Global prevalence of autism and other pervasive developmental disorders

Mayada Elsabbagh, Gauri Divan, Yun-Joo Koh, Young Shin Kim, Shuaib Kauchali, Carlos Marcín, Cecilia Montiel-Nava, Vikram Patel, Cristiane S Paula, Chongying Wang, Mohammad Taghi Yasamy, Eric Fombonne, Mayada Elsabbagh, Gauri Divan, Yun-Joo Koh, Young Shin Kim, Shuaib Kauchali, Carlos Marcín, Cecilia Montiel-Nava, Vikram Patel, Cristiane S Paula, Chongying Wang, Mohammad Taghi Yasamy, Eric Fombonne

Abstract

We provide a systematic review of epidemiological surveys of autistic disorder and pervasive developmental disorders (PDDs) worldwide. A secondary aim was to consider the possible impact of geographic, cultural/ethnic, and socioeconomic factors on prevalence estimates and on clinical presentation of PDD. Based on the evidence reviewed, the median of prevalence estimates of autism spectrum disorders was 62/10 000. While existing estimates are variable, the evidence reviewed does not support differences in PDD prevalence by geographic region nor of a strong impact of ethnic/cultural or socioeconomic factors. However, power to detect such effects is seriously limited in existing data sets, particularly in low-income countries. While it is clear that prevalence estimates have increased over time and these vary in different neighboring and distant regions, these findings most likely represent broadening of the diagnostic concets, diagnostic switching from other developmental disabilities to PDD, service availability, and awareness of autistic spectrum disorders in both the lay and professional public. The lack of evidence from the majority of the world's population suggests a critical need for further research and capacity building in low- and middle-income countries.

© 2012 International Society for Autism Research, Wiley Periodicals, Inc.

Figures

Figure 1
Figure 1
Prevalence of autistic disorder from Tables I and II (rate/10 000 and 95% confidence interval).
Figure 2
Figure 2
Prevalence of PDD from Tables I and II (rate/10 000 and 95% confidence interval).

