residents in eastern China: a cross-sectional study. BMC Med Educ. 2022;22(1):699.
- Mao S, Fan X, Ma Y, Chen Y, Lv J, Yang R. Knowledge and beliefs about autism spectrum disorders among physicians: a cross-sectional survey from China. BMJ Paediatr Open. 2022;6(1):e001696.
- Çitil G, Çöp E, Açıkel SB, Sarı E, Karacan CD, Şenel S. Assessment of the knowledge and awareness of pediatric residents and pediatricians about autism spectrum disorder at a single center in Turkey. J Community Psychol. 2021;49(7):2264-2275.
- Kılınçel Ş, Baki F. Analysis of pediatricians’ knowledge about autism. J Surg Med. 2021;5:153-157.
- Ozcelik A, Soysal Acar A, Arhan E, Demir E, Gücüyener K, Serdaroğlu A. Autism spectrum disorder management practices and level of knowledge among general pediatricians. Gazi Med J. 2015;26:158-162.
- Monteiro SA, Dempsey J, Berry LN, Voigt RG, Goin-Kochel RP. Screening and referral practices for autism spectrum disorder in primary pediatric care. Pediatrics. 2019;144(4):e20183326.
- Wallis KE, Guthrie W, Bennett AE, et al. Adherence to screening and referral guidelines for autism spectrum disorder in toddlers in pediatric primary care. PLoS One. 2020;15(5):e0232335.
- Erden G, Akçakın M, Doğan DG, Ertem İÖ. Çocuk hekimleri ve otizm: Tanıda zorluklar. Turkiye Klinikleri J Pediatrics. 2010;19:9-15.
- Austriaco K, Aban I, Willig J, Kong M. Contemporary trainee knowledge of autism: how prepared are our future providers? Front Pediatr. 2019;7:165.
- Belzer K, Flake E, Kiger M. Enhancing resident education in autism diagnosis: Training on the screening tool for autism in toddlers. J Dev Behav Pediatr. 2023;44(5):e358-e364.
- Akdag B. Investigation of knowledge about autism spectrum disorder among healthcare professionals in a district. JEUNF. 2023;39(2):243-249.
- Zwaigenbaum L, Brian JA, Ip A. Early detection for autism spectrum disorder in young children. Paediatr Child Health. 2019;24(7):424-443.
- Dosreis S, Weiner CL, Johnson L, Newschaffer CJ. Autism spectrum disorder screening and management practices among general pediatric providers. J Dev Behav Pediatr. 2006;27(2):88-94.
- Gabrielsen TP, Farley M, Speer L, Villalobos M, Baker CN, Miller J. Identifying autism in a brief observation. Pediatrics. 2015;135(2):e330-338.
- Moore C, Zamora I, Patel Gera M, Williams ME. Developmental screening and referrals: assessing the influence of provider specialty, training, and interagency communication. Clin Pediatr (Phila). 2017;56(11):1040-1047.
- Schelly D, González PJ, Solís PJ. Barriers to an information effect on diagnostic disparities of autism spectrum disorder in young children. Health Serv Res Manag Epidemiol. 2019;6:2333392819853058.
- Posar A, Visconti P. Is it autism? Some suggestions for pediatricians. Turk Pediatri Ars. 2020;55(3):229-235.
- Kütük MÖ, Tufan AE, Kılıçaslan F, et al. High depression symptoms and burnout levels among parents of children with autism spectrum disorders: a multi-center, cross-sectional, case-control study. J Autism Dev Disord. 2021;51(11):4086-4099.
- Lindly O, Thorburn S, Zuckerman K. Use and nondisclosure of complementary health approaches among us children with developmental disabilities. J Dev Behav Pediatr. 2018;39(3):217-227.
- Dini G, Toletone A, Sticchi L, Orsi A, Bragazzi NL, Durando P. Influenza vaccination in healthcare workers: a comprehensive critical appraisal of the literature. Hum Vaccin Immunother. 2018;14(3):772-789.
- Soke GN, Maenner M, Windham G, et al. Association between breastfeeding initiation and duration and autism spectrum disorder in preschool children enrolled in the study to explore early development. Autism Res. 2019;12(5):816-829.
- Sharp WG, Burrell TL, Berry RC, et al. The Autism managing eating aversions and limited variety plan vs parent education: A randomized clinical trial. J Pediatr. 2019;211:185-192.
- Ostrolenk A, Forgeot d’Arc B, Jelenic P, Samson F, Mottron L. Hyperlexia: systematic review, neurocognitive modelling, and outcome. Neurosci Biobehav Rev. 2017;79:134-149.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları |
| Bölüm | Research Articles |
| Yazarlar | |
| Erken Görünüm Tarihi | 26 Ekim 2023 |
| Yayımlanma Tarihi | 27 Ekim 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 5 Sayı: 4 |
Üniversitelerarası Kurul (ÜAK) Eşdeğerliği: Ulakbim TR Dizin'de olan dergilerde yayımlanan makale [10 PUAN] ve 1a, b, c hariç uluslararası indekslerde (1d) olan dergilerde yayımlanan makale [5 PUAN]
- Dahil olduğumuz İndeksler (Dizinler) ve Platformlar sayfanın en altındadır.
Not: Dergimiz WOS indeksli değildir ve bu nedenle Q olarak sınıflandırılmamaktadır.
Yüksek Öğretim Kurumu (YÖK) kriterlerine göre yağmacı/şüpheli dergiler hakkındaki kararları ile yazar aydınlatma metni ve dergi ücretlendirme politikasını tarayıcınızdan indirebilirsiniz. https://dergipark.org.tr/tr/journal/3449/page/10809/update
Dergi Dizin ve Platformları
TR Dizin ULAKBİM, Google Scholar, Crossref, Worldcat (OCLC), DRJI, EuroPub, OpenAIRE, Turkiye Citation Index, Turk Medline, ROAD, ICI World of Journal's, Index Copernicus, ASOS Index, General Impact Factor, Scilit.