Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 9:14:1071181.
doi: 10.3389/fpsyt.2023.1071181. eCollection 2023.

The global prevalence of autism spectrum disorder: A three-level meta-analysis

Oksana I Talantseva  1   2 , Raisa S Romanova  1 , Ekaterina M Shurdova  2 , Tatiana A Dolgorukova  2 , Polina S Sologub  2 , Olga S Titova  2 , Daria F Kleeva  3 , Elena L Grigorenko  1   2   4   5   6
Affiliations

The global prevalence of autism spectrum disorder: A three-level meta-analysis

Oksana I Talantseva et al. Front Psychiatry. .

Abstract

Autism spectrum disorder (ASD) is one the most disabling developmental disorders, imposing an extremely high economic burden. Obtaining as accurate prevalence estimates as possible is crucial to guide governments in planning policies for identification and intervention for individuals with ASD and their relatives. The precision of prevalence estimates can be heightened by summative analyses of the data collected around the world. To that end, we conducted a three-level mixed-effects meta-analysis. A systematic search of the Web of Science, PubMed, EMBASE, and PsycINFO databases from 2000 up to 13 July 2020 was performed, and reference lists of previous reviews and existing databases of prevalence studies were screened. Overall, 79 studies were included in the analysis of ASD and 59-in the analysis of previously existing relevant diagnoses: 30 for Autistic Disorder (AD), 15 for Asperger Syndrome (AS), and 14 for Atypical Autism (AA) and Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS); these research reports covered the period from 1994 to 2019. Pooled prevalence estimates were 0.72% (95% CI = 0.61-0.85) for ASD, 0.25% (95% CI = 0.18-0.33) for AD, 0.13% (95% CI = 0.07-0.20) for AS, and 0.18% (95% CI = 0.10-0.28) for the combined group of AA and PDD-NOS. Estimates were higher (1) for the studies that used records-review surveillance rather than other designs; (2) in North America compared with other geographical regions; and (3) in high-income compared with lower-income countries. The highest prevalence estimates were registered in the USA. There was an increase in autism prevalence estimates over time. The prevalence was also significantly higher for children aged between 6 and 12 years compared to children under the age of 5 and over the age of 13 years.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019131525, identifier CRD42019131525.

Keywords: autism; epidemiology; meta-analysis; prevalence; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Search strategy. PRISMA flow diagram.
FIGURE 2
FIGURE 2
The distribution of the total variance for ASD.
FIGURE 3
FIGURE 3
The meta-regression analysis of the effect of the HDI on the pooled prevalence of ASD.
FIGURE 4
FIGURE 4
The meta-regression analysis of the effect of the study time on the pooled prevalence of ASD.
FIGURE 5
FIGURE 5
Influential observations by Cooks distance. 18—Hewitt et al. (43); 33—Zahorodny et al. (37); 42—Akhter et al. (44); 125—Kim et al. (47); 130—Aguilera et al. (38); 142—Baio et al. (45); 157—Maenner et al. (46); 202—Shaw et al. (48).
See this image and copyright information in PMC

References

    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Washington, D.C: American Psychiatric Association; (2013). 947 p. 10.1176/appi.books.9780890425596 - DOI
    1. Icd-11 for Mortality and Morbidity Statistics. (2022). Available online at: https://icd.who.int/browse11/l-m/en (accessed October 11, 2022).
    1. Nevill R, Hedley D, Uljarević M, Sahin E, Zadek J, Butter E, et al. Language profiles in young children with autism spectrum disorder: a community sample using multiple assessment instruments. Autism. (2019) 23:141–53. 10.1177/1362361317726245 - DOI - PubMed
    1. Munson J, Dawson G, Sterling L, Beauchaine T, Zhou A, Koehler E, et al. Evidence for latent classes of IQ in young children with autism spectrum disorder. Am J Ment Retard. (2008) 113:439–52. 10.1352/2008.113:439-452 - DOI - PMC - PubMed
    1. Lai M, Kassee C, Besney R, Bonato S, Hull L, Mandy W, et al. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry. (2019) 6:819–29. 10.1016/S2215-0366(19)30289-5 - DOI - PubMed

Publication types