In The Politics of Autism, I discuss the uncertainty surrounding estimates of autism prevalence. c
Elana Gotkine at MedicalXpress:
Damian Santomauro, Ph.D., from the University of Queensland in Archerfield, Australia, and colleagues conducted a systematic literature review to estimate the global prevalence and health burden of autism spectrum disorder.From: Damian F Santomauro et al, The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021, The Lancet Psychiatry (2024). DOI: 10.1016/S2215-0366(24)00363-8
The researchers found that in 2021, an estimated 61.8 million individuals were on the autism spectrum globally. The global age-standardized prevalence was 788.3 per 100,000 people, which was equivalent to 1,064.7 and 508.1 males and females with autism per 100,000 males and females, respectively.
Globally, autism spectrum disorder accounted for 11.5 million disability-adjusted life-years (DALYs), which was equivalent to 147.6 DALYs per 100,000 people. Age-standardized DALY rates varied from 126.5 to 204.1 per 100,000 people in Southeast Asia, East Asia, and Oceania and in the high-income super region, respectively. Across the lifespan, DALYs were evident, emerging for children younger than 5 years (169.2 DALYs per 100,000 people) and decreasing with age (163.4 and 137.7 DALYs per 100,00 people aged younger than 20 and aged 20 years or older, respectively). For people younger than 20 years, autism spectrum disorder was ranked within the top 10 causes of nonfatal health burden.
Prevalence did not vary substantially over time. Studies reporting an increase in the prevalence of the autism spectrum have often relied on registries or administrative records to determine prevalence. Studies using random sampling or consistent active-case finding did not show this trend. This finding aligns with previous work suggesting autistic characteristics in the population have remained stable over time despite a rise in registered diagnoses.32 Nonetheless, the absence of temporal trends in our analysis should be interpreted with caution as we relied on a 15-year time window (reduced from 25 years) to model prevalence data. This time window might have limited our ability to explore temporal trends, but a further reduction was not possible because of data sparsity.
Autism spectrum disorder ranked within the top-ten causes of non-fatal health burden for young people (age <20 years), emphasising the need for early detection and developmental support for autistic people.3,4,33 Most epidemiological investigations into the autism spectrum have been predominantly centred on children and adolescents, leaving a gap in our understanding of the autism spectrum in adults. The prevalence and health burden of autism spectrum disorder persisted across the lifespan, beginning to decline from age 60 years. DisMod MR 2.1 estimated prevalence while also taking into consideration data available from other epidemiological parameters. In this case, with most of our raw prevalence data limited to younger cohorts, the age pattern in prevalence was informed by excess mortality data modelled by DisMod-MR 2.1 because of limited available prevalence data in adulthood. Because of limited data availability, all mortality data sourced from the systematic review relied on passive case finding (eg, from administrative records). This method might overestimate excess mortality for all autistic people, leading to an underestimation of prevalence in adulthood.
32. Lundström, S ∙ Reichenberg, A ∙ Anckarsäter, H ∙ et al.
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33. Peters-Scheffer, N ∙ Didden, R ∙ Korzilius, H ∙ et al. A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with autism spectrum disordersRes Autism Spect Disorder. 2011; 5:60-6 Crossref Scopus (0) Google Scholar
