Hostname: page-component-76d6cb85b7-jhrpq Total loading time: 0 Render date: 2026-07-11T02:47:33.544Z Has data issue: false hasContentIssue false
  • English
  • Français

The epidemiology and global burden of autism spectrum disorders

Published online by Cambridge University Press:  01 August 2014

A. J. Baxter ,
T. S. Brugha ,
H. E. Erskine ,
R. W. Scheurer ,
T. Vos  and
J. G. Scott
A. J. Baxter*
Affiliation:
School of Population Health, University of Queensland, Herston, Australia Queensland Centre for Mental Health Research, Wacol, Australia
T. S. Brugha
Affiliation:
Department of Health Sciences, University of Leicester, Leicester General Hospital, UK
H. E. Erskine
Affiliation:
School of Population Health, University of Queensland, Herston, Australia Queensland Centre for Mental Health Research, Wacol, Australia
R. W. Scheurer
Affiliation:
Queensland Centre for Mental Health Research, Wacol, Australia
T. Vos
Affiliation:
School of Population Health, University of Queensland, Herston, Australia Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
J. G. Scott
Affiliation:
Queensland Centre for Mental Health Research, Wacol, Australia University of Queensland Centre for Clinical Research, Herston, Australia Royal Brisbane and Women's Hospital, Herston, Australia
*
* Address for correspondence: A. J. Baxter, M.P.H., Queensland Centre for Mental Health Research, University of Queensland, Brisbane, QLD 4074, Australia. (Email: amanda_baxter@qcmhr.uq.edu.au)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Autism spectrum disorders (ASDs) are persistent disabling neurodevelopmental disorders clinically evident from early childhood. For the first time, the burden of ASDs has been estimated for the Global Burden of Disease Study 2010 (GBD 2010). The aims of this study were to develop global and regional prevalence models and estimate the global burden of disease of ASDs.

Method

A systematic review was conducted for epidemiological data (prevalence, incidence, remission and mortality risk) of autistic disorder and other ASDs. Data were pooled using a Bayesian meta-regression approach while adjusting for between-study variance to derive prevalence models. Burden was calculated in terms of years lived with disability (YLDs) and disability-adjusted life-years (DALYs), which are reported here by world region for 1990 and 2010.

Results

In 2010 there were an estimated 52 million cases of ASDs, equating to a prevalence of 7.6 per 1000 or one in 132 persons. After accounting for methodological variations, there was no clear evidence of a change in prevalence for autistic disorder or other ASDs between 1990 and 2010. Worldwide, there was little regional variation in the prevalence of ASDs. Globally, autistic disorders accounted for more than 58 DALYs per 100 000 population and other ASDs accounted for 53 DALYs per 100 000.

Conclusions

ASDs account for substantial health loss across the lifespan. Understanding the burden of ASDs is essential for effective policy making. An accurate epidemiological description of ASDs is needed to inform public health policy and to plan for education, housing and financial support services.

Keywords

Asperger's disorderautismautistic spectrum disordersburden of diseaseepidemiological studyepidemiologyglobal healthmental disordersprevalencepublic health

