Autism spectrum disorder in a rural community in Bangladesh: A mid-childhood assessment.
Rural Bangladesh has 1–4 autistic kids per 1,000 aged 8–11, with boys leading and ADOS-2 picking up more cases than ADI-R.
01Research in Context
What this study did
Ali et al. (2022) went door-to-door in rural Bangladesh villages. They screened 8- to 11-year-olds with two gold-standard tools: ADOS-2 and ADI-R.
The team wanted the first clear count of autism in this age group outside cities.
What they found
ADOS-2 flagged 40 kids per 10,000. ADI-R caught only 12 per 10,000.
Boys showed up more often than girls in both counts.
How this fits with other research
The numbers sit between old lows and new highs. Gaily et al. (1998) in Norway saw just 4–5 per 10,000 with ICD-10, so Bangladesh is higher.
Mansell et al. (2002) in Cambridgeshire found 57 per 10,000 among same-age kids—almost matching the ADOS-2 result.
Wong et al. (2025) in Hong Kong report 2.57 %—far above Bangladesh—yet both studies note boys outnumber girls.
Laposa et al. (2017) later showed parents in this same rural area want help after screening, turning the count into action.
Why it matters
You now have a baseline for rural Bangladesh: roughly 1–4 autistic children per 1,000 in third to fifth grade. When you screen, expect fewer girls and know ADI-R may miss cases ADOS-2 catches. Use both tools if you need to be sure, and plan for more boys in your caseload.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Run ADOS-2 first in rural screenings; schedule ADI-R only for kids who pass ADOS-2 to save time and catch more boys who might otherwise be missed.
02At a glance
03Original abstract
Population-based studies employing standardized diagnostics are needed to determine the burden of autism spectrum disorder (ASD) in low-resource settings. A community-based study was conducted among 8-11 year old children in rural, northwestern Bangladesh to establish the prevalence of ASD. A standardized screening and diagnosis protocol was adapted and deployed comprising the social communication questionnaire (SCQ), and the autism diagnostic observation schedule 2, (ADOS-2), and the autism diagnostic interview, revised (ADI-R), respectively. A year-long research training was conducted for a clinical psychologist to be certified to administer ADOS-2 and ADI-R. Over 8000 children were visited at home and administered the SCQ leading to some, based on their score, being further evaluated using the ADOS-2 and ADI-R by the clinical psychologist. Based on ADOS-2 applying the diagnoses of autism or autism spectrum, the prevalence was 40 (95% CI: 27, 54) per 10,000. Autistic disorder using ADI-R was found at 12 (95% CI: 5, 20) per 10,000. Boys were at a higher risk than girls with the rates among boys being 46 (95% CI: 25, 67) using ADOS-2 and 19 (95% CI:6, 33) using ADI-R. Among girls the rates were 34 (95% CI:16, 52) and 5 (95% CI:0, 12) per 10,000, respectively. Challenges to undertaking ASD research in a rural South Asian context are discussed. There was a low-to-moderate prevalence of ASD in a rural, child population in Bangladesh. Future research is needed to estimate rates of ASD and its causes and socioeconomic consequences in rural and urban settings of South Asia. LAY SUMMARY: In a study of over 8000, 8-11 year old children in a rural area of Bangladesh, two to four out of 1000 had ASD. Boys more than girls had ASD. Conducting ASD assessment in this setting was difficult, but more such research is needed to understand what causes ASD and its consequences for the individual, families and the society in rural and urban areas of low-income countries.
Autism research : official journal of the International Society for Autism Research, 2022 · doi:10.1002/aur.2651