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

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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.

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Acknowledgements

This work was supported by the National Health Commission of the People’s Republic of China (201302002, Clinical Trial NCT02200679). We thank all the parents who participated in this study. For data collection, we would like to acknowledge the members of the National Health Commission listed in the supplement in the LATENT-NHC Study Team member list.

Author information

Author notes

  1. Hao Zhou, Xiu Xu, Weili Yan contributed equally.

Authors and Affiliations

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

    Hao Zhou, Lili Zhang, Chunpei Li, Yuanfeng Zhou & Yi Wang

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

    Xiu Xu

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

    Weili Yan

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

    Xiaobing Zou

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

    Lijie Wu

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

    Xuerong Luo

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

    Tingyu Li

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

    Yi Huang

  9. Capital Institute of Pediatrics, Beijing, 100020, China

    Hongyan Guan & Erzhen Li

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

    Xiang Chen

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

    Meng Mao & Lan Zhang

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

    Kun Xia

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

    Xiaoling Ge & Xudong Zhang

  14. Huashan Hospital of Fudan University, Shanghai, 200040, China

    Ding Ding

  15. Autism Speaks, 1 East 33rd Street, New York, NY, 10016, USA

    Andy Shih

  16. Oregon Health and Science University, Portland, OR, 97239, USA

    Eric Fombonne

  17. Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China

    Yi Zheng

  18. Neuroscience Research Institute, Peking University, Beijing, 100191, China

    Jisheng Han

  19. Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing, 100021, China

    Zhongsheng Sun

  20. Department of Genetics and Pediatrics, Yale School of Medicine, New Haven, CT, 06520, USA

    Yong-hui Jiang

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  1. Hao Zhou
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  2. Xiu Xu
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  3. Weili Yan
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  27. Yi Wang
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LATENT-NHC Study Team

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Correspondence to Yi Wang.

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Members of the LATENT-NHC Study Team are listed in the Supplementary Materials.

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Zhou, H., Xu, X., Yan, W. et al. Prevalence of Autism Spectrum Disorder in China: A Nationwide Multi-center Population-based Study Among Children Aged 6 to 12 Years. Neurosci. Bull. 36, 961–971 (2020). https://doi.org/10.1007/s12264-020-00530-6

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