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. 2018 Oct;48(10):3483-3498.
doi: 10.1007/s10803-018-3610-1.

The Estimated Prevalence of Autism in School-Aged Children Living in Rural Nepal Using a Population-Based Screening Tool

Michelle Heys  1   2 , Felicity Gibbons  3 , Ed Haworth  4 , Emilie Medeiros  5 , Kirti Man Tumbahangphe  6 , Mary Wickenden  5 , Merina Shrestha  7   8 , Anthony Costello  5   9 , Dharma Manandhar  6 , Elizabeth Pellicano  10   11
Affiliations

The Estimated Prevalence of Autism in School-Aged Children Living in Rural Nepal Using a Population-Based Screening Tool

Michelle Heys et al. J Autism Dev Disord. 2018 Oct.

Abstract

Few data exist on the prevalence of autism in low-income countries. We translated, adapted and tested the acceptability of a Nepali-language version of a screening tool for autism (Autism Quotient-10). Using this tool, we estimated autism prevalence in 4098 rural Nepali children aged 9-13 years. Fourteen children scored > 6 out of 10, indicative of elevated autistic symptomatology, of which 13 also screened positive for disability. If the AQ-10 screening tool is as sensitive and specific in the Nepali population as it is in the UK, this would yield an estimated true prevalence of 3 in 1000 (95% confidence interval 2-5 in 1000). Future research is required to validate this tool through in-depth assessments of high-scoring children.

Keywords: Autism; Prevalence; Screening.

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Conflict of interest statement

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

Ethical approval was obtained from the University College London ethics committee (Project ID: 5143/002) and the Nepal Health Research Council (Reg.no.L99/2OL3). All procedures performed in studies involving human participants were in accordance with the ethical standards of the university and the Nepali national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

All participants gave informed verbal consent prior to participation, which is more culturally appropriate in this setting than written consent and suited to the low educational achievement/level and literacy rates of the participants.

Figures

Fig. 1
Fig. 1
Participant flow chart from baseline to follow-up in rounds 1 and 2
Fig. 2
Fig. 2
Proportion of children by AQ10 score. Proportions are shown for four groups of children, namely: (1) all children, (2) children who screen positive for MCFD-core; (3) children who screen positive for MCFD-extended and (4) children who screen positive for MCFD-extended questions most intuitively associated with autism symptomatology—MCFD-autism. AQ-10 Autism quotient-10, MCFD module of child functioning and disability
See this image and copyright information in PMC

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