Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-22T17:12:47.813Z Has data issue: false hasContentIssue false

Prevalence of autism-spectrum conditions: UK school-based population study

Published online by Cambridge University Press:  02 January 2018

Simon Baron-Cohen*
Affiliation:
Autism Research Centre, Department of Psychiatry, Cambridge University
Fiona J. Scott
Affiliation:
Autism Research Centre, Department of Psychiatry, Cambridge University
Carrie Allison
Affiliation:
Autism Research Centre, Department of Psychiatry, Cambridge University
Joanna Williams
Affiliation:
Department of Public Health and Primary Care, Institute of Public Health, Cambridge University
Patrick Bolton
Affiliation:
Autism Research Centre, Department of Psychiatry, Cambridge University
Fiona E. Matthews
Affiliation:
Biostatistics Unit, Institute of Public Health, Cambridge University
Carol Brayne
Affiliation:
Department of Public Health and Primary Care, Institute of Public Health, Cambridge University, UK
*
Simon Baron–Cohen, University of Cambridge, Autism Research Centre, Department of Psychiatry, Douglas House, 18b Trumpington Road, Cambridge CB2 8AH, UK. Email: [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background

Recent reports estimate the prevalence of autism-spectrum conditions in the UK to be 1%.

Aims

To use different methods to estimate the prevalence of autism-spectrum conditions, including previously undiagnosed cases, in Cambridgeshire.

Method

We carried out a survey of autism-spectrum conditions using the Special Educational Needs (SEN) register. A diagnosis survey was distributed to participating schools to be handed out to parents of all children aged 5–9 years. The mainstream primary school population was screened for unknown cases.

Results

The prevalence estimates generated from the SEN register and diagnosis survey were 94 per 10 000 and 99 per 10 000 respectively. A total of 11 children received a research diagnosis of an autism-spectrum condition following screening and assessment. The ratio of known:unknown cases is about 3:2 (following statistical weighting procedures). Taken together, we estimate the prevalence to be 157 per 10 000, including previously undiagnosed cases.

Conclusions

This study has implications for planning diagnostic, social and health services.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 2009 

Footnotes

These authors contributed equally to the work.

This study was funded by the Shirley Foundation. S.B-C., F.J.M. and J.W. were funded by the Medical Research Council during the period of this work. P.B. was supported by the UK NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King's College London, and the South London and Maudsley NHS Foundation Trust.

Declaration of interest

F.J.S acted as an expert witness for the diagnosis of autism-spectrum conditions and for the measles, mumps and rubella vaccine litigation, but not for children in the population covered by this study.

