Saturday, March 5, 2016

New study finds autism rates in South Korea now at 1 in 38 children

In the first comprehensive study of autism prevalence using a total population sample, an international team of investigators from the U.S., South Korea, and Canada estimated the prevalence of autism spectrum disorders (ASD) in South Korea to be 2.64%, or approximately 1 in 38 children, and concluded that autism prevalence estimates worldwide may increase when this approach is used to identify children with ASD.
“Prevalence of Autism Spectrum Disorder in a Total Population Sample,” published today online in the American Journal of Psychiatry reports on a study of all children (approximately 55,000) ages 7-12 years in a South Korean community, including those enrolled in special education and the disability registry, as well as all children enrolled in general education schools. Children were systematically assessed using multiple clinical evaluations.

The research by Young Shin Kim, M.D., M.S., M.P.H., Ph.D. of the Yale Child Study Center, and her collaborators Bennett L. Leventhal, M.D., Yun-Joo Koh, Ph.D., Eric Fombonne, M.D., Eugene Laska, Ph.D., Eun-Chung Lim, M.A., Keun-Ah Cheon, M.D., Ph.D., Soo-Jeong Kim, M.D., HyunKyung Lee, M.A., Dong-Ho Song, M.D. and Roy Richard Grinker, Ph.D. found more than two-thirds of ASD cases in the mainstream school population, unrecognized and untreated. “These findings suggest that ASD is under-diagnosed and under-reported and that rigorous screening and comprehensive population studies may be necessary to produce accurate ASD prevalence estimates,” stated Autism Speaks Chief Science Officer Geraldine Dawson, Ph.D. “Autism Speaks funded this study to support better detection, assessment and services and to encourage international autism research.”

Read more: http://www.autismsupportnetwork.com/news/new-study-finds-autism-rates-south-korea-now-1-38-children-38994322#ixzz422yh6O82

According to Dr. Kim, experts disagree about the causes and significance of reported increases in ASD, partly because of variations in diagnostic criteria and incomplete epidemiologic studies that have limited the establishment of actual population-based rates. “We were able to find more children with ASD and describe the full spectrum of ASD clinical characteristics,” said Dr. Kim. “Recent research reveals that part of the increase in reported ASD prevalence appears attributable to factors such as increased public awareness and broadening of diagnostic criteria. This study suggests that better case finding may actually account for an even larger increase. While the current project did not investigate potential risk factors in this particular population, the study does set the stage for ongoing work to examine genetic and environmental factors contributing to the risk of ASD.”
This study is further evidence that autism transcends cultural, geographic, and ethnic boundaries and that autism is a major global public health concern, not limited to the Western world. To date, there is no evidence of differences in the way ASD is expressed in children around the world; however it is possible that cultural factors may impact diagnostic practices and prevalence estimates. As a result, the South Korean study took a comprehensive approach to mitigate potential cultural bias. According to Dr. Grinker, a cultural anthropologist at George Washington University, “Parent and teacher focus groups were conducted to identify local beliefs that might influence symptom reporting and to address stigma and misunderstandings related to ASD. Further, clinical diagnoses were established by Korean diagnosticians with extensive clinical and research experience in both the U.S. and Korea and were validated by North American experts.”
The study does not suggest that Koreans have more autism than any other population in the world. What it does suggest is that autism is more common than previously thought and that, if researchers look carefully, especially in previously understudied, non-clinical populations, they may find more children with ASD. In addition to the South Korean study, Autism Speaks is supporting similar epidemiological research efforts in India, South Africa, Mexico, and Taiwan, including the translation and adaptation of the gold-standard diagnostic instruments into languages spoken by more than 1.7 billion people worldwide.
“This is the first comprehensive population sample-based prevalence calculation in Korea, and replication in other populations is essential,” explained Dr. Dawson. “Notwithstanding the need for replication, this study provides important evidence that the application of validated, reliable and commonly accepted screening procedures and diagnostic criteria applied to a total population has the potential to yield an ASD prevalence exceeding previous estimates.”
“We know that the best outcomes for children with ASD come from the earliest possible diagnosis and intervention,” concluded Dr. Kim and her colleague Dr. Koh from the Korea Institute for Children’s Social Development, “Goyang City, host of the Korea study, has courageously responded to these study findings by providing comprehensive assessment and intervention services for all first graders entering their school system. We hope that others will follow Goyang City’s example so that any population based identification of children with ASD is accompanied by intervention services for those children and their families.”
This research was funded by a Pilot Research Grant from Autism Speaks as well as grants from the Children’s Brain Research Foundation, NIMH and the George Washington University Institute for Ethnographic Research.


