- Design
- Prospective population-based screening and diagnostic cohort study
- Population
- More than 62,000 South Korean children aged 7, 12 birth cohorts
- Primary outcome
- 7-year cumulative incidence and prevalence of autism
- Effect
- Incidence 1.9% to 3.2%, prevalence 2.0% to 3.4%, no significant trend
A JAMA Pediatrics study (14 September) screened every child entering elementary school in a South Korean population across 12 consecutive birth cohorts (born 1998–2010). Of more than 62,000 children, 2,077 screened positive and 881 completed full diagnostic assessment with standard instruments.
The 7-year cumulative incidence of autism ranged from 1.9% to 3.2%, and prevalence at age 7 from 2.0% to 3.4%, with no significant trend across cohorts. Girls with autism were disproportionately found among children not previously diagnosed and sitting in general education, with different presentations and substantial unmet needs.
When every child is actively looked for, the rate does not appear to be climbing. That supports the view that much of the reported rise elsewhere reflects better detection and changing service use. For the clinician, the more urgent finding is who is still missed.
- Consider autism in girls presenting with anxiety, social difficulties or school refusal
- Do not rely on a lack of prior services to rule autism out
- Use a structured screening tool when concerns are raised, not clinical impression alone
- Explain to worried parents that rising figures largely reflect better recognition
Why it matters
It reframes the autism 'epidemic' as largely a detection story, and points to the children still being missed.
Don't overread it
This is one country's population; it does not exclude real changes in incidence elsewhere.
The statistics, in plain English
The confidence intervals for each cohort overlap, and a test for trend found no significant change. Not every screen-positive child completed assessment (881 of 2,077), so the absolute figures carry some uncertainty, but that should affect all cohorts similarly.
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