Urban and Education Disparity for Autism Spectrum Disorders in Taiwan Birth Cohort Study

Area of Science:

• Developmental Pediatrics
• Child Psychology
• Public Health

Background:

• Autism Spectrum Disorder (ASD) diagnosis requires timely and accurate screening.
• Understanding screening tool efficacy and diagnostic distribution is crucial for public health initiatives.
• Taiwanese children's developmental trajectories and ASD prevalence warrant specific investigation.

Purpose of the Study:

• To establish the optimal Modified Checklist for Autism in Toddlers (M-CHAT) cut-off score for ASD screening in 66-month-old children.
• To analyze the geographical and socioeconomic distribution of ASD screening and diagnosis within Taiwan.
• To investigate the impact of parental education and urban disparity on ASD diagnosis rates.

Main Methods:

• Utilized the Taiwan Birth Cohort Study dataset, comprising 20,095 children.
• Applied the Modified Checklist for Autism in Toddlers (M-CHAT) for screening analysis.
• Conducted statistical analysis to determine optimal cut-off points and explore demographic correlations.

Main Results:

• An M-CHAT cut-off score of 13/14 was identified as optimal for screening at 66 months.
• Higher rates of ASD diagnosis were observed in urban areas compared to rural settings.
• Children diagnosed with ASD often had parents with higher education levels, yet lower educated parents' children were screened at higher risk.

Conclusions:

• The M-CHAT cut-off of 13/14 is recommended for ASD screening in 66-month-old Taiwanese children.
• Urban disparity and parental education significantly influence ASD awareness and diagnosis rates.
• Targeted interventions may be needed to address disparities in ASD diagnosis and parental awareness across different socioeconomic strata.