Jul 2026· Journal of Autism and Developmental Disorders· 0 citations· 53 references
Medicine
TL;DR
Sex-stratified differences in adolescent ASD prevalence and domain-level clinical patterns are evident across the Western Pacific region and may reflect a combination of diagnostic practices and sociocultural context.
Although the observed 4:1 ratio aligns with global trends, the findings suggest under-identification of females, and gender-sensitive diagnostic tools are needed to improve detection and understanding of ASD in females.
Nishant Prabhakaran, S. Kaku, Ann Maria Moncy et al.· Journal of Autism and Develo...· 0 citations
Background Despite growing recognition as a public health concern, the burden of autism spectrum disorder (ASD) in Ethiopia remains poorly characterised owing to limited diagnostic capacity and epidemiological data, hampering evidence-based policy and intervention planning. Aims This study aimed to quantify the longitudinal burden of ASD in the Ethiopian paediatric population from 1990 to 2023 and project future trends to 2050 to inform national health strategies. Method Using Global Burden of Disease (GBD) 2023 data, we estimated ASD prevalence, incidence and disability-adjusted life-years (DALYs) among Ethiopian children and adolescents. Trends were analysed using joinpoint regression and future burden was forecast to 2050 using autoregressive integrated moving average (ARIMA) modelling. Results Between 1990 and 2023, ASD prevalence increased by 155%, from 271 805 to 693 644 cases. Correspondingly, the age-standardised prevalence rate increased from 950 to 1185 cases per 100 000 population. Although annual incident cases nearly doubled (from 24 576 to 47 274), the age-standardised incidence rate declined slightly from 86 to 81 cases per 100 000. DALYs increased by 162% to 134 386 in 2023, while the age-standardised DALY rate increased from 179 to 230 per 100 000. Projections to 2050 suggest that the overall ASD burden will persist, with a stable incidence rate but an increasing DALY rate. Conclusions Nearly 700 000 Ethiopian children and adolescents were living with ASD in 2023. The significant increases in prevalence and DALYs over three decades underscore the urgent need for a comprehensive national strategy, including enhanced diagnostic infrastructure and early intervention programmes.
Autism spectrum disorder (ASD) is commonly identified in childhood and can affect communication, adaptive functioning, supervision, and access to health and educational services. These needs may be relevant to child safety planning, but this study did not measure injury outcomes.
We analyzed Global Burden of Disease 1990–2023 estimates of ASD incidence and disability-adjusted life-year (DALY) rates across 798 locations. Age-standardized and under-20 rates were benchmarked against a Socio-demographic Index-related frontier using free disposal hull analysis. Socioeconomic inequalities were assessed using the slope index of inequality and concentration index.
In 2023, 98 countries and territories (48.0%) were classified as behind the age-standardized incidence frontier and 78 (38.2%) as behind the age-standardized DALY frontier. Among individuals younger than 20 years, 100 (49.0%) were behind the incidence frontier and 123 (60.2%) were behind the DALY frontier. Frontier deviation increased in most countries between 1990 and 2023. Sweden had the largest reduction across all four national metrics, whereas Japan had the largest increase. Japan also had the largest 2023 deviations for age-standardized incidence, age-standardized DALYs, and under-20 DALYs; Brunei Darussalam had the largest under-20 incidence deviation. Selected Japanese prefectures were prominent subnational outliers, while locations in Pakistan and Nigeria showed the largest reductions. Recorded under-20 DALY burden became more concentrated in higher-SDI populations globally, whereas disadvantaged populations within low-SDI settings retained substantial absolute inequality.
These findings provide descriptive benchmarks for ASD surveillance, early recognition, service organization, and equitable healthcare planning. They should not be interpreted as direct measures of service quality, unmet need, or injury risk.