Information

Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 3 , February 2015 , pp. 601 - 613
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Ahmad, O, Boschi-Pinto, C, Lopez, A, Murray, C, Lozano, R, Inoue, M (2001). Age Standardization of Rates: A New WHO Standard. World Health Organization: Geneva.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). American Psychiatric Association: Washington, DC.Google Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). American Psychiatric Association: Washington, DC.Google Scholar
APA (2013). Desk Reference to the Diagnostic Criteria from DSM-5. American Psychiatric Publishing: Arlington, VA.Google Scholar
Baird, G, Simonoff, E, Pickles, A, Chandler, S, Loucas, T, Meldrum, D, Charman, T (2006). Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP). Lancet 368, 210–215.CrossRefGoogle Scholar
Baxter, AJ, Patton, G, Degenhardt, L, Scott, KM, Whiteford, HA (2013). Global epidemiology of mental disorders: what are we missing? PLoS One 8, e65514.CrossRefGoogle ScholarPubMed
Billstedt, E, Gillberg, C, Gillberg, C (2005). Autism after adolescence: population-based 13- to 22-year follow-up of 120 individuals with autism diagnosed in childhood. Journal of Autism and Developmental Disorders 33, 351–360.CrossRefGoogle Scholar
Blaxill, M, Baskin, D, Spitzer, W (2003). Commentary: Blaxill, Baskin, and Spitzer on Croen et al (2002), the changing prevalence of autism in California. Journal of Autism and Developmental Disorders 33, 223–226.CrossRefGoogle ScholarPubMed
Boyle, CA, Boulet, S, Schieve, LA, Cohen, RA, Blumberg, SJ, Yeargin-Allsopp, M, Visser, S, Kogan, MD (2011). Trends in the prevalence of developmental disabilities in US children, 1997-2008. Pediatrics 127, 1034–1042. CrossRefGoogle ScholarPubMed
Brugha, T, Cooper, S, McManus, S, Purdon, S, Smith, J, Scott, FJ, Spiers, N, Tyrer, F; the NHS Information Centre Community and Mental Health Team (2012). Estimating the Prevalence of Autism Spectrum Conditions in Adults – Extending the 2007 Adult Psychiatric Morbidity Survey. Health and Social Care Information Centre: London.Google Scholar
Brugha, TS, McManus, S, Bankart, J, Scott, F, Purdon, S, Smith, J, Bebbington, P, Jenkins, R, Meltzer, H (2011). Epidemiology of autism spectrum disorders in adults in the community in England. Archives of General Psychiatry 68, 459–466.CrossRefGoogle ScholarPubMed
Brugha, T, McManus, S, Meltzer, H, Smith, J, Scott, F, Purdon, S, Harris, J, Bankart, J (2009). Autism Spectrum Disorders in Adults Living in Households Throughout England. Report from the Adult Psychiatric Morbidity Survey 2007. The NHS Information Centre: London.Google Scholar
Cantwell, DP, Baker, L (1989). Stability and natural history of DSM-III childhood diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry 28, 691–700.CrossRefGoogle ScholarPubMed
Cederlund, M, Hagberg, B, Billstedt, E, Gillberg, IC, Gillberg, C (2008). Asperger syndrome and autism: a comparative longitudinal follow-up study more than 5 years after original diagnosis. Journal of Autism and Developmental Disorders 38, 72–85.CrossRefGoogle ScholarPubMed
Chakrabarti, S, Fombonne, E (2005). Pervasive developmental disorders in preschool children: confirmation of high prevalence. American Journal of Psychiatry 162, 1133–1141.CrossRefGoogle ScholarPubMed