References

1 World Health Organization. The ICD–10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. WHO, 1993.Google Scholar
2 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). APA, 1994.Google Scholar
3 Baron-Cohen, S, Hoekstra, RA, Knickmeyer, R, Wheelwright, S. The Autism-Spectrum Quotient (AQ) – adolescent version. J Autism Dev Disord 2006; 36: 343–50.Google Scholar
4 Baron-Cohen, S, Wheelwright, S, Skinner, R, Martin, J, Clubley, E. The Autism-Spectrum Quotient (AQ): evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. J Autism Dev Disord 2001; 31: 517.Google Scholar
5 Wakabayashi, A, Baron-Cohen, S, Wheelwright, S, Tojo, Y. The Autism-Spectrum Quotient (AQ) in Japan: a cross-cultural comparison. J Autism Dev Disord 2006; 36: 263–70.Google Scholar
6 Wakabayashi, A, Baron-Cohen, S, Uchiyama, T, Yoshida, Y, Tojo, Y, Kuroda, M, et al. The Autism-Spectrum Quotient (AQ) children's version in Japan: a cross-cultural comparison. J Autism Dev Disord 2007; 37: 491500.CrossRefGoogle ScholarPubMed
7 Constantino, JN, Todd, RD. Autistic traits in the general population: a twin study. Arch Gen Psychiatry 2003; 60: 524–30.Google Scholar
8 Scott, FJ, Baron-Cohen, S, Bolton, P, Brayne, C. The CAST (Childhood Asperger Syndrome Test): preliminary development of a UK screen for mainstream primary-school-age children. Autism 2002; 6: 931.Google Scholar
9 Rutter, M. Diagnosis and definition of childhood autism. J Autism Child Schizophr 1978; 8: 139–61.Google Scholar
10 Baird, G, Simonoff, E, Pickles, A, Chandler, S, Loucas, T, Meldrum, D, et al. Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP). Lancet 2006; 368: 210–5.Google Scholar
11 Charman, T. The prevalence of autism spectrum disorders. Recent evidence and future challenges. Eur Child Adolesc Psychiatry 2002; 11: 249–56.CrossRefGoogle ScholarPubMed
12 Williams, JG, Higgins, JP, Brayne, CE. Systematic review of prevalence studies of autism spectrum disorders. Arch Dis Child 2006; 91: 815.CrossRefGoogle ScholarPubMed
13 Fombonne, E. Epidemiological trends in rates of autism. Mol Psychiatry 2002; 7 (suppl 2): s46.Google Scholar
14 Fombonne, E. The prevalence of autism. JAMA 2003; 289: 87–9.Google Scholar
15 Fombonne, E. Epidemiological surveys of autism and other pervasive developmental disorders: an update. J Autism Dev Disord 2003; 33: 365–82.Google ScholarPubMed
16 Wing, L, Potter, D. The epidemiology of autistic spectrum disorders: is the prevalence rising? Ment Retard Dev Disabil Res Rev 2002; 8: 151–61.Google ScholarPubMed
17 Bertrand, J, Mars, A, Boyle, C, Bove, F, Yeargin-Allsopp, M, Decoufle, P. Prevalence of autism in a United States population: the Brick Township, New Jersey, investigation. Pediatrics 2001; 108: 1155–61.CrossRefGoogle Scholar
18 Croen, LA, Grether, JK, Hoogstrate, J, Selvin, S. The changing prevalence of autism in California. J Autism Dev Disord 2002; 32: 207–15.Google Scholar
19 Yeargin-Allsopp, M, Rice, C, Karapurkar, T, Doernberg, N, Boyle, C, Murphy, C. Prevalence of autism in a US metropolitan area. JAMA 2003; 289: 4955.Google Scholar
20 Mattila, ML, Kielinen, M, Jussila, K, Linna, SL, Bloigu, R, Ebeling, H, et al. An epidemiological and diagnostic study of asperger syndrome according to four sets of diagnostic criteria. J Am Acad Child Adolesc Psychiatry 2007; 46: 636–46.CrossRefGoogle ScholarPubMed
21 Ehlers, S, Gillberg, C, Wing, L. A screening questionnaire for Asperger syndrome and other high-functioning autism spectrum disorders in school age children. J Autism Dev Disord 1999; 29: 129–41.Google Scholar
22 Williams, J, Scott, F, Stott, C, Allison, C, Bolton, P, Baron-Cohen, S, et al. The CAST (Childhood Asperger Syndrome Test): test accuracy. Autism 2005; 9: 4568.Google Scholar
23 Office for National Statistics. The National Statistics Socio-economic Classification (NS-SEC). ONS, 2002 (http://www.statistics.gov.uk/nsbase/methods_quality/ns_sec/default.asp).Google Scholar
24 Lord, C, Risi, S, Lambrecht, L, Cook, EH Jr, Leventhal, BL, DiLavore, PC, et al. The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord 2000; 30: 205–23.Google Scholar
25 Lord, C, Rutter, M, Le Couteur, A. Autism Diagnostic Interview – Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord 1994; 24: 659–85.CrossRefGoogle ScholarPubMed
26 Williams, J, Allison, C, Scott, F, Stott, C, Bolton, P, Baron-Cohen, S, et al. The Childhood Asperger Syndrome Test (CAST): test–retest reliability. Autism 2006; 10: 415–27.CrossRefGoogle ScholarPubMed
27 Allison, C, Williams, J, Scott, F, Stott, C, Bolton, P, Baron-Cohen, S, et al. The Childhood Asperger Syndrome Test (CAST): test–retest reliability in a high scoring sample. Autism 2007; 11: 173–85.Google Scholar
28 Ronald, A, Happe, F, Bolton, P, Butcher, LM, Price, TS, Wheelwright, S, et al. Genetic heterogeneity between the three components of the autism spectrum: a twin study. J Am Acad Child Adolesc Psychiatry 2006; 45: 691–9.Google Scholar
29 Bishop, DV, Norbury, CF. Exploring the borderlands of autistic disorder and specific language impairment: a study using standardised diagnostic instruments. J Child Psychol Psychiatry 2002; 43: 917–29.Google Scholar
