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.

Assessing the Accuracy of the Modified Chinese Autism Spectrum Rating Scale and Social Responsiveness Scale for Screening Autism Spectrum Disorder in Chinese Children

The reported prevalence of autism spectrum disorder（ASD） has been increasing rapidly in many parts of the world. However, data on its prevalence in China are largely missing. Here, we assessed the suitability of the modi？ed Chinese version of a newly-developed ASD screening tool, the Modi？ed Chinese Autism Spectrum Rating Scales（MC-ASRS） in screening for ASD in Chi nese children aged 6–12 years, through comparison with the Social Responsiveness Scale（SRS） that has been widely used for ASD screening. We recruited the par ents/caregivers of 1588 typically-developing children and190 children with ASD aged 6–12 years to complete the MC-ASRS and SRS, and evaluated the validity of both scales in discriminating children with ASD from those developing typically. The results showed that MC-ASRSperformed as well as SRS in sensitivity, speci？city, and area-under-the-curve（both [0.95） in receiver operating characteristic analysis, with a fair false-negative rate.These results suggest that MC-ASRS is a promising tool for screening for children with ASD in the general Chinese population.

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.