Charman, T, Pickles, A, Chandler, S, Wing, L, Bryson, S, Simonoff, E, Loucas, T, Baird, G (2009). Commentary: effects of diagnostic thresholds and research vs service and administrative diagnosis on autism prevalence. International Journal of Epidemiology 38, 1234–1238.CrossRefGoogle ScholarPubMed
Croen, L, Grether, J (2003). Response: a response to Blaxill, Baskin, and Spitzer on Croen et al (2002), ‘The changing prevalence of autism in California’. Journal of Autism and Developmental Disorders 33, 227–229.CrossRefGoogle Scholar
Croen, LA, Grether, JK, Hoogstrate, J, Selvin, S (2002). The changing prevalence of autism in California. Journal of Autism and Developmental Disorders 32, 207–215.CrossRefGoogle ScholarPubMed
de Bildt, A, Sytema, S, Ketelaars, C, Kraijer, D, Mulder, E, Volkmar, F, Minderaa, R (2004). Interrelationship between Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview Revised (ADI-R), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) classification in children and adolescents with mental retardation. Journal of Autism and Developmental Disorders 34, 129–137.CrossRefGoogle ScholarPubMed
Dilavore, PC, Lord, C, Rutter, M (1995). The pre-linguistic autism diagnostic observation schedule. Journal of Autism and Developmental Disorders 25, 355–379.CrossRefGoogle ScholarPubMed
Erskine, HE, Ferrari, AJ, Polanczyk, GV, Moffitt, TE, Murray, CJL, Vos, T, Whiteford, HA, Scott, JG (2014). The global burden of conduct disorder and attention-deficit/hyperactivity disorder in 2010. Journal of Child Psychology and Psychiatry 55, 328–336.CrossRefGoogle ScholarPubMed
Faraone, SV, Biederman, J, Mick, E (2006). The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychological Medicine 36, 159–165.CrossRefGoogle ScholarPubMed
Fombonne, E (2008). Thimerosal disappears but autism remains. Archives of General Psychiatry 65, 15–16.CrossRefGoogle ScholarPubMed
Gillberg, C, Steffenburg, S, Schaumann, H (1991). Is autism more common now than 10 years ago? British Journal of Psychiatry 158, 403–409.CrossRefGoogle ScholarPubMed
Howlin, P, Goode, S, Hutton, J, Rutter, M (2004). Adult outcome for children with autism. Journal of Child Psychology and Psychiatry 45, 212–229.CrossRefGoogle ScholarPubMed
Kim, YS, Leventhal, BL, Koh, YJ, Fombonne, E, Laska, E, Lim, EC, Cheon, KA, Kim, SJ, Kim, YK, Lee, H, Song, DH, Grinker, RR (2011). Prevalence of autism spectrum disorders in a total population sample. American Journal of Psychiatry 168, 904–912.CrossRefGoogle Scholar
King, M, Bearman, P (2009). Diagnostic change and the increased prevalence of autism. International Journal of Epidemiology 38, 1224–1234.CrossRefGoogle ScholarPubMed
Kogan, MD, Strickland, BB, Blumberg, SJ, Singh, GK, Perrin, JM, van Dyck, PC (2008). A national profile of the health care experiences and family impact of autism spectrum disorder among children in the United States, 2005-2006. Pediatrics 122, e1149–e1158.CrossRefGoogle ScholarPubMed
Laidler, JR (2005). US Department of Education data on ‘autism’ are not reliable for tracking autism prevalence. Pediatrics 116, e120–e124.CrossRefGoogle Scholar
Lauritsen, MB, Pedersen, CB, Mortensen, PB (2004). The incidence and prevalence of pervasive developmental disorders: a Danish population-based study. Psychological Medicine 34, 1339–1346.CrossRefGoogle ScholarPubMed
