Prevalence of autism spectrum disorders in preschool children of Guangzhou kindergartens

Objective: To investigate the epidemic characteristics and related factors of autism spectrum disorders(ASDs) in preschool children of Guangzhou mainstream kindergartens.Methods: In this cross-sectional study,7500 children aged 2-6 years were selected from 21 kindergartens of 6 regions in Guangzhou City by multi-stage sampling method,who were preliminarily screened with the Clancy Autism Behavior Rating Scale(CABRS),children growth and development questionnaire and teacher nomination strategy.The children were observed,evaluated,and diagnosed to get the prevalence and related factors.Results:(1) The prevalence of ASDs in preschool children in Guangzhou mainstream kindergartens was 75.4/10000(95%CI 53.8/10 000-97.0/10000),and the rates were 29.5/10000(95%CI 16.1/10000-43.1/10000) for autism,with the proportion of 16.7% for high functioning autism(HFA),41.0/10000(95%CI 25.0/10 000-57.0/10 000) for Asperger syndrome(AS),4.9/10000(95%CI 0/10000-10.6/10000) for pervasive developmental disorder-not otherwise specified(including atypical autism).The sex ratio of male to female was 6.6 :1.(2) The teacher nomination strategy was used to preliminarily screen ASDs,and the sensitivity was 95.6%,specificity was 91.1%,Youden' s index was 0.867.(3) The proportion of higher maternal(25-29 years and 30-34 years) and paternal age(30-34 years and ≥35 years),higher maternal education(bachelor and above) and maternal emotional instability during the pregnant time in ASDs group were higher than those in the normal group(P0.05),and logistic analysis showed that male children,higher paternal age and maternal emotional instability were the risk factors to ASDs in children.Conclusion: The prevalence of autism spectrum disorders in preschool children in Guangzhou mainstream kindergartens is similar to that of foreign reports.The teacher nomination strategy shows good objectivity,high accuracy and high efficiency in screening stage,and could be used widely.