Prevalence of Autism Spectrum Disorder in China:A Nationwide Multi-center Population-based Study Among Children Aged 6 to 12 Years

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder(ASD) in Chinese children.We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling.The Modified Chinese Autism Spectrum Rating Scale was used for the screening process.Of the target population of 142,086 children,88.5%(n=125,806) participated in the study.A total of 363 children were confirmed as having ASD.The observed ASD prevalence rate was 0.29%(95% CI:0.26%-0.32%) for the overall population.After adjustment for response rates,the estimated number of ASD cases was867 in the target population sample,thereby achieving an estimated prevalence of 0.70%(95% CI:0.64%-0.74%).The prevalence was significantly higher in boys than in girls(0.95%;95% CI:0.87%-1.02% versus 0.30%;95%CI:0.26%-0.34%;P <0.001).Of the 363 confirmed ASD cases,43.3% were newly diagnosed,and most of those(90.4%) were attending regular schools,and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity.Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

Impact of clinical research on public health policy of neonatal screening for congenital heart disease in China

Congenital heart disease(CHD)is one of the most common congenital malformations,with a prevalence of approximately 1%in live births.[1,2]Among them,1/4 to 1/3 are major CHD,including critical CHD(CCHD)and serious CHD,which require surgical or catheter intervention before 1 year of age.[3]Major CHD,if left untreated,may cause serious outcomes,such as heart failure,cardiogenic shock,acidosis,and hypoxic-ischemic brain damage,and is one of the leading causes of infant death and childhood disability.[4]The missed diagnosis rate of CCHD in four nurseries ranges from 13%to 48%in developed countries,[4,5]but in China,is>71%before serious symptoms occur after birth.[6]Therefore,screening for CHD is useful for early detection,diagnosis,and treatment and helps to improve prognosis and reduces the medical,economic,and mental burden to both the family and the society.[5,7]

Modifying the Autism Spectrum Rating Scale(6–18 years)to a Chinese Context:An Exploratory Factor Analysis

The purpose of this study was to explore the psychometric properties of the Chinese version of the autism spectrum rating scale（ASRS）. We recruited 1,625community-based children and 211 autism spectrum disorder（ASD） cases from 4 sites, and the parents of all participants completed the Chinese version of the ASRS. A robust weighted least squares means and variance adjusted estimator was used for exploratory factor analysis. The3-factor structure included 59 items suitable for the current sample. The item reliability for the modi？ed Chinese version of the ASRS（MC-ASRS） was excellent. Moreover,with 60 as the cut-off point, receiver operating characteristic analysis showed that the MC-ASRS had excellent discriminate validity, comparable to that of the unmodi？ed Chinese version（UC-ASRS）, with area under the curve values of 0.952（95% CI： 0.936–0.967） and 0.948（95% CI：0.930–0.965）, respectively. Meanwhile, the con？rm factor analysis revealed that MC-ASRS had a better construct validity than UC-ASRS based on the above factor solution in another children sample. In conclusion, the MC-ASRS shows better ef？cacy in epidemiological screening for ASD in Chinese children.

Chinese Norms for the Autism Spectrum Rating Scale

This study aimed to establish norms for the modi？ed Chinese version of the Autism Spectrum Rating Scale（ASRS）. Participants were recruited from Shanghai,Harbin, Guangzhou, and Changsha, China, and their parents and teachers were invited to complete the Chinese Parent version and the Teacher version of the ASRS. In both versions, boys had signi？cantly higher sub-scale scores and total score（T-score） by 1–3 and 4–5 points respectively, than girls（both P ／ 0.001）. Age had weak correlations with some sub-scores and the T-score（r ranged from-0.1859 to 0.0738）, and some reached signi？cance（P ／ 0.03）. The correlations appeared stronger and were more common in females. The T-score based on Chinese norms ideally correlated with the score based on the United States norms in boys and girls for both versions.Norms for the Chinese version of the ASRS for children aged 6–12 years are proposed and may be helpful for screening individuals with autism spectrum disorders from the general population of children.