Prevalence of Autism Spectrum Disorders in a Total Population Sample
Prevalence of Autism Spectrum Disorders in a Total Population Sample
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DOI：
10.1176/appi.ajp.2011.10101532
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发表时间：
2011-09-01
影响因子：
17.7
通讯作者：
Grinker, Roy Richard
中科院分区：
文献类型：
--
作者：
Kim, Young Shin;Leventhal, Bennett L.;Grinker, Roy Richard
目的：专家们对最近自闭症谱系障碍（ASD）患病率增加的原因和意义存在分歧。关于人口基本比率的有限数据造成了这种不确定性。使用人口为基础的样本，作者试图估计患病率和描述的临床特征的ASD学龄children.Method：目标人群是所有7- 12岁的儿童（N=55,266）在韩国社区，研究使用了一个高概率组从特殊教育学校和残疾登记处和低概率，普通人群样本从正规学校。为了识别病例，作者使用自闭症谱系筛查问卷进行系统的多信息者筛查。结果：ASD患病率为2.64%（95%CI =1.91-3.37），其中普通人群为1.89%（95%CI =1.43-2.36），高概率人群为0.75%（95%CI =0.58-0.93）。两组的ASD特征不同：普通人群样本和高概率组的男女比例分别为2.5：1和5.1：1，自闭症与其他ASD亚型的比例分别为1：2.6和2.6：1;普通人群样本中有12%的人具有上级智商，而高概率组只有7%;一般人群样本中有16%患有智力残疾，而高概率人群中有59%患有智力残疾。在整个样本中，三分之二的ASD病例来自主流学校人群，未被诊断和治疗。这些研究结果表明，严格的筛查和全面的人口覆盖是必要的，以产生更准确的ASD患病率估计，并强调需要更好的检测，评估和服务。
Objective: Experts disagree about the causes and significance of the recent increases in the prevalence of autism spectrum disorders (ASDs). Limited data on population base rates contribute to this uncertainty. Using a population-based sample, the authors sought to estimate the prevalence and describe the clinical characteristics of ASDs in school-age children.Method: The target population was all 7-to 12-year-old children (N=55,266) in a South Korean community; the study used a high-probability group from special education schools and a disability registry and a low-probability, general-population sample from regular schools. To identify cases, the authors used the Autism Spectrum Screening Questionnaire for systematic, multi-informant screening. Parents of children who screened positive were offered comprehensive assessments using standardized diagnostic procedures.Results: The prevalence of ASDs was estimated to be 2.64% (95% CI=1.91-3.37), with 1.89% (95% CI=1.43-2.36) in the general-population sample and 0.75% (95% CI=0.58-0.93) in the high-probability group. ASD characteristics differed between the two groups: the male-to-female ratios were 2.5:1 and 5.1:1 in the general population sample and high-probability group, respectively, and the ratios of autistic disorders to other ASD subtypes were 1:2.6 and 2.6:1, respectively; 12% in the general-population sample had superior IQs, compared with 7% in the high-probability group; and 16% in the general-population sample had intellectual disability, compared with 59% in the high-probability group.Conclusions: Two-thirds of ASD cases in the overall sample were in the mainstream school population, undiagnosed and untreated. These findings suggest that rigorous screening and comprehensive population coverage are necessary to produce more accurate ASD prevalence estimates and underscore the need for better detection, assessment, and services.