Mattila, M-L, Kielinen, M, Jussila, K, Linna, S-L, Bloigu, R, Ebeling, H, Moilanen, I (2007). An epidemiological and diagnostic study of Asperger syndrome according to four sets of diagnostic criteria. Journal of the American Academy of Child and Adolescent Psychiatry 46, 636–646.CrossRefGoogle ScholarPubMed
Montiel-Nava, C, Pena, JA (2008). Epidemiological findings of pervasive developmental disorders in a Venezuelan study. Autism 12, 191–202.CrossRefGoogle Scholar
Mouridsen, SE, Bronnum-Hansen, H, Rich, B, Isager, T (2008). Mortality and causes of death in autism spectrum disorders: an update. Autism 12, 403–414.CrossRefGoogle ScholarPubMed
Murray, CJL, Ezzati, M, Flaxman, AD, Lim, S, Lozano, R, Michaud, C, Naghavi, M, Salomon, JA, Shibuya, K, Vos, T, Wikler, D, Lopez, AD (2012). GBD 2010: design, definitions, and metrics. Lancet 380, 2063–2066.CrossRefGoogle ScholarPubMed
Newschaffer, CJ, Croen, LA, Daniels, J, Giarelli, E, Grether, JK, Levy, SE, Mandell, DS, Miller, LA, Pinto-Martin, J, Reaven, J, Reynolds, AM, Rice, CE, Schendel, D, Windham, GC (2007). The epidemiology of autism spectrum disorders. Annual Review of Public Health 28, 235–258.CrossRefGoogle ScholarPubMed
Park, A (2009). Autism numbers are rising. The question is why? Time (http://content.time.com/time/health/article/0,8599,1948842,00.html). Accessed 30 June 2014.Google Scholar
Powell, JE, Edwards, A, Edwards, M, Pandit, BS, Sungum-Paliwal, SR, Whitehouse, W (2000). Changes in the incidence of childhood autism and other autistic spectrum disorders in preschool children from two areas of the West Midlands, UK. Developmental Medicine and Child Neurology 42, 624–628.Google ScholarPubMed
Salomon, JA, Vos, T, Hogan, DR, Gagnon, M, Naghavi, M, Mokdad, A, Begum, N, Shah, R, Karyana, M, Kosen, S, Farje, MR, Moncada, G, Dutta, A, Sazawal, S, Dyer, A, Seiler, J, Aboyans, V, Baker, L, Baxter, A, Benjamin, EJ, Bhalla, K, Abdulhak, AB, Blyth, F, Bourne, R, Braithwaite, T, Brooks, P, Brugha, TS, Bryan-Hancock, C, Buchbinder, R, Burney, P, Calabria, B, Chen, H, Chugh, SS, Cooley, R, Criqui, MH, Cross, M, Dabhadkar, KC, Dahodwala, N, Davis, A, Degenhardt, L, Díaz-Torné, C, Dorsey, ER, Driscoll, T, Edmond, K, Elbaz, A, Ezzati, M, Feigin, V, Ferri, CP, Flaxman, AD, Flood, L, Fransen, M, Fuse, K, Gabbe, BJ, Gillum, RF, Haagsma, J, Harrison, JE, Havmoeller, R, Hay, RJ, Hel-Baqui, A, Hoek, HW, Hoffman, H, Hogeland, E, Hoy, D, Jarvis, D, Karthikeyan, G, Knowlton, LM, Lathlean, T, Leasher, JL, Lim, SS, Lipshultz, SE, Lopez, AD, Lozano, R, Lyons, R, Malekzadeh, R, Marcenes, W, March, L, Margolis, DJ, McGill, N, McGrath, J, Mensah, GA, Meyer, A-C, Michaud, C, Moran, A, Mori, R, Murdoch, ME, Naldi, L, Newton, CR, Norman, R, Omer, SB, Osborne, R, Pearce, N, Perez-Ruiz, F, Perico, N, Pesudovs, K, Phillips, D, Pourmalek, F, Prince, M, Rehm, JT, Remuzzi, G, Richardson, K, Room, R, Saha, S, Sampson, U, Sanchez-Riera, L, Segui-Gomez, M, Shahraz, S, Shibuya, K, Singh, D, Sliwa, K, Smith, E, Soerjomataram, I, Steiner, T, Stolk, WA, Stovner, LJ, Sudfeld, C, Taylor, HR, Tleyjeh, IM, van der Werf, MJ, Watson, WL, Weatherall, DJ, Weintraub, R, Weisskopf, MG, Whiteford, H, Wilkinson, JD, Woolf, AD, Zheng, Z-J, Murray, CJL (2012). Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010. Lancet 380, 2129–2143.CrossRefGoogle ScholarPubMed