30 NOMIS – Official Labour Market Statistics. Census 2001. Office for National Statistics, 2001 (https://www.nomisweb.co.uk/default.asp).Google Scholar
31 Efron, B. Bootstrap methods: another look at the jackknife. Ann Stat 1979; 7: 126.Google Scholar
32 Rutter, M. Aetiology of autism: findings and questions. J Intellect Disabil Res 2005; 49: 231–8.CrossRefGoogle ScholarPubMed
33 Fombonne, E. The changing epidemiology of autism. J Applied Res Intell Dis 2005; 18: 281–94.Google Scholar
34 Gillberg, C, Cederlund, M, Lamberg, K, Zeijlon, L. Brief report: ‘the autism epidemic’. The registered prevalence of autism in a Swedish urban area. J Autism Dev Disord 2006; 36: 429–35.Google Scholar
35 Kadesjo, B, Gillberg, C, Hagberg, B. Brief report: autism and Asperger syndrome in seven-year-old children: a total population study. J Autism Dev Disord 1999; 29: 327–31.CrossRefGoogle ScholarPubMed
36 Rose, G, Barker, DJ. Conduct of surveys. BMJ 1978; 2: 1201–2.CrossRefGoogle ScholarPubMed
37 Posserud, MB, Lundervold, AJ, Gillberg, C. Autistic features in a total population of 7–9-year-old children assessed by the ASSQ (Autism Spectrum Screening Questionnaire). J Child Psychol Psychiatry 2006; 47: 167–75.CrossRefGoogle Scholar
38 Department for Children, Schools and Families. Education and training statistics for the United Kingdom 2007. National Statistics, 2007 (http://www.dcsf.gov.uk/rsgateway/DB/VOL/v000761/index.shtml).Google Scholar
39 Ehlers, S, Gillberg, C. The epidemiology of Asperger syndrome. A total population study. J Child Psychol Psychiatry 1993; 34: 1327–50.CrossRefGoogle ScholarPubMed
40 Wing, L. Sex ratios in early childhood autism and related conditions. Psychiatry Res 1981; 5: 129–37.Google Scholar
41 Lutchmaya, S, Baron-Cohen, S, Raggatt, P. Foetal testosterone and eye contact in 12-month-old human infants. Infant Behav Dev 2002; 25: 327–35.Google Scholar
42 Lutchmaya, S, Baron-Cohen, S, Raggatt, P. Foetal testosterone and vocabulary size in 18- and 24-month-old infants. Infant Behav Dev 2002; 24: 418–24.Google Scholar
43 Williams, JG, Allison, C, Scott, FJ, Bolton, PF, Baron-Cohen, S, Matthews, FE, et al. The Childhood Autism Spectrum Test (CAST): sex differences. J Autism Dev Disord 2008; 38: 1731–9.Google Scholar
44 Holliday-Willey, L. Pretending to be Normal. Living with Asperger's Syndrome. Jessica Kingsley Publishers, 1999.Google Scholar
45 Kopp, S, Gillberg, C. Girls with social deficits and learning problems: autism, atypical Asperger syndrome or a variant of these conditions. Eur Child Adolesc Psychiatry 1992; 1: 8999.CrossRefGoogle ScholarPubMed
46 Wolff, S, McGuire, RJ. Schizoid personality in girls: a follow-up study – what are the links with Asperger's syndrome? J Child Psychol Psychiatry 1995; 36: 793817.CrossRefGoogle ScholarPubMed
47 Allison, C, Baron-Cohen, S, Wheelwright, S, Charman, T, Richler, J, Pasco, G, et al. The Q-CHAT (Quantitative CHecklist for Autism in Toddlers): a normally distributed quantitative measure of autistic traits at 18–24 months of age: preliminary report. J Autism Dev Disord 2008; 38: 1414–25.CrossRefGoogle ScholarPubMed
39 Ehlers, S, Gillberg, C. The epidemiology of Asperger syndrome. A total population study. J Child Psychol Psychiatry 1993; 34: 1327–50.CrossRefGoogle ScholarPubMed
40 Wing, L. Sex ratios in early childhood autism and related conditions. Psychiatry Res 1981; 5: 129–37.Google Scholar
41 Lutchmaya, S, Baron-Cohen, S, Raggatt, P. Foetal testosterone and eye contact in 12-month-old human infants. Infant Behav Dev 2002; 25: 327–35.Google Scholar
42 Lutchmaya, S, Baron-Cohen, S, Raggatt, P. Foetal testosterone and vocabulary size in 18- and 24-month-old infants. Infant Behav Dev 2002; 24: 418–24.Google Scholar
43 Williams, JG, Allison, C, Scott, FJ, Bolton, PF, Baron-Cohen, S, Matthews, FE, et al. The Childhood Autism Spectrum Test (CAST): sex differences. J Autism Dev Disord 2008; 38: 1731–9.Google Scholar
44 Holliday-Willey, L. Pretending to be Normal. Living with Asperger's Syndrome. Jessica Kingsley Publishers, 1999.Google Scholar
45 Kopp, S, Gillberg, C. Girls with social deficits and learning problems: autism, atypical Asperger syndrome or a variant of these conditions. Eur Child Adolesc Psychiatry 1992; 1: 8999.Google Scholar
46 Wolff, S, McGuire, RJ. Schizoid personality in girls: a follow-up study – what are the links with Asperger's syndrome? J Child Psychol Psychiatry 1995; 36: 793817.Google Scholar
47 Allison, C, Baron-Cohen, S, Wheelwright, S, Charman, T, Richler, J, Pasco, G, et al. The Q-CHAT (Quantitative CHecklist for Autism in Toddlers): a normally distributed quantitative measure of autistic traits at 18–24 months of age: preliminary report. J Autism Dev Disord 2008; 38: 1414–25.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Baron-Cohen et al. supplementary material

Appendix 1

Download Baron-Cohen et al. supplementary material(PDF)
PDF 27.5 KB
Submit a response

eLetters

No eLetters have been published for this article.