A High Prevalence of Autism Spectrum Disorder in Preschool Children in an Immigrant, Multiethnic Population in Sweden: Challenges for Health Care.
Petra Linnsand, Christopher Gillberg, Åsa Nilses and 2 others
PMID 32533384WHAT IT FOUND
In a high-immigrant Swedish district, 3.66% of preschoolers were diagnosed with autism, rising to 4.32% with later cases.
Most had intellectual disability and multiple risk factors, including maternal migration and family history, challenging standard care models.
Key findings
01The prevalence of ASD was 3.66% among 902 children, increasing to 4.32% when including cases diagnosed after the census date.
0264.5% of diagnosed children had intellectual disability, and all had co-existing conditions such as sleep, eating, or attention problems.
03Maternal migration was the most common risk factor (90.3%), followed by other prenatal risks (77.4%) and family history of neurodevelopmental disorders (58.1%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study area was a single, small district in Gothenburg, so results may not generalize to other immigrant populations or regions. The sample size (33 children) is too small for statistical analysis of risk factor interactions. Prevalence is likely a minimum estimate, as children with ASD and average intellectual functioning may be underdiagnosed in this population. Data relied on medical records, so missing information (e.g., maternal vitamin D, smoking) could obscure other risk factors. The high prevalence may partly reflect the local healthcare system's effective screening and access, rather than a true biological increase in risk.
Declared interests
No specific funding source or conflict of interest declaration is explicitly stated in the provided text, though the study was conducted within the Swedish public healthcare system.
The easy way to misread this
Do not conclude that maternal migration itself causes ASD. The high prevalence likely reflects a combination of biological risks, environmental stressors, and the effective identification of cases through a well-resourced, accessible local screening and assessment program that might miss cases in less supportive settings.