Prevalence of Autism Spectrum Disorder among Rural, Urban, and Tribal Children (1–10 Years of Age)

Abstract

Introduction:Studies on autism spectrum disorders (ASDs) have largely focused on children in specific settings. The current scenario of research in ASDs is limited largely to clinic-based case reports, case series, and retrospective chart reviews. The present study is the first population-based prevalence study conducted across rural, urban, and tribal populations in India.Materials and Methods:A cross-sectional two-phase study was conducted covering children in the age group of 1–10 years of age across geographical regions representing rural, urban, and tribal populations. The first phase (screening phase) involved administration of the Hindi version of the Indian Scale for Assessment of Autism. Those identified as suspected of ASD and 10% of all classified as nonsuspects for autism were also evaluated by the clinical team in second phase (evaluation phase).Results:Forty-three children out of a total of 28,070 children in rural, urban, and tribal area in the age group of 1–10 years were diagnosed as cases of ASD yielding a prevalence of 0.15% (95% confidence interval [CI] =0.15–0.25). Logistic regression analysis showed a two times significantly higher risk of diagnosing ASD in rural area as compared to tribal (odds ratio [OR]; 95% CI = 2.17 [1.04–4.52], P = 0.04). Male sex and upper socioeconomic group of head of family/father had a higher risk of getting diagnosed as autism as compared to lower socioeconomic group (OR; 95% CI - 3.23; 0.24–44.28, P = 0.38).Conclusions:Estimation of true prevalence of ASD in India is going to improve policies on developmental disabilities.

The Estimated Prevalence of Autism in School-Aged Children Living in Rural Nepal Using a Population-Based Screening Tool

“…This estimated prevalence of 3 per 1000 is lower than that in HICs, which is reported as 10–20 per 1000 (Elsabbagh et al 2012 ), and lower than the only other LIC study showing Ugandan population estimates in 1–10-year-olds to be 12–13 per 1000 (Kakooza-Mwesige et al 2014 ). Nevertheless, this estimate is higher than global median estimates (1.7/1000) and estimates from a recent study in rural India 0.9 per 1000 for all children in the full cohort of 11,000 children aged between 1 and 10 years and 1.1 per 1000 in the rural cohort (Raina et al 2017 ). In the latter study, urban rural abode and higher socio-economic class were associated with reduced prevalence.…”

“…In fact, there is a paucity of research examining autism generally in these regions at all (Abubakar et al 2016 ). Studies that have been conducted in lower-middle and upper-middle income countries have produced varied results reporting prevalence estimates ranging from 0.32 (China: Tao 1987 ) to 250 per 10,000 (China: Ren et al 2003 ) and more recently 90 per 10,000 (India: Raina et al 2017 ). These discrepancies are possibly due to a variety of reasons, including the fact that autism is a spectrum condition (American Psychiatric Association 2013 ), the variety of traits; changing definitions of autism; varying levels of awareness in different countries; cultural variation in expectations and understandings of children’s behavior; different methodological approaches used to assess prevalence; and the lack of availability of culturally-sensitive diagnostic tools and year of assessment (Elsabbagh et al 2012 ).…”

The Relationship of Urbanization and Performance of Activity and Participation Functioning among Adults with Developmental Disabilities in Taiwan

“…While they could not directly examine the specific reasons behind these associations, their results demonstrating particularly strong associations between ASD diagnosis and post-birth migration suggest the influence of identification-related factors, such as access to services, might have a substantive role on the ASD differentials we observed [ 29 ]. Obviously, the results of studies on the distribution of autism in adults and children are very different [ 30 , 31 , 32 ], and there is a lack of research on the relationship between a person with autism’s functional performance and urbanization. Even so, in the present study, there was not any association between their living cities and the functioning score for adults with autism.…”

Autism and Food Selectivity

“…al. [16]. These differences are possibly due to a variety of reasons, including the fact that autism is a spectrum condition according to American Psychiatric Association, 2013, the variety of traits; changing definitions of autism; varying levels of awareness in different countries; cultural variation in expectations and understandings of children's behavior; different methodological approaches used to assess prevalence; and the lack of availability of culturally-sensitive diagnostic tools and year of assessment [18].…”