Read more: http://www.autismsupportnetwork.com/news/new-study-finds-autism-rates-south-korea-now-1-38-children-38994322#ixzz422y1xqoZ
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Korea autism rate

Study Suggests Autism Rate May Be Underestimated

An exhaustive study of autism in one community has found that the disorder is far more common than suggested by earlier research.
The study of 55,000 children in Goyang, South Korea, found that 2.64 percent — one in every 38 children — had an autism spectrum disorder.
"That is two-and-a-half times what the estimated prevalence is in the United States," says Roy Richard Grinker, a professor of anthropology at George Washington University and one of the study's authors.
The South Korean study probably produced such a high figure because it screened a lot of kids who seemed to be doing OK and included in-person evaluations of any child suspected of having autism, Grinker says.
"Two-thirds of the children with autism that we ended up identifying were in mainstream schools, unrecognized, untreated," he says.
The team of Korean and American scientists who carried out the study, published online in the American Journal of Psychiatry, say the result doesn't mean there's something different about South Korean children.
"There's no reason to think that South Korea has more children with autism than anyplace else in the world," says Bennett Leventhal, another author of the study. Leventhal is also deputy director of New York's Nathan Klein Institute for Psychiatric Research and a professor of child and adolescent psychiatry at New York University Medical Center.
The study's primary message, Leventhal says, is that "if you really go look carefully among all children everywhere, you find that things are far more common than you previously expected."
Previous efforts to identify children with autism have tended to focus on kids in special education classes, or those whose school records show they have language or learning problems.
But that approach has the potential to miss a lot of kids, Grinker says. "What we wanted to do was to go beyond that and pick a medium-sized city where we could look at every child," he says.
The city they chose, Goyang, is not far from Seoul. And South Korea is an ideal place for this kind of study because the government makes sure that every child goes to school.
Until now, South Korean officials and educators have assumed that autism was quite rare. The group's five-year study of children ages 7 to 12 showed otherwise.
"I had some expectation that it's going to be a little higher than the previous studies because we're including children from the general population that have been understudied in the past," says Young-Shin Kim, the study's first author and an assistant professor at the Child Study Center at Yale University. "But the extent — that was a surprise to us."
Many of the children were probably missed because they didn't misbehave and they weren't failing academically, Kim says.
"These children could function at a level that was expected, even though they were having a lot of difficulties with their peers and social engagement," she says.
Also, Kim says, autism carries a severe stigma in South Korea, so some parents may have ignored some telltale behaviors. And she says they were often upset to learn they had a child on the spectrum.
"Some of the parents were yelling at us like, 'You guys are crazy, my child is OK,' " she says. "Some parents are shocked. Some are devastated. But some are like, 'Oh, my God, now it makes sense. Actually, I'm so glad you told me that because I couldn't make any sense out of my child.' "
The authors say maybe people shouldn't be surprised to find that autism is so common. After all, other brain disorders, such as severe depression, affect more than 2 percent of adults; severe anxiety disorder affects about 4 percent.
And the implications of this study are global, Leventhal says. He says there are powerful reasons to identify all kids with autism, even if they aren't failing in school.
"They're socially awkward and they have trouble making friends. They get in trouble because their behavior is a little odd," he says. "And then when we teach them their skills, they actually can fit in better and succeed better."

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