Prevalence of Autism Spectrum Disorder in China: A Nationwide Multi-center Population-based Study Among Children Aged 6 to 12 Years

Hao Zhou1 • Xiu Xu2 • Weili Yan3 • Xiaobing Zou4 • Lijie Wu5 • Xuerong Luo6 • Tingyu Li7 • Yi Huang8 • Hongyan Guan9 • Xiang Chen10 • Meng Mao11 • Kun Xia12 • Lan Zhang11 • Erzhen Li9 • Xiaoling Ge13 • Lili Zhang1 • Chunpei Li1 • Xudong Zhang13 • Yuanfeng Zhou1 • Ding Ding14 • Andy Shih15 • Eric Fombonne16 • Yi Zheng17 • Jisheng Han18 • Zhongsheng Sun19 • Yong-hui Jiang20 • Yi Wang1 • LATENT-NHC Study Team


1 Department of Neurology, Children’s Hospital of Fudan University, Shanghai 201102, China

2 Child Health Care, Children’s Hospital of Fudan University, Shanghai 201102, China

3 Department of Clinical Epidemiology, Children’s Hospital of Fudan University, Shanghai 201102, China

4 Child Development Behavior Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China

5 Department of Children and Adolescent Health, School of Public Health, Harbin Medical University, Harbin 150081, China

6 Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha 410011, China

7 Child Health Care, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China

8 Department of Psychiatry, West China Hospital of Sichuan University, Chengdu 610041, China

9 Capital Institute of Pediatrics, Beijing 100020, China

10 The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China

11 Child Health Care, Chengdu Women and Children’s Hospital, Chengdu 610091, China

12 Center for Medical Genetics, School of Life Sciences, Central South University, Changsha 410013, China

13 Children’s Hospital of Fudan University, Shanghai 201102, China

14 Huashan Hospital of Fudan University, Shanghai 200040, China 15 Autism Speaks, 1 East 33rd Street, New York, NY 10016, USA

Abstract

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%–0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%–0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%–1.02% versus 0.30%; 95% CI: 0.26%–0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

Keywords

Autism spectrum disorder; Prevalence; Comorbidity; Autism Spectrum Rating Scale; China

[SpringerLink]

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