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Exploring the Underdiagnosis and Prevalence of Autism Spectrum Conditions in B eijing
Author(s) -
Sun Xiang,
Allison Carrie,
Matthews Fiona E.,
Zhang Zhixiang,
Auyeung Bonnie,
BaronCohen Simon,
Brayne Carol
Publication year - 2015
Publication title -
autism research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.656
H-Index - 66
eISSN - 1939-3806
pISSN - 1939-3792
DOI - 10.1002/aur.1441
Subject(s) - autism , medicine , confidence interval , autism spectrum disorder , population , epidemiology , pediatrics , demography , psychiatry , environmental health , sociology
Previous studies reported that the prevalence of Autism Spectrum Conditions (ASC) in mainland C hina is much lower than estimates from developed countries (around 1%). The aim of the study is to apply current screening and standardized diagnostic instruments to a C hinese population to establish a prevalence estimate of ASC in an undiagnosed population in mainland C hina. We followed the design development used previously in the UK published in 2009 by Baron‐Cohen and colleagues. The M andarin Childhood Autism Spectrum Test ( CAST ) was validated by screening primary school pupils (n = 737 children age 6–10 years old) in Beijing and by conducting diagnostic assessments using the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview‐Revised. The prevalence estimate was generated after adjusting and imputing for missing values using the inverse probability weighting. Response was high (97%). Using the UK cutoff (≥15), CAST performance has 84% sensitivity and 96% specificity (95% confidence interval [ CI ]: 46, 98, and 96, 97, respectively). Six out of 103 children, not previously diagnosed, were found to the meet diagnostic criteria (8.5 after adjustment, 95% CI : 1.6, 15.4). The preliminary prevalence in an undiagnosed primary school population in mainland C hina was 119 per 10,000 (95% CI : 53, 265). The utility of CAST is acceptable as a screening instrument for ASC in large epidemiological studies in C hina. Using a comparable method, the preliminary prevalence estimate of ASC in mainland C hina is similar to that of those from developed countries. Autism Res 2015, 8: 250–260 . © 2015 The Authors. Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research