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Prevalence and Cumulative Incidence of Autism Spectrum Disorders and the Patterns of Co-Occurring Neurodevelopmental Disorders in a Total Population Sample of 5-Years-Old Children

23 Pages Posted: 28 Mar 2019

See all articles by Manabu Saito

Manabu Saito

Hirosaki University - Department of Neuropsychiatry

Tomoya Hirota

Hirosaki University - Department of Neuropsychiatry

Yui Sakamoto

Hirosaki University - Department of Neuropsychiatry

Masaki Adachi

Hirosaki University - Research Center for Child Mental Development

Michio Takahashi

Hirosaki University - Research Center for Child Mental Development

Ayako Osato-Kaneda

Hirosaki University - Department of Neuropsychiatry

Young Shin Kim

University of California, San Francisco (UCSF) - Department of Psychiatry

Bennett Leventhal

University of California, San Francisco (UCSF) - Department of Psychiatry

Amy Shui

University of California, San Francisco (UCSF) - Department of Psychiatry

Sumi Kato

Aomori Chuo Gakuin University

Kazuhiko Nakamura

Hirosaki University - Department of Neuropsychiatry; Hirosaki University - Research Center for Child Mental Development

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Abstract

Background: Whether there is a true increase in Autism Spectrum Disorder (ASD) frequency or not remains unclear. Additionally, the rates of co-existing neurodevelopmental disorders (NDD) in a total population sample hasn't been fully examined before.

Methods: All 5-year-old children in the catchment area in Japan underwent the screening annually from the year 2013 - 2016. Screen-positive children were invited to a comprehensive assessment, including child and parent interview, behavioral observation, and cognitive and motor function testing. All cases were reviewed by a multidisciplinary team. ASD prevalence and cumulative incidence were computed.

Outcomes: Caregivers of 3,954 children returned the screening, among which 559 children underwent the assessment with 87 children receiving an ASD diagnosis. Adjusted ASD prevalence was 3.22% (95% Confidence Interval (CI): 2.66 - 3.76). The male to female ratio of the crude prevalence was 2.2:1. The cumulative incidence of ASD up to 5 years of age for the total study years was 1.31 (95% CI: 1.00 - 1.62). A generalized linear model revealed no significant linear trends in 5-year cumulative incidence over the study years. Only 11.5% of children had ASD alone; the remaining 88.5% were found to have at least one co-existing NDD.

Interpretation: Our findings demonstrate the stability of the 5-year cumulative incidence of ASD, implying no true rise in ASD incident cases over the 4-year study period in the study catchment area. High rates of co-existing NDDs reflect the importance of investigating broad developmental challenges in ASD children.

Funding: Grants-in-Aid for Scientific Research and Hirosaki Institute of Neuroscience.

Declaration of Interest: The authors have no financial relationships relevant to this article to disclose.

Ethical Approval: This study was approved by the Committee of Medical Ethics of Hirosaki University Graduate School of Medicine. Moreover, the information security policies of the city and committee were followed to protect the personal data of the participants.

Keywords: Autism Spectrum Disorder, a total population sample, prevalence, cumulative incidence

Suggested Citation

Saito, Manabu and Hirota, Tomoya and Sakamoto, Yui and Adachi, Masaki and Takahashi, Michio and Osato-Kaneda, Ayako and Kim, Young Shin and Leventhal, Bennett and Shui, Amy and Kato, Sumi and Nakamura, Kazuhiko, Prevalence and Cumulative Incidence of Autism Spectrum Disorders and the Patterns of Co-Occurring Neurodevelopmental Disorders in a Total Population Sample of 5-Years-Old Children (March 26, 2019). Available at SSRN: https://ssrn.com/abstract=3360118 or http://dx.doi.org/10.2139/ssrn.3360118

Manabu Saito

Hirosaki University - Department of Neuropsychiatry

Hirosaki
Japan

Tomoya Hirota

Hirosaki University - Department of Neuropsychiatry

Hirosaki
Japan

Yui Sakamoto

Hirosaki University - Department of Neuropsychiatry

Hirosaki
Japan

Masaki Adachi

Hirosaki University - Research Center for Child Mental Development

Hirosaki
Japan

Michio Takahashi

Hirosaki University - Research Center for Child Mental Development

Hirosaki
Japan

Ayako Osato-Kaneda

Hirosaki University - Department of Neuropsychiatry

Hirosaki
Japan

Young Shin Kim

University of California, San Francisco (UCSF) - Department of Psychiatry

982 Mission St
San Francisco, CA 94103
United States

Bennett Leventhal

University of California, San Francisco (UCSF) - Department of Psychiatry

982 Mission St
San Francisco, CA 94103
United States

Amy Shui

University of California, San Francisco (UCSF) - Department of Psychiatry

982 Mission St
San Francisco, CA 94103
United States

Sumi Kato

Aomori Chuo Gakuin University

Aomori
Japan

Kazuhiko Nakamura (Contact Author)

Hirosaki University - Department of Neuropsychiatry ( email )

Hirosaki
Japan

Hirosaki University - Research Center for Child Mental Development ( email )

Hirosaki
Japan

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