title: Prevalence of autism spectrum disorders in a total population sample.
abstract: OBJECTIVE
  Experts disagree about the causes and significance of the recent increases in the prevalence of autism spectrum disorders (ASDs). Limited data on population base rates contribute to this uncertainty. Using a population-based sample, the authors sought to estimate the prevalence and describe the clinical characteristics of ASDs in school-age children.
  
  
  METHODS
  The target population was all 7- to 12-year-old children (N=55,266) in a South Korean community; the study used a high-probability group from special education schools and a disability registry and a low-probability, general-population sample from regular schools. To identify cases, the authors used the Autism Spectrum Screening Questionnaire for systematic, multi-informant screening. Parents of children who screened positive were offered comprehensive assessments using standardized diagnostic procedures.
  
  
  RESULTS
  The prevalence of ASDs was estimated to be 2.64% (95% CI=1.91-3.37), with 1.89% (95% CI=1.43-2.36) in the general-population sample and 0.75% (95% CI=0.58-0.93) in the high-probability group. ASD characteristics differed between the two groups: the male-to-female ratios were 2.5:1 and 5.1:1 in the general population sample and high-probability group, respectively, and the ratios of autistic disorders to other ASD subtypes were 1:2.6 and 2.6:1, respectively; 12% in the general-population sample had superior IQs, compared with 7% in the high-probability group; and 16% in the general-population sample had intellectual disability, compared with 59% in the high-probability group.
  
  
  CONCLUSIONS
  Two-thirds of ASD cases in the overall sample were in the mainstream school population, undiagnosed and untreated. These findings suggest that rigorous screening and comprehensive population coverage are necessary to produce more accurate ASD prevalence estimates and underscore the need for better detection, assessment, and services.
authors.affiliation: Child Study Center, Yale University School of Medicine, New Haven, CT 06520, USA. young-shin.kim@yale.edu
authors.forename: Young Shin
authors.initials: YS
authors.lastname: Kim
authors.forename: Bennett L
authors.initials: BL
authors.lastname: Leventhal
authors.forename: Yun-Joo
authors.initials: YJ
authors.lastname: Koh
authors.forename: Eric
authors.initials: E
authors.lastname: Fombonne
authors.forename: Eugene
authors.initials: E
authors.lastname: Laska
authors.forename: Eun-Chung
authors.initials: EC
authors.lastname: Lim
authors.forename: Keun-Ah
authors.initials: KA
authors.lastname: Cheon
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Kim
authors.forename: Young-Key
authors.initials: YK
authors.lastname: Kim
authors.forename: Hyunkyung
authors.initials: H
authors.lastname: Lee
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Song
authors.forename: Roy Richard
authors.initials: RR
authors.lastname: Grinker
mesh_terms: D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D004519:Education, Special / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007360:Intelligence; D008282:Mainstreaming, Education / Q000706:statistics & numerical data; D008297:Male; D056910:Republic of Korea; D012737:Sex Factors; D011795:Surveys and Questionnaires