Prevalence of Autism Spectrum Disorders in a Total Population Sample

TLDR

Experts disagree about the causes and significance of recent increases in ASD prevalence, and limited population base‑rate data add to this uncertainty. The study aimed to estimate ASD prevalence and describe clinical characteristics among 7‑12‑year‑old children in a South Korean community. The authors sampled all 7‑12‑year‑old children in the community, screened them with the Autism Spectrum Screening Questionnaire, and offered comprehensive standardized diagnostic assessments to those who screened positive. ASD prevalence was 2.64% overall (1.89% in the general population, 0.75% in the high‑probability group), with notable differences in sex ratios, subtype distribution, IQ, and intellectual disability; two‑thirds of cases were in mainstream schools and remained undiagnosed, underscoring the need for rigorous screening and comprehensive coverage.

Abstract

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.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.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.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.