References

    1. Abrahams BS, Geschwind DH. Advances in ASD genetics: on the threshold of a new neurobiology. Nature Reviews Genetics. 2008;9:341–355.
    1. Al-Farsi Y, Al-Sharbati M, Al-Farsi O, Al- Shafaee M, Brooks D, Waly M. Brief report: prevalence of autistic spectrum disorders in the Sultanate of Oman. 2010.
    1. Al-Salehi SM, Al-Hifthy EH, Ghaziuddin M. Autism in Saudi Arabia: presentation, clinical correlates and comorbidity. Transcultural Psychiatry. 2009;46:340–347.
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Arlington, VA: American Psychiatric Association; 1980.
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Arlington, VA: American Psychiatric Association; 1987. Revised.
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Arlington, VA: American Psychiatric Association; 1994.
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Arlington, VA: American Psychiatric Association; 2000.
    1. Ametepee LK, Chitiyo M. What we know about autism in Africa: a brief research synthesis. The Journal of the International Association of Special Education. 2009;10:11–13.
    1. Arvidsson T, Danielsson B, Forsberg P, Gillberg C, Johansson M, Kjellgren G. Autism in 3–6 year-old in a suburb of Goteborg, Sweden. Autism. 1997;2:163–173.
    1. Baird G, Simonoff E, Pickles A, Chandler S, Loucas T, et al. Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the special needs and autism project (SNAP) Lancet. 2006;368:210–215.
    1. Bakare MO, Munir KM. Autism spectrum disorders (ASD) in Africa: a perspective. African Journal of Psychiatry (Johannesbg) 2011;14:208–210.
    1. van Balkom IDC, Bresnahan M, Vogtländer MF, van Hoeken D, Minderaa R, et al. Prevalence of treated autism spectrum disorders in Aruba. Journal of Neurodevelopmental Disorders. 2009;1:197–204.
    1. Begeer S, Bouk SE, Boussaid W, Terwogt MM, Koot HM. Underdiagnosis and referral bias of autism in ethnic minorities. Journal of Autism and Developmental Disorders. 2009;39:142–148.
    1. Belmonte MK, Cook EHJ, Anderson GM, Rubenstein JL, Greenough WT, et al. Autism as a disorder of neural information processing: directions for research and targets for therapy. Molecular Psychiatry. 2004;9:646–663.
    1. Brask B. 1972. A prevalence investigation of childhood psychoses. Paper presented at the Nordic Symposium on the Care of Psychotic Children.
    1. Burd L, Fisher W, Kerbeshan J. A prevalence study of pervasive developmental disorders in North Dakota. Journal of the American Academy of Child and Adolescent Psychiatry. 1987;26:700–703.
    1. CDC. Center for Disease Control: Prevalence of autism spectrum disorder—autism and developmental disabilities monitoring network, six sites, United States (2000) MMWR Surveillance Summary. 2007a;56:1–11.
    1. Center for Disease Control. Prevalence of autism spectrum disorders—autism and developmental disabilities monitoring network, 14 sites, United States (2002) MMWR Surveillance Summary. 2007b;56:12–28.
    1. Center for Disease Control. Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring network, United States, 2006. Morbidity and Mortality Weekly Report Surveillance Summary. 2009;58:1–14.
    1. Chakrabarti S, Fombonne E. Pervasive developmental disorders in preschool children. Journal of the American Medical Association. 2001;285:3093–3099.
    1. Chakrabarti S, Fombonne E. Pervasive developmental disorders in preschool children: confirmation of high prevalence. American Journal. 2005;162:1133–1141.
    1. Croen LA, Grether JK, Hoogstrate J, Selvin S. The changing prevalence of autism in California. Journal of Autism and Developmental Disorders. 2002;32:207–215.
    1. Currenti SA. Understanding and determining the etiology of autism. Cellular & Molecular Neurobiology. 2009;30:161–171.
    1. Daley TC. From symptom recognition to diagnosis: children with autism in urban India. Social Science and Medicine. 2004;58:1323–1335.
    1. Dealberto MJ. Prevalence of autism according to maternal immigrant status and ethnic origin. Acta Psychiatrica Scandinavica. 2011;123:339–348.
    1. Eapen V, Mabrouk AA, Zoubeidi T, Yunis F. Prevalence of pervasive developmental disorders in preschool children in the UAE. Journal of Tropical Pediatrics. 2007;53:202–205.
    1. Elsabbagh M, Johnson MH. Getting answers from babies about autism. Trends in Cognitive Science. 2010;14:81–87.
    1. Farley M, McMahon W, Fombonne E, Jenson WR, Miller J, et al. Twenty-year outcome for individuals with autism and average or near-average cognitive abilities. Autism Research. 2009;2:109–118.
    1. Fombonne E. Epidemiological surveys of autism and other pervasive developmental disorders: an update. Journal of Autism and Developmental Disorders. 2003a;33:365–382.
    1. Fombonne E. The prevalence of autism. Journal of the American Medical Association. 2003b;289:1–3.
