Showing papers by "Emma J. Glasson published in 2013"
TL;DR: Findings show that indicators of a poor intrauterine environment are associated with an elevated risk of ID, while for ASD, and particularly ASD without ID, the associations are much weaker, highlighting the importance of accounting for the absence or presence of ID when examining ASD.
Abstract: Background
As well as being highly comorbid conditions, autism spectrum disorders (ASD) and intellectual disability (ID) share a number of clinically-relevant phenomena. This raises questions about similarities and overlap in diagnosis and aetiological pathways that may exist for both conditions.
125 citations
TL;DR: Children with an ID or ASD experience an increased risk of hospitalisation after the first year of life which varied from 2 to 10 times that of the rest of the population.
Abstract: Objectives To describe the hospitalisation patterns in children with intellectual disability (ID) and/or autism spectrum disorder (ASD) after the first year of life and compare with those unaffected. Design Prospective cohort study using data linkage between health, ID and hospitalisation population-based datasets. Setting Western Australia. Participants 416 611 individuals born between 1983 and 1999 involving 1 027 962 hospital admission records. Five case categories were defined (mild/moderate ID, severe ID, biomedically caused ID, ASD with ID and ASD without ID) and compared with the remainder of children and young people. Primary and secondary outcome measures Time to event analysis was used to compare time hospitalisation and rate of hospitalisation between the different case-groups by estimating HR, accounting for birth year and preterm birth status. Results ID and/or ASD were found to be associated with an increased risk of hospitalisation compared with the remainder of the population. The increase in risk was highest in those with severe ID and no ASD (HR=10.33, 95% CI 8.66 to 12.31). For those with ID of known biomedical cause or mild ID of unknown cause, the risk of hospitalisation was lower (HR=7.36, 95% CI 6.73 to 8.07 and HR=3.08, 95% CI 2.78 to 3.40, respectively). Those with ASDs had slightly increased risk (HR=2.82, 95% CI 2.26 to 3.50 for those with ID and HR=2.09, 95% CI 1.85 to 2.36 for those without ID). Conclusions Children with an ID or ASD experience an increased risk of hospitalisation after the first year of life which varied from 2 to 10 times that of the rest of the population. Findings can inform service planning or resource allocation for these children with special needs.
36 citations
TL;DR: The purpose of this chapter is to use the Western Australian experience to describe the potential of data linkage to improve the understanding of the epidemiology of intellectual disability and autism and some recently developed novel initiatives are described.
Abstract: Data linkage is the bringing together of specific datasets from different sources using demographic information on individuals within a population. In Western Australia, systematic record linkages between multiple datasets including births, deaths, and hospital morbidity have occurred since 1997. Linkage to other population datasets related to intellectual disability and autism provides an infrastructure to undertake research in this area. The purpose of this chapter is to use the Western Australian experience to describe the potential of data linkage to improve the understanding of the epidemiology of intellectual disability and autism. Information is provided on the core datasets and specific disability registers available in Western Australia. Some recently developed novel initiatives are also described. One of these involves the linkage of data from a number of other Western Australian jurisdictions such as education, child protection, and justice in addition to health. The other uses a federated approach, developed by the bioinformatics team at the Telethon Institute for Child Health Research, to enable analysis of autism risk factors from international population-based datasets without the data leaving its home base. Examples of published research examining both determinants and outcomes of intellectual disability and autism are reported as well as information on several studies, which are in the planning stages. We also include a section on some of the challenges of data management and describe some of the statistical techniques that have been used. Studies investigating sociodemographic factors, prenatal growth, alcohol exposure, and maternal physical health have identified risk factors associated with intellectual disability and autism. Analyses of outcomes for these children have shown an increased risk of hospitalizations from two to ten times that of the rest of the population. For those with Down syndrome, a quarter of their admissions occurred in the first year of life, with upper respiratory tract infections being the most common cause. Non-Aboriginal children with intellectual disability were shown to have a threefold risk of substantiated child maltreatment and Aboriginal children a twofold risk, after taking parental factors into account. Linked data studies using population data on intellectual disability and autism can help understand the complex multidimensional factors contributing to different outcomes for this particularly vulnerable and underresearched population and provide valuable information for informing policies and programs.
14 citations