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. 2013 Jul;128(1):45-53.
doi: 10.1111/acps.12034. Epub 2012 Nov 22.

Quantitative autistic traits ascertained in a national survey of 22 529 Japanese schoolchildren

Y Kamio  1 , N Inada, A Moriwaki, M Kuroda, T Koyama, H Tsujii, Y Kawakubo, H Kuwabara, K J Tsuchiya, Y Uno, J N Constantino
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Free PMC article

Quantitative autistic traits ascertained in a national survey of 22 529 Japanese schoolchildren

Y Kamio et al. Acta Psychiatr Scand. 2013 Jul.
Free PMC article

Abstract

Objective: Recent epidemiologic studies worldwide have documented a rise in prevalence rates for autism spectrum disorders (ASD). Broadening of diagnostic criteria for ASD may be a major contributor to the rise in prevalence, particularly if superimposed on an underlying continuous distribution of autistic traits. This study sought to determine the nature of the population distribution of autistic traits using a quantitative trait measure in a large national population sample of children.

Method: The Japanese version of the Social Responsiveness Scale (SRS) was completed by parents on a nationally representative sample of 22 529 children, age 6-15.

Results: Social Responsiveness Scale scores exhibited a skewed normal distribution in the Japanese population with a single-factor structure and no significant relation to IQ within the normal intellectual range. There was no evidence of a natural 'cutoff' that would differentiate populations of categorically affected children from unaffected children.

Conclusion: This study provides evidence of the continuous nature of autistic symptoms measured by the SRS, a validated quantitative trait measure. The findings reveal how paradigms for diagnosis that rest on arbitrarily imposed categorical cutoffs can result in substantial variation in prevalence estimation, especially when measurements used for case assignment are not standardized for a given population.

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Figures

Fig. 1
Fig. 1
Distribution of Social Responsiveness Scale (SRS) total raw scores rated by caregivers in the general sample of 6- to 15-year-old children.
Fig. 2
Fig. 2
Distribution of Social Responsiveness Scale (SRS) total raw scores in child psychiatric patients with and without autistic spectrum disorders (ASD).
Fig. 3
Fig. 3
Social Responsiveness Scale (SRS) total raw scores as a function of Autism Diagnostic Interview-Revised (ADI-R) total scores for children with autism spectrum disorders (ASD), non-ASD, and typical development (TD).
See this image and copyright information in PMC

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