Pervasive developmental disorders in preschool children: confirmation of high prevalence
Suniti Chakrabarti1, Eric Fombonne
1Child Development Centre, Central Clinic, Stafford, UK.
Insights
The prevalence of pervasive developmental disorders (PDD) in preschoolers remains stable, with a rate of 58.7 per 10,000 children. This study found no significant change from previous PDD rates in the same area.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Epidemiology
Background:
- Rising concerns regarding the prevalence of pervasive developmental disorders (PDD).
- Previous study in Stafford, U.K. reported a PDD rate of 62.6 per 10,000 preschoolers.
- Need to assess prevalence in a later birth cohort and compare with prior findings.
Purpose of the Study:
- To estimate the prevalence of PDD in a 2002 birth cohort of children in the Midlands.
- To compare current PDD prevalence with historical data from the same region.
- To identify characteristics of children diagnosed with PDD.
Main Methods:
- Survey of 10,903 children aged 4.0-6.0 years in a Midlands town.
- Intensive assessment of children with suspected PDD by a multidisciplinary team.
- Utilized standardized diagnostic interviews, psychometric tests, and medical evaluations.
Main Results:
- Prevalence of PDD was 58.7 per 10,000 children (85.9% boys).
- Autistic disorder prevalence was 22.0 per 10,000; other PDD variants were 36.7 per 10,000.
- Rates were comparable to previous studies; mean age at diagnosis was 37.8 months; 29.8% had mental retardation.
Conclusions:
- The prevalence of PDD in this cohort is stable and comparable to previous findings.
- The consistent rates suggest a stable incidence of PDD in the studied population.
- Health visitors played a key role in early referral for diagnosis.
Objective:
The rate of reported pervasive developmental disorders has increased, and the authors found a rate of 62.6 per 10,000 in a previous study of preschoolers in Stafford, U.K. They conducted another survey in 2002 to estimate the prevalence in children in a later birth cohort and to compare it to previous findings from the same area.
Method:
Screening for developmental problems included 10,903 children ages 4.0 to 6.0 years who were living in a Midlands town on the survey date. Children with symptoms suggestive of pervasive developmental disorders were intensively assessed by a multidisciplinary team using standardized diagnostic interviews, psychometric tests, and medical workups.
Results:
Sixty-four children (85.9% boys) were diagnosed with pervasive developmental disorders. The prevalence was 58.7 per 10,000, with a 95% confidence interval (CI) of 45.2-74.9, for all pervasive developmental disorders, 22.0 per 10,000 (95% CI=14.1-32.7) for autistic disorder, and 36.7 per 10,000 (95% CI=26.2-49.9) for other variants. These rates were not significantly different from the previous rates. The mean age at diagnosis was 37.8 months, and 53.1% of the children were originally referred by health visitors. Of the 64 children with pervasive developmental disorders, 29.8% had mental retardation, but this rate varied by disorder subtype. Few children had associated medical conditions.
Conclusions:
The rate of pervasive developmental disorders is higher than reported 15 years ago. The rate in this study is comparable to that in previous birth cohorts from the same area and surveyed with the same methods, suggesting a stable incidence.
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