Global burden, inequalities, and predictions of autism spectrum disorders among children and adolescents aged 0-19 years: Results from the Global Burden of Disease 2021 Study.

This large study looked at autism rates worldwide in children and teens from 1990 to 2021. It found that autism diagnosis rates have slightly decreased over time, but the number of people living with autism and disability impacts have increased. Wealthier countries tend to have higher reported autism rates. Boys are more affected than girls, but this gap is slowly narrowing. The researchers predict autism-related challenges will continue to increase globally through 2036.

This global epidemiological study analyzed autism spectrum disorder (ASD) burden among children and adolescents aged 0-19 years from 1990-2021 using Global Burden of Disease data. The research examined trends in incidence, prevalence, and years lived with disability (YLDs), revealing complex patterns across different sociodemographic regions. Key findings include slight decreases in age-standardized incidence rates (-0.11% annually) but increases in prevalence (0.1%) and YLDs (0.12%). Higher sociodemographic index countries showed greater ASD burden, with Japan and high-income Asia Pacific regions displaying maximum rates.

Males consistently faced higher burden than females, though the male-to-female ratio declined by 2021. Projections suggest continued global burden increases through 2036, particularly affecting males and lower sociodemographic index countries.

Findings highlight need for enhanced diagnostic capacity in lower sociodemographic index regions and continued attention to ASD recognition in females. The projected increasing global burden emphasizes importance of early intervention services and support systems, particularly for males and in resource-limited settings.

Study relies on Global Burden of Disease estimates which may not capture true diagnostic practices across all regions. Observed trends may reflect changes in diagnostic criteria, awareness, and healthcare access rather than true epidemiological changes. No individual-level data or intervention outcomes reported.

To evaluate the long-term trends of autism spectrum disorders (ASD) in children and adolescents from birth to 19 years. Using dataset from the Global Burden of Disease 2021 database, we identified the ASD burden among children and adolescents and corresponding age-sex differences from 1990 to 2021, assessed inequalities related to the sociodemographic index (SDI) by the slope index of inequality (SII) and concentration index (CI), and predicted the burden by the Bayesian age-period-cohort model between 2022 and 2036. The global estimated annual percentage changes for the age-standardized incidence rate (ASIR), age-standardized YLDs rate (ASYR), and age-standardized prevalence rate (ASPR) of ASD among children and adolescents were -0.11 % (95 % CI: -0.2 %-0.02 %), 0.12 % (95 % CI: 0.11 %-0.12 %), and 0.1 % (95 % CI, 0.1 %-0.11 %), respectively, suggesting the decreasing or increasing patterns over the study period. In 2021, the maximum ASIR, ASYR, and ASPR were detected in regions with high SDI.

Japan and high-income Asia Pacific displayed the maximum ASPR, ASIR, and ASYR, with South Asia and India experiencing the highest counts in 2021. Males faced a more severe burden than females globally between 1990 and 2021, and a decline in the male-to-female ratio of ASR was noted in 2021. The SII and CI indicated that the ASD burden was increasingly concentrated in higher SDI countries and territories. The global burden was projected to continue increasing from 2022 to 2036.

Targeted interventions should be strengthened to alleviate the ASD burden among children and adolescents, especially for males and low SDI countries.