Exploring the Underdiagnosis and Prevalence of Autism Spectrum Conditions in Beijing

Xiang Sun, Carrie Allison, Fiona E Matthews, Zhixiang Zhang, Bonnie Auyeung, Simon Baron-Cohen, Carol Brayne

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Previous studies reported that the prevalence of Autism Spectrum Conditions (ASC) in mainland China 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 Chinese population to establish a prevalence estimate of ASC in an undiagnosed population in mainland China. We followed the design development used previously in the UK published in 2009 by Baron-Cohen and colleagues. The Mandarin 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 China 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 China. Using a comparable method, the preliminary prevalence estimate of ASC in mainland China is similar to that of those from developed countries. Autism Res 2015, ●●: ●●-●●. © 2015 The Authors. Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.

Original languageEnglish
Pages (from-to)250-260
JournalAutism Research
Issue number3
Early online date6 May 2015
Publication statusPublished - Jun 2015

Keywords / Materials (for Non-textual outputs)

  • autism
  • prevalence
  • screening
  • diagnosis
  • CAST
  • China


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