Autism prevalence in China is comparable to Western prevalence

Abstract Background Autism prevalence in the West is approximately 1% of school age children. Autism prevalence in China has been reported to be lower than in the West. This is likely due to at least two reasons: (1) most studies in China only included the special school population, overlooking the...

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Main Authors: Xiang Sun, Carrie Allison, Liping Wei, Fiona E. Matthews, Bonnie Auyeung, Yu Yu Wu, Sian Griffiths, Jie Zhang, Simon Baron-Cohen, Carol Brayne
Format: Article
Language:English
Published: BMC 2019-02-01
Series:Molecular Autism
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13229-018-0246-0
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author Xiang Sun
Carrie Allison
Liping Wei
Fiona E. Matthews
Bonnie Auyeung
Yu Yu Wu
Sian Griffiths
Jie Zhang
Simon Baron-Cohen
Carol Brayne
author_facet Xiang Sun
Carrie Allison
Liping Wei
Fiona E. Matthews
Bonnie Auyeung
Yu Yu Wu
Sian Griffiths
Jie Zhang
Simon Baron-Cohen
Carol Brayne
author_sort Xiang Sun
collection DOAJ
description Abstract Background Autism prevalence in the West is approximately 1% of school age children. Autism prevalence in China has been reported to be lower than in the West. This is likely due to at least two reasons: (1) most studies in China only included the special school population, overlooking the mainstream school population; and (2) most studies in China have not used contemporary screening and diagnostic methods. To address this, we tested total autism prevalence (mainstream and special schools) in Jilin City, and mainstream school autism prevalence in Jiamusi and Shenzhen cities. Methods The study included a three-step process: (1) screening; (2) clinical assessment of ‘screen positives’ plus controls; and (3) research diagnostic assessment of those meeting clinical threshold for concerns at step 2. Prevalence estimates per 10,000 children aged 6–10 years old were weighted for study design using diagnostic criteria applied at the research assessment stage. Results In Jilin City, 77 cases of autism were identified from a total population of 7258, equating to a prevalence of 108 per 10,000 (95% confidence interval (CI) 89, 130). In Shenzhen City: 21,420 children were screened and 35 cases of autism were identified, resulting in a mainstream prevalence of 42 per 10,000 (95% CI 20–89). In Jiamusi City, 16,358 children were screened, with 10 autism cases being identified, with a mainstream prevalence of 19 per 10,000 (95% CI 10–38). Conclusions Results from Jilin City, where both mainstream and special school data were available, revealed a similar prevalence of autism in China to the West, at around 1%. Results from Shenzhen and Jiamusi cities, where only mainstream data were available, prevalence is also in line with Western estimates. In all three cities, new cases of autism were identified by the study in mainstream schools, reflecting current under-diagnosis. Non-significant variation across different cities is seen indicating the need to explore potential variation of autism across diverse Chinese regions with large sample sizes to achieve a fully robust national picture.
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spelling doaj.art-0a91e1f42fa84446806f2357348d8c5f2022-12-22T03:15:56ZengBMCMolecular Autism2040-23922019-02-0110111910.1186/s13229-018-0246-0Autism prevalence in China is comparable to Western prevalenceXiang Sun0Carrie Allison1Liping Wei2Fiona E. Matthews3Bonnie Auyeung4Yu Yu Wu5Sian Griffiths6Jie Zhang7Simon Baron-Cohen8Carol Brayne9Cambridge Institute of Public Health, Department of Public Health and Primary Care, University of CambridgeAutism Research Centre, Department of Psychiatry, University of CambridgeCentre for Bioinformatics, School of Life Sciences, Peking UniversityInstitute of Health and Society, Newcastle UniversityAutism Research Centre, Department of Psychiatry, University of CambridgeYuNing Psychiatry Clinic, YuNing Growing With You Mental Health CentreThe Jockey Club School of Public Health and Primary Care, The Chinese University of Hong KongCentre for Bioinformatics, School of Life Sciences, Peking UniversityAutism Research Centre, Department of Psychiatry, University of CambridgeCambridge Institute of Public Health, Department of Public Health and Primary Care, University of CambridgeAbstract Background Autism prevalence in the West is approximately 1% of school age children. Autism prevalence in China has been reported to be lower than in the West. This is likely due to at least two reasons: (1) most studies in China only included the special school population, overlooking the mainstream school population; and (2) most studies in China have not used contemporary screening and diagnostic methods. To address this, we tested total autism prevalence (mainstream and special schools) in Jilin City, and mainstream school autism prevalence in Jiamusi and Shenzhen cities. Methods The study included a three-step process: (1) screening; (2) clinical assessment of ‘screen positives’ plus controls; and (3) research diagnostic assessment of those meeting clinical threshold for concerns at step 2. Prevalence estimates per 10,000 children aged 6–10 years old were weighted for study design using diagnostic criteria applied at the research assessment stage. Results In Jilin City, 77 cases of autism were identified from a total population of 7258, equating to a prevalence of 108 per 10,000 (95% confidence interval (CI) 89, 130). In Shenzhen City: 21,420 children were screened and 35 cases of autism were identified, resulting in a mainstream prevalence of 42 per 10,000 (95% CI 20–89). In Jiamusi City, 16,358 children were screened, with 10 autism cases being identified, with a mainstream prevalence of 19 per 10,000 (95% CI 10–38). Conclusions Results from Jilin City, where both mainstream and special school data were available, revealed a similar prevalence of autism in China to the West, at around 1%. Results from Shenzhen and Jiamusi cities, where only mainstream data were available, prevalence is also in line with Western estimates. In all three cities, new cases of autism were identified by the study in mainstream schools, reflecting current under-diagnosis. Non-significant variation across different cities is seen indicating the need to explore potential variation of autism across diverse Chinese regions with large sample sizes to achieve a fully robust national picture.http://link.springer.com/article/10.1186/s13229-018-0246-0AutismScreeningDiagnosisPrevalenceChildrenChina
spellingShingle Xiang Sun
Carrie Allison
Liping Wei
Fiona E. Matthews
Bonnie Auyeung
Yu Yu Wu
Sian Griffiths
Jie Zhang
Simon Baron-Cohen
Carol Brayne
Autism prevalence in China is comparable to Western prevalence
Molecular Autism
Autism
Screening
Diagnosis
Prevalence
Children
China
title Autism prevalence in China is comparable to Western prevalence
title_full Autism prevalence in China is comparable to Western prevalence
title_fullStr Autism prevalence in China is comparable to Western prevalence
title_full_unstemmed Autism prevalence in China is comparable to Western prevalence
title_short Autism prevalence in China is comparable to Western prevalence
title_sort autism prevalence in china is comparable to western prevalence
topic Autism
Screening
Diagnosis
Prevalence
Children
China
url http://link.springer.com/article/10.1186/s13229-018-0246-0
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