The epidemiology of autism: a review

Psychol Med. 1999 Jul;29(4):769-86. doi: 10.1017/s0033291799008508.


Background: There is some uncertainty about the rate and correlates of autism.

Method: Twenty-three epidemiological surveys of autism published in the English language between 1966 and 1998 were reviewed.

Results: Over 4 million subjects were surveyed; 1533 subjects with autism were identified. The methodological characteristics of each study are summarized, including case definition, case-finding procedures, participation rates and precision achieved. Across surveys, the median prevalence estimate was 5.2/10000. Half the surveys had 95% confidence intervals consistent with population estimates of 5.4-5.5/10000. Prevalence rates significantly increased with publication year, reflecting changes in case definition and improved recognition; the median rate was 7.2/10 000 for 11 surveys conducted since 1989. The average male/female ratio was 3.8:1, varying according to the absence or presence of mental retardation. Intellectual functioning within the normal range was reported in about 20% of subjects. On average, medical conditions of potential causal significance were found in 6% of subjects with autism, with tuberous sclerosis having a consistently strong association with autism. Social class and immigrant status did not appear to be associated with autism. There was no evidence for a secular increase in the incidence of autism. In eight surveys, rates for other forms of pervasive developmental disorders were two to three times higher than the rate for autism.

Conclusion: Based on recent surveys, a minimum estimate of 18.7/10000 for all forms of pervasive developmental disorders was derived, which outlines the needs in special services for a large group of children.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Autistic Disorder / diagnosis
  • Autistic Disorder / epidemiology*
  • Autistic Disorder / etiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Health Surveys
  • Humans
  • Incidence
  • Infant
  • Intellectual Disability / diagnosis
  • Intellectual Disability / epidemiology
  • Intellectual Disability / etiology
  • Male