Prevalence of DSM-5 Autism Spectrum Disorder Among School-Based Children Aged 3-12 Years in Shanghai, China.

Jin et al. (2018) screened every child aged 3-12 in regular Shanghai schools. They used DSM-5 checklists and IQ tests to count how many kids had autism spectrum disorder.

The team also recorded each child's IQ score to see if autism and intellectual disability overlapped.

Only 8 out of every 10,000 pupils met DSM-5 ASD criteria. That is far below the 1-in-70 figure often quoted in Western media.

Four out of five of these children also had very low IQ scores under 40. The low count may miss brighter children who still fit the autism criteria.

Scattoni et al. (2023) ran the same kind of school count across all of Italy and found 134 cases per 10,000—sixteen times higher. The gap shows Shanghai's number is probably an under-count, not proof that Chinese kids have less autism.

Tonnsen et al. (2016) looked the other way round: they started with children already diagnosed with intellectual disability and found 18 % also had ASD. Taken together, the two papers hint that severe-ID kids are easier to spot, while average-IQ autistic pupils are still being missed.

Sasson et al. (2018) tracked German insurance records and saw diagnoses rise each year. Their data remind us that wider awareness, not biology, often drives the final count.

If you screen in Chinese schools, expect far fewer referrals than Western norms. Do not relax—double-check your tools for children who talk on time but still show social-communication gaps. Add teacher interviews and peer-play observations so you catch the kids whose IQ masks their autism.