This study aimed to identify potential modifiable factors prior to early intervention that are associated with better adaptive skills in children with autism spectrum disorder. This cross-sectional study recruited patients with autism spectrum disorder, aged 5–12 years from two tertiary developmental programmes in Singapore. Demographics, family socio-economic status and early intervention details were collected. The primary outcome was the Vineland Adaptive Behaviour Scales Adaptive Behaviour Composite score. Multivariate linear regression analysis was done. The sample (N = 193) comprised 84% males with a mean age of 6 years and 7 months. Mean age at diagnosis was 35.5 months and mean Vineland Adaptive Behaviour Scales Adaptive Behaviour Composite standard score was 76.5. Mean waiting time for early intervention was 6.2 months with a mean intensity of 8.0 h/week. Waiting time for early intervention was a negative correlate of the Vineland Adaptive Behaviour Scales Adaptive Behaviour Composite score after controlling for other variables (β = −0.74, p = 0.04). Significant correlates also included paternal education (β = 5.44, p = 0.03) and the presence of financial difficulties in the family (β = −5.98, p = 0.04). Waiting time for early intervention is a modifiable risk factor that may be addressed during service planning to potentially improve adaptive skills in autism spectrum disorder. Children from low socio-economic status families may be at risk for poor functional skills and will benefit from targeted intervention plans.

Lay abstract

Despite improving services and care for individuals with autism spectrum disorder, functional outcomes such as daily living skills tend to be suboptimal for many. This study wanted to identify modifiable early intervention factors that are associated with better outcomes and possible high-risk groups of children who are at risk of poorer outcomes. Participants included 193 children aged between 5 and 12 years of age whose parents provided information on their family background and early intervention characteristics. These children also had their adaptive behaviour skills examined by formal testing. Results indicated that shorter wait time for early intervention was associated with better adaptive behaviour scores. Children from families with financial difficulties and lower paternal education were also at risk of poorer adaptive skills. Designing services for children with autism such that wait times to enter early intervention services are minimised following initial diagnosis can improve their eventual functional outcomes. Changes in healthcare policy to allow expedited entry or targeted intervention to children from low socio-economic status families can also enhance their eventual adaptive skill gains.

中文翻译：

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自闭症谱系障碍儿童适应能力的相关性

本研究旨在在早期干预之前确定与自闭症谱系障碍儿童更好的适应技能相关的潜在可改变因素。这项横断面研究从新加坡的两个高等教育发展项目中招募了年龄在 5-12 岁之间的自闭症谱系障碍患者。收集了人口统计学、家庭社会经济地位和早期干预细节。主要结果是 Vineland 适应性行为量表适应性行为综合评分。进行了多元线性回归分析。样本（N= 193) 包括 84% 的男性，平均年龄为 6 岁零 7 个月。诊断时的平均年龄为 35.5 个月，平均 Vineland 适应性行为量表适应性行为综合标准得分为 76.5。早期干预的平均等待时间为 6.2 个月，平均强度为 8.0 小时/周。在控制其他变量后，早期干预的等待时间与 Vineland 适应性行为量表适应性行为综合评分呈负相关（β = -0.74，p = 0.04）。显着的相关性还包括父亲教育 ( β = 5.44, p = 0.03) 和家庭经济困难的存在 ( β = -5.98, p= 0.04）。早期干预的等待时间是一个可改变的风险因素，可以在服务计划期间解决，以潜在地提高自闭症谱系障碍的适应技能。来自低社会经济地位家庭的儿童可能面临功能技能差的风险，并将受益于有针对性的干预计划。

摘要

尽管改善了对自闭症谱系障碍患者的服务和护理，但对许多人来说，日常生活技能等功能结果往往并不理想。本研究希望确定与更好的结果和可能存在较差结果风险的高风险儿童群体相关的可修改的早期干预因素。参与者包括 193 名年龄在 5 至 12 岁之间的儿童，他们的父母提供了有关其家庭背景和早期干预特征的信息。这些孩子还通过正式测试检查了他们的适应性行为技能。结果表明，较短的早期干预等待时间与更好的适应性行为评分相关。来自经济困难家庭和父亲教育程度较低的儿童也面临着适应能力较差的风险。为自闭症儿童设计服务，以便在初步诊断后最大限度地减少进入早期干预服务的等待时间，可以改善他们的最终功能结果。改变医疗保健政策以允许来自低社会经济地位家庭的儿童加快入学或有针对性的干预也可以提高他们最终的适应技能。