Scott, FJ, Baron-Cohen, S, Bolton, P, Brayne, C (2002). Brief report: prevalence of autism spectrum conditions in children aged 5–11 years in Cambridgeshire, UK. Autism 6, 231–237.CrossRefGoogle ScholarPubMed
Scott, JG, Duhig, M, Hamlyn, J, Norman, R (2013). Environmental contributions to autism: explaining the rise in incidence of autistic spectrum disorders. Journal of Environmental Immunology and Toxicology 1, 75–79.CrossRefGoogle Scholar
Shavelle, RM, Strauss, DJ, Pickett, J (2001). Causes of death in autism. Journal of Autism and Developmental Disorders 31, 569–576.CrossRefGoogle ScholarPubMed
Sponheim, E, Skjeldal, O (1998). Autism and related disorders: epidemiological findings in a Norwegian study using ICD-10 diagnostic criteria. Journal of Autism and Developmental Disorders 28, 217–227.CrossRefGoogle Scholar
Vos, T, Flaxman, AD, Naghavi, M, Lozano, R, Michaud, C, Ezzati, M, Shibuya, K, Salomon, JA, Abdalla, S, Aboyans, V, Abraham, J, Ackerman, I, Aggarwal, R, Ahn, SY, Ali, MK, Alvarado, M, Anderson, HR, Anderson, LM, Andrews, KG, Atkinson, C, Baddour, LM, Bahalim, AN, Barker-Collo, S, Barrero, LH, Bartels, DH, Basáñez, M-G, Baxter, A, Bell, ML, Benjamin, EJ, Bennett, D, Bernabé, E, Bhalla, K, Bhandari, B, Bikbov, B, Abdulhak, AB, Birbeck, G, Black, JA, Blencowe, H, Blore, JD, Blyth, F, Bolliger, I, Bonaventure, A, Boufous, S, Bourne, R, Boussinesq, M, Braithwaite, T, Brayne, C, Bridgett, L, Brooker, S, Brooks, P, Brugha, TS, Bryan-Hancock, C, Bucello, C, Buchbinder, R, Buckle, G, Budke, CM, Burch, M, Burney, P, Burstein, R, Calabria, B, Campbell, B, Canter, CE, Carabin, H, Carapetis, J, Carmona, L, Cella, C, Charlson, F, Chen, H, Cheng, AT-A, Chou, D, Chugh, SS, Coffeng, LE, Colan, SD, Colquhoun, S, Colson, KE, Condon, J, Connor, MD, Cooper, LT, Corriere, M, Cortinovis, M, de Vaccaro, KC, Couser, W, Cowie, BC, Criqui, MH, Cross, M, Dabhadkar, KC, Dahiya, M, Dahodwala, N, Damsere-Derry, J, Danaei, G, Davis, A, De Leo, D, Degenhardt, L, Dellavalle, R, Delossantos, A, Denenberg, J, Derrett, S, Des Jarlais, DC, Dharmaratne, SD, Dherani, M, Diaz-Torne, C, Dolk, H, Dorsey, ER, Driscoll, T, Duber, H, Ebel, B, Edmond, K, Elbaz, A, Ali, SE, Erskine, H, Erwin, PJ, Espindola, P, Ewoigbokhan, SE, Farzadfar, F, Feigin, V, Felson, DT, Ferrari, A, Ferri, CP, Fèvre, EM, Finucane, MM, Flaxman, S, Flood, L, Foreman, K, Forouzanfar, MH, Fowkes, FGR, Franklin, R, Fransen, M, Freeman, MK, Gabbe, BJ, Gabriel, SE, Gakidou, E, Ganatra, HA, Garcia, B, Gaspari, F, Gillum, RF, Gmel, G, Gosselin, R, Grainger, R, Groeger, J, Guillemin, F, Gunnell, D, Gupta, R, Haagsma, J, Hagan, H, Halasa, YA, Hall, W, Haring, D, Haro, JM, Harrison, JE, Havmoeller, R, Hay, RJ, Higashi, H, Hill, C, Hoen, B, Hoffman, H, Hotez, PJ, Hoy, D, Huang, JJ, Ibeanusi, SE, Jacobsen, KH, James, SL, Jarvis, D, Jasrasaria, R, Jayaraman, S, Johns, N, Jonas, JB, Karthikeyan, G, Kassebaum, N, Kawakami, N, Keren, A, Khoo, J-P, King, CH, Knowlton, LM, Kobusingye, O, Koranteng, A, Krishnamurthi, R, Lalloo, R, Laslett, LL, Lathlean, T, Leasher, JL, Lee, YY, Leigh, J, Lim, SS, Limb, E, Lin, JK, Lipnick, M, Lipshultz, SE, Liu, W, Loane, M, Ohno, SL, Lyons, R, Ma, J, Mabweijano, J, MacIntyre, MF, Malekzadeh, R, Mallinger, L, Manivannan, S, Marcenes, W, March, L, Margolis, DJ, Marks, GB, Marks, R, Matsumori, A, Matzopoulos, R, Mayosi, BM, McAnulty, JH, McDermott, MM, McGill, N, McGrath, J, Medina-Mora, ME, Meltzer, M, Mensah, GA, Merriman, TR, Meyer, A-C, Miglioli, V, Miller, M, Miller, TR, Mitchell, PB, Mocumbi, AO, Moffitt, TE, Mokdad, AA, Monasta, L, Montico, M, Moradi-Lakeh, M, Moran, A, Morawska, L, Mori, R, Murdoch, ME, Mwaniki, MK, Naidoo, K, Nair, MN, Naldi, L, Narayan, KMV, Nelson, PK, Nelson, RG, Nevitt, MC, Newton, CR, Nolte, S, Norman, P, Norman, R, O'Donnell, M, O'Hanlon, S, Olives, C, Omer, SB, Ortblad, K, Osborne, R, Ozgediz, D, Page, A, Pahari, B, Pandian, JD, Rivero, AP, Patten, SB, Pearce, N, Padilla, RP, Perez-Ruiz, F, Perico, N, Pesudovs, K, Phillips, D, Phillips, MR, Pierce, K, Pion, S, Polanczyk, GV, Polinder, S, Pope, CA, Popova, S, Porrini, E, Pourmalek, F, Prince, M, Pullan, RL, Ramaiah, KD, Ranganathan, D, Razavi, H, Regan, M, Rehm, JT, Rein, DB, Remuzzi, G, Richardson, K, Rivara, FP, Roberts, T, Robinson, C, De Leòn, FR, Ronfani, L, Room, R, Rosenfeld, LC, Rushton, L, Sacco, RL, Saha, S, Sampson, U, Sanchez-Riera, L, Sanman, E, Schwebel, DC, Scott, JG, Segui-Gomez, M, Shahraz, S, Shepard, DS, Shin, H, Shivakoti, R, Singh, D, Singh, GM, Singh, JA, Singleton, J, Sleet, DA, Sliwa, K, Smith, E, Smith, JL, Stapelberg, NJC, Steer, A, Steiner, T, Stolk, WA, Stovner, LJ, Sudfeld, C, Syed, S, Tamburlini, G, Tavakkoli, M, Taylor, HR, Taylor, JA, Taylor, WJ, Thomas, B, Thomson, WM, Thurston, GD, Tleyjeh, IM, Tonelli, M, Towbin, JA, Truelsen, T, Tsilimbaris, MK, Ubeda, C, Undurraga, EA, van der Werf, MJ, van Os, J, Vavilala, MS, Venketasubramanian, N, Wang, M, Wang, W, Watt, K, Weatherall, DJ, Weinstock, MA, Weintraub, R, Weisskopf, MG, Weissman, MM, White, RA, Whiteford, H, Wiersma, ST, Wilkinson, JD, Williams, HC, Williams, SRM, Witt, E, Wolfe, F, Woolf, AD, Wulf, S, Yeh, P-H, Zaidi, AKM, Zheng, Z-J, Zonies, D, Lopez, AD, Murray, CJL (2012). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380, 2163–2196.CrossRefGoogle ScholarPubMed
Wazana, A, Bresnahan, M, Kline, J (2007). The autism epidemic: fact or artifact? Journal of the American Academy of Child and Adolescent Psychiatry 46, 721–730.CrossRefGoogle ScholarPubMed
Whiteford, HA, Degenhardt, L, Rehm, J, Baxter, AJ, Ferrari, AJ, Erskine, HE, Charlson, FJ, Norman, RE, Flaxman, AD, Johns, N, Burstein, R, Murray, CJL, Vos, T (2013). Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 382, 1575–1586.CrossRefGoogle ScholarPubMed
WHO (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. World Health Organization: Geneva.Google Scholar
Williams, K, Glasson, EJ, Wray, J, Tuck, M, Helmer, M, Bower, CI, Mellins, CM (2005). Incidence of autism spectrum disorders in children in two Australian states. Medical Journal of Australia 182, 108–111.CrossRefGoogle ScholarPubMed
Wing, L (1997). The autistic spectrum. Lancet 350, 1761–1766.Google ScholarPubMed
Wing, L, Potter, D (2002). The epidemiology of autistic spectrum disorders – is the prevalence rising? Mental Retardation and Developmental Disabilities Research and Reviews 8, 151–161.CrossRefGoogle ScholarPubMed
Wong, VC, Hui, SL (2008). Epidemiological study of autism spectrum disorder in China. Journal of Child Neurology 23, 67–72.CrossRefGoogle ScholarPubMed
World Bank (1993). World Development Report 1993: Investing in Health. Oxford University Press: New York.Google Scholar
Supplementary material: File

Baxter Supplementary Material

Appendix

Download Baxter Supplementary Material(File)
File 267.8 KB