TL;DR
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.
There is an urgent need for prospective longitudinal studies to adequately map the aging trajectories of this population of older adults with ASD, which constitute a vulnerable population.
Abstract Aim In this study, we aimed to examine the associations between adverse childhood experience (ACE) exposure, adult autism spectrum disorder (ASD), and attention‐deficit/hyperactivity disorder (ADHD) traits in a nationwide sample, and assess links with specific symptom subdomains. Methods We conducted a cross‐sectional analysis using 2024 data from the Japan “Society and New Tobacco” Internet Survey. Adults (N = 29,268; ≥18 years) completed self‐reports including the 10‐item ACE questionnaire (categorized: 0, 1, 2, 3, or ≥4 ACEs), Autism‐Spectrum Quotient short form, and Adult ADHD Self‐Report Scale. Logistic regression models assessed associations between ACEs and positive ASD (score ≥ 7) and ADHD (score ≥ 4) screens, adjusting for demographics, health, mental distress (K6), and alcohol use. Results Among respondents, 4.9% reported experiencing ≥4 ACEs. Positive screening rates were 11.9% for ASD traits and 7.7% for ADHD traits. ASD traits were only associated with high ACE exposure (≥4 ACEs: odds ratio [OR] 1.29, 95% confidence intervals [CIs] 1.11–1.49). ADHD traits showed a dose–response relationship starting at 1 ACE (OR 1.15, 95% CI 1.00–1.31), and increased with greater exposure (≥4 ACEs: OR 1.70, 95% CI 1.45–1.98). High exposure was linked to specific ASD symptoms (e.g., social and communication difficulties) and ADHD symptoms (e.g., disorganization, task avoidance, and hyperactivity). Conclusion ACEs were associated with adult ASD and ADHD traits and related symptom subdomains in adulthood.
Autism is a neurodevelopmental condition characterized by differences in social interaction, communication and behaviour. Despite a global prevalence of one in 127 individuals, autism remains underdiagnosed in low-resource settings. We examined the epidemiology of autism among children aged 2 to 9 years in Northern Uganda. Using multistage sampling, 1,139 children were screened for neurodevelopmental conditions using the validated 23Q screening tool. Children who screened positive underwent clinical assessment, and suspected cases received specialist assessments according to DSM-5-TR criteria. Descriptive statistics and Firth logistic regression were employed for analysis. The mean age was 5.38 years (SD = 2.07), and 51.0% were male. The prevalence of autism was 10.5 per 1,000 children (95% confidence interval [CI] [6.0, 18.5]), of whom 75.0% had co-occurring neurodevelopmental conditions. Autistic children were more likely to have intellectual disability, epilepsy, learning disabilities, global developmental delay, attention-deficit/hyperactivity disorder, dyslexia, cerebral palsy, hearing impairment and speech delay (p < .0045). After adjusting for gender, family history of autism (adjusted odds ratio [aOR] = 6.95, 95% CI [1.60, 30.23]), teenage motherhood (aOR = 8.30, 95% CI [1.30, 53.12]), breech presentation (aOR = 12.23, 95% CI [1.83, 81.64]), and oxygen resuscitation at birth (aOR = 4.56, 95% CI [1.08, 19.33]) were independent predictors of autism. These findings highlight the need to strengthen early identification and targeted services for autistic children in low-resource settings. Lay Abstract Autism affects how people communicate, interact, and process information, and about one in 127 people worldwide are autistic. In low-resource settings, autism is often under-researched and underdiagnosed. We carried out a study in Northern Uganda to estimate how common autism is among children aged 2 to 9 years, to identify co-occurring neurodevelopmental conditions, and to explore factors that may increase likelihood of autism. We enrolled 1,139 children from diverse communities using a multi-step sampling process. After parental consent, one child per household was screened with the 23Q neurodevelopmental screener. Children with possible conditions received further assessment by trained health care workers, and likely cases were confirmed by specialist clinicians using DSM-5-TR diagnostic criteria. Approximately 1 in 95 children were autistic, and none had previously received a diagnosis of autism. The average age of the children diagnosed with autism was about 5 years, and slightly more than half were boys, and most lived in rural areas. Most autistic children (82%) had at least one additional neurodevelopmental condition, such as intellectual disability, learning delays, or epilepsy. Autism was linked to family history, teenage motherhood, and certain birth complications. Improving maternal care, community awareness, and early diagnosis could better support autistic children in Northern Uganda.
Background: Autism Spectrum Disorder (ASD) represents a heterogeneous group of neurodevelopmental disorders characterized by deficits in social interaction, communication and restricted, repetitive behaviours. Understanding socio-demographic factors and clinical features in local populations is essential for early diagnosis and intervention. Objective: To evaluate the status socio-demographic profile and clinical characteristics of children diagnosed with ASD attending a tertiary care hospital. Methods: Study was conducted at child development center (CDC) of Bangladesh Shishu Hospital & Institute on 100 children aged 1–12 years diagnosed with ASD. Socio-demographic information, developmental history behavioural profile and comorbidities were recorded. Data were analysed using descriptive statistics. Results: Majority of children were males (78%). Most belonged to the 2–5 year age group (54%). Delayed speech was the most common presenting concern (82%). First parental concern appeared at a mean age of 20.5 months, Common clinical features included poor eye contact (86%), limited social reciprocity (74%), repetitive behaviours (68%) and sensory abnormalities (56%). Comorbid conditions were present in 48% most commonly ADHD (22%) and speech-language disorders (18%). Socioeconomically, 62% belonged to middle-income families and 44% had parents with graduate-level education. Family history of neurodevelopmental disorders was noted in 14%. Conclusion: The findings highlight male predominance, diagnostic delays, high prevalence of speech delay and behavioural abnormalities and significant comorbidity burden in children with ASD. Early screening and parent education programs may reduce diagnostic gap and improve outcomes.