title: Statistical analysis of twenty years (1993 to 2012) of data from mainland China's first intervention center for children with autism spectrum disorder.
abstract: BACKGROUND
  Autism spectrum disorder (ASD) is characterized by persistent deficits in social communication and interaction, and restrictive and repetitive patterns of behavior, interests or activities. This study aimed to analyze trends in ASD diagnosis and intervention in 20 years of data from the Beijing Stars and Rain Education Institute for Autism (SR), the first autism intervention center in mainland China, and from a recent survey of members of the Heart Alliance, an industry association of autism intervention centers in China.
  
  
  METHODS
  We analyzed the registration data at the SR from 1993 to 2012 for a total of 2,222 children who had a parent-reported diagnosis of ASD and 612 of 'autistic tendencies'. Most of the children who were the primary focus of our analyses were age six and under. We also analyzed results of a survey we conducted in 2013 of 100 member centers of the Heart Alliance. Generalized Estimating Equations, multiple linear regression and the Mann-Whitney test were used for data analysis. Statistically significant findings are reported here.
  
  
  RESULTS
  The number of hospitals where SR children received their diagnosis increased from several in the early 1990s to 276 at present. The proportion of 'autistic tendencies' diagnosis increased 2.04-fold from 1998 to 2012 and was higher for children diagnosed at a younger age. The mean age at first diagnosis of ASD or 'autistic tendencies' decreased by 0.27 years every decade. A higher level of parental education was statistically significantly associated with an earlier diagnosis of the child. The mean parental age at childbirth increased by about 1.48 years per decade, and the mean maternal age was 1.40 and 2.10 years higher than that in the national population censuses of 2000 and 2010, respectively. At the time of the survey 3,957 children with ASD were being trained at the 100 autism intervention centers. Ninety-seven of these centers opened after the year 2000. Economically underdeveloped regions are still underserved.
  
  
  CONCLUSIONS
  This study revealed encouraging trends and remaining challenges in ASD diagnosis and intervention among children at the SR over the past 20 years and the 100 autism intervention centers in China at present.
authors.affiliation: Center for Bioinformatics, State Key Laboratory of Protein and Plant Gene Research, School of Life Sciences, Peking University, No.5 Yiheyuan Road, Haidian District, Beijing, 100871 China.
authors.forename: Wei-Zhen
authors.initials: WZ
authors.lastname: Zhou
authors.affiliation: National Institute of Biological Sciences, No.7 Science Park Road, Zhongguancun Life Science Park, Beijing, 102206 China.
authors.forename: Adam Yongxin
authors.initials: AY
authors.lastname: Ye
authors.affiliation: Beijing Stars and Rain Education Institute for Autism, No.18 Shuangqiao East Road, Beijing, 100121 China.
authors.forename: Zhong-Kai
authors.initials: ZK
authors.lastname: Sun
authors.affiliation: Beijing Stars and Rain Education Institute for Autism, No.18 Shuangqiao East Road, Beijing, 100121 China.
authors.forename: Hope Huiping
authors.initials: HH
authors.lastname: Tian
authors.affiliation: Shanghai Parkway Health, No.51 Hongfeng Road, Jin Qiao, Pudong, Shanghai, 201206 China.
authors.forename: Tad Zhengzhang
authors.initials: TZ
authors.lastname: Pu
authors.affiliation: Yuning Psychiatry Clinic, No.6, Section 2, Fuxing South Road, Da'an District, Taipei, 10664 Taiwan.
authors.forename: Yu-Yu
authors.initials: YY
authors.lastname: Wu
authors.affiliation: National Institute of Biological Sciences, No.7 Science Park Road, Zhongguancun Life Science Park, Beijing, 102206 China.
authors.forename: Dan-Dan
authors.initials: DD
authors.lastname: Wang
authors.affiliation: National Institute of Biological Sciences, No.7 Science Park Road, Zhongguancun Life Science Park, Beijing, 102206 China.
authors.forename: Ming-Zhen
authors.initials: MZ
authors.lastname: Zhao
authors.affiliation: Center for Bioinformatics, State Key Laboratory of Protein and Plant Gene Research, School of Life Sciences, Peking University, No.5 Yiheyuan Road, Haidian District, Beijing, 100871 China.
authors.forename: Shu-Juan
authors.initials: SJ
authors.lastname: Lu
authors.affiliation: National Institute of Biological Sciences, No.7 Science Park Road, Zhongguancun Life Science Park, Beijing, 102206 China.
authors.forename: Chang-Hong
authors.initials: CH
authors.lastname: Yang
authors.affiliation: Center for Bioinformatics, State Key Laboratory of Protein and Plant Gene Research, School of Life Sciences, Peking University, No.5 Yiheyuan Road, Haidian District, Beijing, 100871 China ; National Institute of Biological Sciences, No.7 Science Park Road, Zhongguancun Life Science Park, Beijing, 102206 China.
authors.forename: Liping
authors.initials: L
authors.lastname: Wei
keywords: Autism spectrum disorder; China; Diagnosis; Intervention; Parental age