Unknown authors· Frontiers in Public Health· 0 citations
Background The global increase in autism spectrum disorder (ASD) diagnoses is expected to substantially increase demand for long-term rehabilitation services. However, little is known about how this increase affects rehabilitation service utilization and capacity in low- and middle-income countries. Methods We conducted a retrospective longitudinal study of children receiving developmental care at a tertiary rehabilitation center in Salvador, Brazil (2017-2026). Patients were classified into Childhood Autism, Other ASD, and non-ASD diagnostic groups according to ICD-10 diagnoses. Temporal trends in admissions and patients under follow-up were analyzed using generalized additive models and segmented Poisson regression. Factors associated with follow-up duration were evaluated using multivariable Cox proportional hazards models. Results Among 2,123 eligible children, 833 (39.2%) had Childhood Autism, 462 (21.8%) had Other ASD, and 828 (39.0%) had non-ASD diagnoses. Compared with children with non-ASD diagnoses, those with Childhood Autism entered care at younger ages, were predominantly male (77.9% vs. 57.2%), attended more visits, and remained under follow-up longer (all P<0.001). Admissions of children with Childhood Autism increased by 30.2% annually before 2023 but declined thereafter (-19.6% annually; P<0.001). Despite this decline, the number of children with Childhood Autism receiving ongoing rehabilitation continued to increase, reflecting prolonged follow-up. In adjusted analyses, Childhood Autism was associated with a substantially lower hazard of reaching the last recorded follow-up visit than non-ASD diagnoses (adjusted hazard ratio, 0.35; 95% CI, 0.30-0.40; P<0.001). Conclusions The rapid increase in ASD admissions fundamentally reshaped rehabilitation service utilization. Because children with ASD remained under follow-up substantially longer than those with other developmental conditions, they accounted for an increasing share of the rehabilitation caseload, even after new admissions began to decline. These findings highlight the importance of planning rehabilitation services according to both new admissions and the cumulative demand generated by long-term follow-up.
J. A. Aguilar Ticona, A. F. Ferreira-Stagliorio, G. de Oliveira Costa et al.· medRxiv· 0 citations
This narrative literature review synthesizes evidence on social, medical, and structural barriers affecting children with ASD, with a focus on healthcare access, comorbidity-related medical vulnerability, and public stigma in Kazakhstan and internationally.
Svetlana Mofa, Bauyrzhan Omarkulov, N. Delellis et al.· Journal of Clinical Medicine...· 0 citations
Youth with autism spectrum disorder or attention-deficit/hyperactivity disorder (ADHD) may face barriers to sexual and reproductive health (SRH) services. Yet, data on preventive SRH service use remain limited, especially digital care. This population-based registry study investigated whether patterns of SRH service use differed by digital versus in-person care among 12-22-year-olds in Stockholm County (2018-2022). Among 454,405 youth (48.6% female; mean age 16 years), 11,850 were autistic, 31,144 had ADHD, and 9126 had both conditions; the majority of SRH contacts were in-person visits. ADHD youth had higher adjusted Odds Ratios [aOR] of in-person (females: 2.02 [95% CI, 1.93-2.11]; males, 1.46 [1.39-1.54]) and digital visits (females, 1.21 [1.14-1.29]; males, 1.26 [1.05-1.52]) than control peers. Autistic youth had lower aOR of in-person (females, 0.67 [0.63-0.72]; males, 0.45 [0.40-0.51]) and digital visits (females, 0.79 [0.71-0.89]; males, 0.79 [0.54-1.15]). Intensity of use (incidence rate ratios) was higher among ADHD youth but similar among autistic females compared with control peers. Autistic females were more likely to consult physicians but less likely to see midwives or use short-acting contraception. ADHD was associated with higher odds of all provider types, contraceptive methods, and abortion. In conclusion, ADHD youth engaged more and autistic youth less-particularly males-with SRH services than controls. Smaller relative digital than in-person differences suggest digital options might reduce access disparities. Similar intensity of use between autistic and control females suggests barriers may be entry to care, whereas high SRH use among ADHD youth challenges assumptions that low engagement drives risk outcomes.
Lovisa Hellsten, Jessica E. Rast, A. Nielsen et al.· Autism Research· 0 citations
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