Kate E. Reynolds

  • Autism in China: how prevalent is it?

    Like the United Kingdom, there is no central register of people with autism in China. Studies estimate a possible 2.8 million autistic children in the People’s Republic, with around 10 000 in Shanghai alone. In 2005 the official figures for autism spectrum disorders in China were 1.1 per 1000 children. In the UK the statistics are 1:110 and in the United States the latest are 1:88.

    The statistics in the People’s Republic are likely to be lower than the reality for several reasons:

    1. Diagnosis is difficult to achieve due to the expense of getting a medical opinion.

    2. Parents may be unaware of medical facilities which are available to facilitate diagnosis.

    3. There is a dearth of specialised medical doctors who could diagnose autism.

    4. Parents may not seek diagnosis, due to embarrassment or feeling shame at having what may be perceived as an ‘idiot’ child.

    5. Only more extreme cases of autism are likely to be diagnosed, when children are profoundly affected. Cases of Asperger syndrome are less commonly diagnosed because the child can develop an acceptable level of communication or sufficient to have a working role in society.

    In July a three year initiative will be launched to investigate the prevalence of autism in China. The project itself will cost 32 million yuan (approximately £3 327 900) and aims to produce national screening and treatment protocols. Autism Speaks, based in the US, will give advice on the study which aims to produce trained and skilled staff to diagnose and provide interventions. The actual statistics will guide policy development.

    The project has three stages:

    1. Lasting 4-6 months when staff at 8 selected hospital across China will be trained and pilot schemes run.

    2. The second, epidemiological stage will last at least a year when a count of the rate of autism in China will involve around 200 000 school pupils aged between 6-12 years of age.

    3. The overall aim will be achieved in the final stage when a nationwide database will be created. Health care providers will be able to share knowledge and skills in screening, diagnosis and treatment to produce uniform protocols.

    Only when these samples are analysed will more realistic figures for the prevalence of autism be available. This should guide government policy and investment in the field. At present, those autistic children who do get an education do so in special needs institutions, alongside children with a range of chromosomal, genetic and other disorders. Many of these children are intellectually impaired, whereas it is becoming clear that many autistic children are not. By definition, autism is a disorder of social communication which may have no concurrent reduction in IQ.

    Many educationalists in China are pushing for inclusion of autistic children in mainstream schools. Most schools resist this, because they have neither the resources nor trained staff to accommodate these children. Long-term, new information about the extent of autism may shape the education system via policies and the law.

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