Autism spectrum disorder prevalence and associated sociodemographic factors in the school population: EPINED study.
Active school screening in Spain caught twice as many kids with ASD as official records claimed.
01Research in Context
What this study did
The team visited every school in Tarragona, Spain. They screened kids of all ages for autism signs. Then they checked each flagged child with full tests.
Parents also answered questions about family income, language, and education. The goal was to see how many kids truly had ASD, not just those with a clinic file.
What they found
One in every 65 pupils had ASD. That is almost twice the number listed in the regional disability registry.
Most cases were mild or moderate. Only seven percent showed severe traits.
How this fits with other research
Morales-Hidalgo et al. (2018) ran a similar Spanish survey three years earlier. Their rate was almost the same, so the new figure is a solid update, not a fluke.
Pillay et al. (2021) looked at South African schools the same year. They found only 0.08 percent. The huge gap is not biology—it is paperwork. South Africa lacks trained assessors, so most kids stay invisible.
van Bakel et al. (2015) used French clinic records and got 0.37 percent. Again, the lower number comes from waiting for families to reach clinics, not actively screening schools.
Why it matters
Your own district may mirror Tarragona: real prevalence double the listed count. Use wide school screens instead of waiting for outside diagnoses. Add Spanish-language tools and travel to lower-SES neighborhoods; those kids are the ones who slip through.
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02At a glance
03Original abstract
An increase in the prevalence of autism spectrum disorder has been reported around the world over the past decade. However, the prevalence data for southern Europe seem to be lower than international reports and notable methodological differences have been reported among studies. The objective of the Neurodevelopmental Disorders Epidemiological Research Project was to estimate the prevalence of autism spectrum disorder in a representative school sample of the province of Tarragona, Spain. The study included a screening procedure through parents (N = 3727) and teachers (N = 6894), and an individual assessment of children at risk and a comparison group (N = 781). The overall estimated prevalence in our sample was 1.53%, being significantly higher than the 0.83% previously registered diagnoses. A total of 3.31% of the children presented subclinical characteristics of autism spectrum disorder. Girls showed a significantly lower estimated prevalence in all the conditions. Severity profiles were distributed as 46% mild, 47% moderate and 7% severe. Psychological support (65%), educational support (65%) and language therapy (51%) were given to children with autism spectrum disorder. Pharmacological treatment was only found among school-aged children (37.5%). Public schools provided more educational supports (72%) than private schools (36%). The heterogeneity of autism spectrum disorder makes it difficult to determine specific associated sociodemographic factors. The results confirmed a high prevalence of autism spectrum disorder in the province, suggesting a current under-diagnosis in public health services. In view of the results, it is important to promote early diagnosis and intervention, especially in particular groups such as girls, children with intellectual disabilities and children from immigrant families.
Autism : the international journal of research and practice, 2021 · doi:10.1177/13623613211007717