Autism prevalence in China is comparable to Western prevalence.

Sun, Xiang 
Wei, Liping 
Matthews, Fiona E 
Auyeung, Bonnie 

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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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Online Publication Date
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Autism, Children, China, Diagnosis, Prevalence, Screening, Autistic Disorder, Child, China, Female, Humans, Male, Prevalence
Journal Title
Mol Autism
Journal ISSN
Volume Title
Springer Science and Business Media LLC
Medical Research Council (G0600977)
Autism Research Trust (unknown)
National Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) (unknown)
Autism Research Trust (unknown)
European Commission and European Federation of Pharmaceutical Industries and Associations (EFPIA) FP7 Innovative Medicines Initiative (IMI) (777394)
Templeton World Charity Foundation (TWCF) (TWCF0138/AB89)
XS was supported by the International Development Fund-Cambridge-CUHK Collaboration on Autism Research in Hong Kong and China during the early stage of the writing up. Then XS was supported by the University of California, Davis and the Star-Cambridge Centre for Children with Autism in China during the later stage of the writing up. SBC, CA, BA, and CB were supported by the Autism Research Trust, and the MRC. FEM is supported by the MRC (research grant: U105292687). In addition, the research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East of England at Cambridgeshire and Peterborough NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The study also benefitted from support from the NIHR Cambridge Biomedical Research Centre.