    1. Fombonne E. Epidemiological studies of pervasive developmental disorders. In: Volkmar FR, Paul R, Klin A, Cohen D, editors. Handbook of autism and pervasive developmental disorders. Hoboken, NJ: Wiley; 2005. pp. 42–69.
    1. Fombonne E, Quirke S, Hagen A. Epidemiology of pervasive developmental disorders. In: Amaral DG, Dawson G, Geschwind DH, editors. Autism spectrum disorders. Oxford: Oxford University Press; 2011.
    1. Fombonne E, Zakarian R, Bennett A, Meng L, McLean-Heywood D. Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations. Pediatrics. 2006;118:e139–e150.
    1. Ganz ML. The lifetime distribution of the incremental societal costs of autism. Archives of Pediatric and Adolescent Medicine. 2007;161:343–349.
    1. Gardener H, Spiegelman D, Buka SL. Prenatal risk factors for autism: comprehensive meta-analysis. British Journal of Psychiatry. 2009;195:7–14.
    1. Ghanizadeh A. A preliminary study on screening prevalence of pervasive developmental disorder in school children in Iran. Journal of Autism and Developmental Disorders. 2008;38:759–763.
    1. Gillberg C. Infantile autism in children of immigrant parents: a population-based study from Göteborg, Sweden. British Journal of Psychiatry. 1987;150:856–858.
    1. Gillberg C, Schaumann H, Gillberg IC. Autism in immigrants: children born in Sweden to mothers born in Uganda. Journal of Intellectual Disability Research. 1995;39:141–144.
    1. Gillberg C, Steffenburg S, Schaumann H. Is autism more common now than ten years ago? British Journal of Psychiatry. 1991;158:403–409.
    1. Gurney JG, Fritz MS, Ness KK, Sievers P, Newschaffer CJ, Shapiro EG. Analysis of prevalence trends of autism spectrum disorder in Minnesota [comment] Archives of Pediatrics and Adolescent Medicine. 2003;157:622–627.
    1. Honda H, Shimizu Y, Misumi K, Niimi M, Ohashi Y. Cumulative incidence and prevalence of childhood autism in children in Japan. British Journal of Psychiatry. 1996;169:228–235.
    1. Honda H, Shimizu Y, Rutter M. No effect of MMR withdrawal on the incidence of autism: a total population study. Journal of Child Psychology and Psychiatry. 2005;46:572–579.
    1. Icasiano F, Hewson P, Machet P, Cooper C, Marshall A. Childhood autism spectrum disorder in the Barwon region: a community based study. Journal of Paediatric Child Health. 2004;40:696–701.
    1. Juneja M, Mukherjee SB, Sharma S. A descriptive hospital based study of children with autism. Indian Pediatrics. 2004;42:453–458.
    1. Kalra V, Seth R, Sapra S. Autism—experiences in a tertiary care hospital. Indian Journal of Pediatrics. 2005;72:227–230.
    1. Kawamura Y, Takahashi O, Ishii T. Reevaluating the incidence of pervasive developmental disorders: impact of elevated rates of detection through implementation of an integrated system of screening in Toyota, Japan. Psychiatry and Clinical Neuroscience. 2008;62:152–159.
    1. Khan N, Hombarume J. Levels of autistic behavior among the mentally handicapped children in Zimbabwe. Central African Journal of Medicine. 1996;42:36–39.
    1. Kielinen M, Linna SL, Moilanen I. Autism in northern Finland. European Child and Adolescent Psychiatry. 2000;9:162–167.
    1. Kim YS, Leventhal BL, Koh YJ, Fombonne E, Laska E, et al. Prevalence of autism spectrum disorders in a total population sample. American Journal of Psychiatry. 2011;168:904–912.
    1. Knapp M, Romeo R, Beecham J. The economic consequences of autism in the UK. London: Foundation for People with Learning Disabilities; 2007.
    1. Lazoff TL, Piperni T, Fombonne E. Prevalence of pervasive developmental disorders among children at the English Montreal School Board. Canadian Journal of Psychiatry. 2010;55:715–720.
    1. Le Couteur A, Rutter M, Lord C, Rios P, Robertson S, et al. Autism Diagnostic Interview: a standardized investigator-based instrument. Journal of Autism and Developmental Disorders. 1989;19:363–387.
    1. Lejarraga H, Menendez AM, Menzano E, Guerra L, Silvia Biancato S, et al. Screening for developmental problems at primary care level: a field programme in SanIsidro, Argentina. Pediatric and Perinatal Epidemiology. 2008;22:180–187.
    1. Lord C, Risi S, Lambrecht L, Cook EH, Jr, Leventhal BL, et al. The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders. 2000;30:205–223.
    1. Lotter V. Epidemiology of autistic conditions in young children: I. Prevalence. Social Psychiatry. 1966;1:124–137.
    1. Lotter V. Childhood autism in Africa. Journal of Child Psychology and Psychiatry. 1978;19:231–244.
    1. Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, et al. A population-based study of measles, mumps, and rubella vaccination and autism. New England Journal of Medicine. 2002;347:1477–1482.
    1. Magnússon P, Saemundsen E. Prevalence of autism in Iceland. Journal of Autism and Developmental Disorders. 2001;31:153–163.
