Gender and geographic differences in the prevalence of autism spectrum disorders in children: analysis of data from the national disability registry of Taiwan.
Taiwan’s whole-country data show autism keeps rising, boys and city kids still lead, but the rural gap can shrink if we screen and refer sooner.
01Research in Context
What this study did
Lai et al. (2012) counted every child with autism in Taiwan. They used the island’s national disability registry from 2004 to 2010. Kids were aged 3 to 17.
The team split counts by boys versus girls and by big cities versus small towns or farms.
What they found
Autism numbers rose every single year. Boys stayed 5–6 times more likely to be listed than girls. City kids stayed 2–3 times more likely than rural kids.
The city edge got a little smaller over the seven years, but the boy edge did not.
How this fits with other research
The same registry shows the climb kept going past 2010. Lai et al. (2013) widened the view to all disabilities and still found autism the fastest-rising group.
Australia saw the same boy surge, but with a twist. May et al. (2018) found the boy-to-girl gap shrinks among older girls, something Taiwan did not yet see.
Chen et al. (2008) explain part of the city lead: rural preschoolers get diagnosed later and receive fewer services, so they enter the registry later.
Lung et al. (2017) add that parents with more school years are more likely to register their child, boosting city counts even when rural kids screen positive.
Why it matters
Rising numbers mean more clients on your caseload. The stable boy excess tells you to keep boy-focused screening tools, but the hint of a narrowing gap in Australia says watch for missed girls. The city–rural split tells you to start outreach and tele-assessment in small towns so kids do not wait.
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02At a glance
03Original abstract
The prevalence of autism spectrum disorders (ASD) in the world has increased dramatically in the recent decades. However, data at the national level are limited, and geographic differences are seldom evaluated. According to the law, the local governments in Taiwan began to certify disabled residents and provide various services in 1980, and the central government maintains a registry of certified cases. The registry started to enroll cases of ASD in 1990, providing a unique opportunity for studying ASD at the national level. Because the government discourages the certification under 3 years of age, we limited our analyses to those who were at least 3 years old. Using the registry data from 2004 to 2010, we calculated the prevalence of ASD by age, gender, and geographic area and assessed the changes over time. From 2004 to 2010, the registered cases between 3 and 17 years old increased from 3995 to 8072 annually, and the prevalence generally increased every year in all age groups (p<0.01). In each year there were more boy cases than girl cases, and the prevalence rate ratio ranged from 5.64:1 to 6.06:1 (p<0.01 in all years), with an increasing trend over time (p<0.01). A higher prevalence was observed in the urban areas over the years, and the prevalence rate ratio ranged from 2.24:1 to 2.72:1 (p<0.01 in all years), with a decreasing trend over time (p<0.01).
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.12.015