SLPSurveyMolecular autism2019

Autism prevalence in China is comparable to Western prevalence.

Xiang Sun, Carrie Allison, Liping Wei and 7 others

PMID 30858963

WHAT IT FOUND

Autism prevalence in three Chinese cities was comparable to Western estimates, and mainstream schools had children with no previous diagnosis, suggesting under-diagnosis.

Jilin total prevalence was 108.0 per 10,000.

Key findings

01Total autism prevalence in Jilin City was 108.0 per 10,000 after including children from special schools, private intervention centres and community settings.

02Mainstream school autism prevalence was 42.3 per 10,000 in Shenzhen and 19.0 per 10,000 in Jiamusi, adjusted for non-response.

03Research assessment confirmed 35 autism cases in Shenzhen mainstream schools and 10 in Jiamusi, and none of the screened children in those cities had a prior autism diagnosis.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study covered only three cities and is not yet nationally representative of China. In Shenzhen and Jiamusi, special school data were not included, so the mainstream school estimates do not describe all children with autism in those cities. Not all schools or communities in Shenzhen and Jiamusi took part, and non-participation could affect the estimates. Parents with higher education were less likely to participate in Shenzhen, and in Jiamusi some higher education and income groups were less likely to participate, so the sample may not represent all families. Mainstream school inclusion of children with autism varied across cities, and moderate to severe autism may be under-represented in mainstream schools. The city estimates had wide confidence intervals, and the difference between Shenzhen and Jiamusi did not reach statistical significance. Using both DSM-IV-TR and DSM-5 could affect comparability, although the authors tried to minimise this.

Declared interests

The study was funded by the Chinese University of Hong Kong, Autism Research Trust, Medical Research Council, National Institute for Health Research, and Cambridgeshire and Peterborough NHS Foundation Trust. The supplied text does not state additional author disclosures.

The easy way to misread this

Do not treat the Jilin total estimate of 108.0 per 10,000 as China's national prevalence. It was a city-specific estimate, and Shenzhen and Jiamusi reported mainstream school prevalence only.

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The study

Participants
Children aged 6 to 10 in mainstream schools: 7167 in Jilin (6149 screened data analysed), 21,420 questionnaires returned in Shenzhen (20,802 analysed), 16,358 questionnaires distributed in Jiamusi (15,663 analysed); Jilin also included 91 children from special schools, private intervention centres and community settings.
Certainty of evidence
Low

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Xiang Sun, Carrie Allison, Liping Wei, et al. Autism prevalence in China is comparable to Western prevalence. Molecular autism. 2019.

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