    1. Malhi P, Singhi S. Patterns of development in young children with autism. Indian Journal of Pediatrics. 2005;72:553–556.
    1. Mankoski RE, Collins M, Ndosi NK, Mgalla EH, Sarwatt VV, Folstein SE. Etiologies of autism in a case series from Tanzania. Journal of Autism Developmental Disorders. 2006;36:1039–1051.
    1. Montiel-Nava C, Peña J. Epidemiological findings of pervasive developmental disorders in a Venezuelan Study. Autism. 2008;12:191–202.
    1. Murray CJL, Lopez AD, Mathers CD, Stein C. The Global Burden of Disease 2000 project: aims, methods and data sources. Geneva: World Health Organization; 2001.
    1. Palmer F, Blanchard S, Jean CR, Mandell DS. School district resources and identification of children with autistic disorder. American Journal of Public Health. 2005;95:125–130.
    1. Patel V, Garrison P, de Jesus Mari J, Minas H, Prince M, Saxena S. Advisory group of the Movement for Global Mental Health. The Lancet's series on global mental health: 1 year on. Lancet. 2008;372:1354–1357.
    1. Paula CS, Ribeiro S, Fombonne E, Mercadante MT. Brief report: Prevalence of pervasive developmental disorder in Brazil: a pilot study. Journal of Autism and Developmental Disorders. 2011;41:1738–1741.
    1. Perera H, Wijewardena K, Aluthwelage R. Screening of 18-24-month-old children for autism in a semi-urban community in Sri Lanka. Journal of Tropical Pediatrics. 2009;55:402–405.
    1. Plubrukarn R, Piyasil V, Moungnoi P, Tanprasert S, Chutchawalitsakul V. Trend study of autistic spectrum disorders at Queen Sirikit National Institute of Child Health. Journal of Medical Association of Thailand. 2005;88:891–897.
    1. Powell J, Edwards A, Edwards M, Pandit B, Sungum-Paliwal S, Whitehouse W. Changes in the incidence of childhood autism and other autistic spectrum disorders in preschool children from two areas of the West Midlands, UK. Developmental Medicine and Child Neurology. 2000;42:624–628.
    1. Rutter M. Autistic children: infancy to adulthood. Seminars in Psychiatry. 1970;2:435–450.
    1. Samadi SA, Mahmoodizadeh A, McConkey R. A national study of the prevalence of autism among five-year-old children in Iran. Autism. 2012;16:5–14.
    1. Schopler E, Andrews CE, Strupp K. Do autistic children come from upper-middle-class parents. Journal of Autism and Developmental Disorders. 1979;9:139–151.
    1. Seif Eldin A, Habib D, Noufal A, Farrag S, Bazaid K, et al. Use of M-CHAT for a multinational screening of young children with autism in the Arab countries. International Review of Psychiatry. 2008;20:281–289.
    1. Singhi P, Malhi P. Clinical and neurodevelopmental profile of young children with autism. Indian Pediatrics. 2001;38:384–390.
    1. Sun X, Allison C. A review of the prevalence of Autism Spectrum Disorder in Asia. Research in Autism Spectrum Disorders. 2010;4:156–167.
    1. Webb E, Lobo S, Hervas A, Scourfield J, Fraser W. The changing prevalence of autistic disorder in a Welsh health district. Developmental Medicine and Child Neurology. 1997;39:150–152.
    1. Wignyosumarto S, Mukhlas M, Shirataki S. Epidemiological and clinical study of autistic children in Yogyakarta, Indonesia. Kobe Journal of Medical Sciences. 1992;38:1–19.
    1. Williams JG, Higgins JP, Brayne CE. Systematic review of prevalence studies of autism spectrum disorders. Archives of Disease in Childhood. 2006;91:8–15.
    1. Wing L. Childhood autism and social class: a question of selection? British Journal of Psychiatry. 1980;137:410–417.
    1. Wing L, Gould J. Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. Journal of Autism and Developmental Disorders. 1979;9:11–29.
    1. Wing L, Yeates S, Brierly L, Gould J. The prevalence of early childhood autism: comparison of administrative and epidemiological studies. Psychological Medicine. 1976;6:89–100.
    1. Wong VC, Hui SL. Epidemiological study of autism spectrum disorder in China. Journal of Child Neurology. 2008;23:67–72.
    1. World Health Organization (WHO) The ICD-9 Classification of Mental and Behavioural Disorders. 1975. Clinical descriptions and diagnostic guidelines. Geneva.
    1. World Health Organization (WHO) The ICD-10 Classification of Mental and Behavioural Disorders. 1992. Clinical descriptions and diagnostic guidelines. Geneva.
    1. World Health Organization (WHO) Geneva: 2008. mhGAP Mental Health Gap Action Programme Scaling up care for mental, neurological, and substance use disorders.
    1. Yeargin-Allsopp M, Rice C, Karapurkar T, Doernberg N, Boyle C, Murphy C. Prevalence of autism in a US metropolitan area [comment. Journal of the American Medical Association. 2003;289:49–55.
    1. Zhang X, Ji CY. Autism and mental retardation of young children in China. Biomedical and Environmental Sciences. 2005;18:334–340.

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