The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis

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Abstract

Background

Autism spectrum disorder (ASD) is one of the serious developmental disorders that is usually diagnosed below the age of three years. Although the severity of the disease’s symptoms varies from patient to patient, the ability to communicate with others is affected in all forms of ASD. This study aimed to determine the prevalence of ASD in high-risk groups by continent.

Methods

The present study was conducted by systematic review and meta-analysis from 2008 to July 2021. Databases such as Science Direct, PubMed, Scopus, SID, Magiran, Web of Science (WoS), and Google Scholar from 2008 to July 2021 were searched to find related studies. Data were analysed using Comprehensive Meta-Analysis software (Version 2).

Results

A total of 74 studies with 30,212,757 participants were included in this study. The prevalence of ASD in the world was 0.6% (95% confidence interval: 0.4–1%). Subgroup analyses indicated that the prevalence of ASD in Asia, America, Europe, Africa and Australia was 0.4% (95% CI: 0.1–1), 1% (95% CI: 0.8–1.1), 0.5% (95% CI: 0.2–1), 1% (95% CI: 0.3–3.1), 1.7% (95% CI: 0.5–6.1) respectively.

Conclusion

ASD imposes a heavy health burden on communities around the world. Early detection of ASD can reduce the incidence of developmental disorders and improve patients’ communication skills. Therefore, health policymakers need to be aware of the prevalence and increasing trend of ASD to implement appropriate planning and interventions to reduce its consequences.

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Most cited references 124

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Diagnostic and Statistical Manual of Mental Disorders

American Psychiatric Association (2013)

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Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

David Moher, Larissa Shamseer, Mike Clarke … (2017)

Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.

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Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016

Matthew J Maenner, Kelly Shaw, Jon Baio … (2020)

Problem/Condition Autism spectrum disorder (ASD). Period Covered 2016. Description of System The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance program that provides estimates of the prevalence of ASD among children aged 8 years whose parents or guardians live in 11 ADDM Network sites in the United States (Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin). Surveillance is conducted in two phases. The first phase involves review and abstraction of comprehensive evaluations that were completed by medical and educational service providers in the community. In the second phase, experienced clinicians who systematically review all abstracted information determine ASD case status. The case definition is based on ASD criteria described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Results For 2016, across all 11 sites, ASD prevalence was 18.5 per 1,000 (one in 54) children aged 8 years, and ASD was 4.3 times as prevalent among boys as among girls. ASD prevalence varied by site, ranging from 13.1 (Colorado) to 31.4 (New Jersey). Prevalence estimates were approximately identical for non-Hispanic white (white), non-Hispanic black (black), and Asian/Pacific Islander children (18.5, 18.3, and 17.9, respectively) but lower for Hispanic children (15.4). Among children with ASD for whom data on intellectual or cognitive functioning were available, 33% were classified as having intellectual disability (intelligence quotient [IQ] ≤70); this percentage was higher among girls than boys (40% versus 32%) and among black and Hispanic than white children (47%, 36%, and 27%, respectively). Black children with ASD were less likely to have a first evaluation by age 36 months than were white children with ASD (40% versus 45%). The overall median age at earliest known ASD diagnosis (51 months) was similar by sex and racial and ethnic groups; however, black children with IQ ≤70 had a later median age at ASD diagnosis than white children with IQ ≤70 (48 months versus 42 months). Interpretation The prevalence of ASD varied considerably across sites and was higher than previous estimates since 2014. Although no overall difference in ASD prevalence between black and white children aged 8 years was observed, the disparities for black children persisted in early evaluation and diagnosis of ASD. Hispanic children also continue to be identified as having ASD less frequently than white or black children. Public Health Action These findings highlight the variability in the evaluation and detection of ASD across communities and between sociodemographic groups. Continued efforts are needed for early and equitable identification of ASD and timely enrollment in services.

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Author and article information

Contributors

Nader Salari: n_s_54@yahoo.com

Shabnam Rasoulpoor: Sh.raoulpour@gmail.com

Shna Rasoulpoor: Shna.rasolpur@gmail.com

Shamarina Shohaimi: shamarna@upm.edu.my

Sima Jafarpour: Jafarpourrr_SS2@gmail.com

Nasrin Abdoli: abdoli31@gmail.com

Behnam Khaledi-Paveh: bkhaldi@ymail.com

Masoud Mohammadi:

ORCID: http://orcid.org/0000-0002-5722-8300

Masoud.mohammadi1989@yahoo.com

Journal

Journal ID (nlm-ta): Ital J Pediatr

Journal ID (iso-abbrev): Ital J Pediatr

Title: Italian Journal of Pediatrics

Publisher: BioMed Central (London )

ISSN (Electronic): 1824-7288

Publication date (Electronic): 8 July 2022

Publication date PMC-release: 8 July 2022

Publication date Collection: 2022

Volume: 48

Electronic Location Identifier: 112

Affiliations

[1 ]GRID grid.412112.5, ISNI 0000 0001 2012 5829, Department of Biostatistics, School of Health, , Kermanshah University of Medical Sciences, ; Kermanshah, Iran

[2 ]GRID grid.412763.5, ISNI 0000 0004 0442 8645, Department of Psychiatric Nursing, School of Nursing and Midwifery, , Urmia University of Medical Sciences, ; Urmia, Iran

[3 ]GRID grid.412112.5, ISNI 0000 0001 2012 5829, Student research committee, Kermanshah University of Medical Sciences, ; Kermanshah, Iran

[4 ]GRID grid.11142.37, ISNI 0000 0001 2231 800X, Department of Biology, Faculty of Science, , University Putra Malaysia, ; Serdang, Selangor Malaysia

[5 ]GRID grid.411036.1, ISNI 0000 0001 1498 685X, Department of Genetics and Molecular Biology, School of Medicine, , Isfahan University of Medical Sciences, ; Isfahan, Iran

[6 ]GRID grid.412112.5, ISNI 0000 0001 2012 5829, Department of Psychiatry, , Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, ; Kermanshah, Iran

[7 ]GRID grid.412112.5, ISNI 0000 0001 2012 5829, Sleep Disorders Research Center, Kermanshah University of Medical Sciences, ; Kermanshah, Iran

[8 ]GRID grid.512375.7, ISNI 0000 0004 4907 1301, Cellular and Molecular Research Center, , Gerash University of Medical Sciences, ; Gerash, Iran

Author information

Masoud Mohammadi http://orcid.org/0000-0002-5722-8300

Article

Publisher ID: 1310

DOI: 10.1186/s13052-022-01310-w

PMC ID: 9270782

PubMed ID: 35804408

SO-VID: 0dbc2052-0886-45a4-a527-e66cf87f99aa

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 7 October 2021

Date accepted : 24 June 2022

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ScienceOpen disciplines: Pediatrics

Keywords: asd,autism spectrum disorder,prevalence,systematic review,meta-analysis

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ScienceOpen disciplines: Pediatrics

Keywords: asd, autism spectrum disorder, prevalence, systematic review, meta-analysis

The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis

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Most cited references 124

Diagnostic and Statistical Manual of Mental Disorders

Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016

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