title: Epidemiological investigation of suspected autism in children and implications for healthcare system: a mainstream kindergarten-based population study in Longhua District, Shenzhen.
abstract: BACKGROUND
  Individuals with autism put a heavy demand on medical services, and prevalence estimates are needed for the planning of such services. Screening for autism in children has important implications for individuals and policy makers. This study aimed to estimate prevalence of suspected autism in children in Longhua District, Shenzhen, and to investigate risk factors for autism.
  
  
  METHODS
  A cross-sectional study was conducted in Longhua District, Shenzhen in October 2014. A total of 141 kindergartens were approached and consented to participate in the current study. All children who met the inclusion criteria were screened for autism by using the Autism Behavior Checklist (ABC).
  
  
  RESULTS
  15,200 children in total completed the survey and were included in the final analysis. 2.6 % (95 % CI 2.3-2.9) respondents had a high probability of autism, while 4.0 % (95 % CI 3.7-4.3) respondents had questionable autism. Male children were more likely to develop autism when compared with their female counterparts (P < 0.001). Children of mothers with a lower education level and younger age tended to develop autism (P < 0.001).
  
  
  CONCLUSIONS
  Our study shows a high prevalence rate of suspected autism in children which suggests an urgent need of early detection of autism with ABC across the Shenzhen city, or even around China. Further studies with diagnostic procedure are warranted. Maternal age and education level, and gender of children are possible factors related to autism.
authors.affiliation: Center for Maternal and Child Healthcare of Longhua District, Shenzhen, China. 9043948@qq.com.|Health Education Institute of Longhua District, Shenzhen, China. 9043948@qq.com.
authors.forename: Weikang
authors.initials: W
authors.lastname: Yang
authors.affiliation: Health Inspection Institute of Longhua District, Shenzhen, China. 37078763@qq.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Xia
authors.affiliation: Center for Maternal and Child Healthcare of Longhua District, Shenzhen, China. 402769941@qq.com.|Health Education Institute of Longhua District, Shenzhen, China. 402769941@qq.com.
authors.forename: Guoming
authors.initials: G
authors.lastname: Wen
authors.affiliation: School of Public Health, Sun Yat-Sen University, Guangzhou, China. 2305396242@qq.com.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: School of Medicine, Shenzhen University, Nanhai Ave 3688, Shenzhen, Guangdong, PR China. fuxy@szu.edu.cn.
authors.forename: Xiaoyuan
authors.initials: X
authors.lastname: Fu
authors.affiliation: School of Medicine, Shenzhen University, Nanhai Ave 3688, Shenzhen, Guangdong, PR China. lujq@szu.edu.cn.
authors.forename: Junqiang
authors.initials: J
authors.lastname: Lu
authors.affiliation: School of Medicine, Shenzhen University, Nanhai Ave 3688, Shenzhen, Guangdong, PR China. htli1223@szu.edu.cn.
authors.forename: Haitao
authors.initials: H
authors.lastname: Li
mesh_terms: D001321:Autistic Disorder / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution