An incidence study of diagnosed autism-spectrum disorders among immigrants to the Netherlands

Acta Psychiatr Scand. 2013 Jul;128(1):54-60. doi: 10.1111/acps.12054. Epub 2012 Dec 9.


Objective: To estimate the risk of developing autism-spectrum disorder (ASD) in children born to immigrants as compared with children of Dutch-born parents.

Method: Retrospective, population-based cohort study of all live births (n = 106 953) between 1998 and 2007 in a circumscribed geographical region in the Netherlands. Cohort members were linked to the Psychiatric Case Register to identify diagnosed cases.

Results: A total of 518 cases of ASD were identified, including 150 children with autism and 368 children with Asperger syndrome or Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). Children born to migrants from developing countries were at significantly lower risk of ASD [rate ratio (RR) = 0.6, 95% confidence interval (CI) 0.5-0.9] than children of Dutch-born parents. Within the ASD group, the risk for the subgroup with Asperger syndrome and PDD-NOS was reduced (RR = 0.4, 95% CI 0.3-0.6), whereas that for narrowly defined autism was non-significantly increased (RR = 1.4, 95% CI 0.9-2.4). Migrant groups did not differ in age at diagnosis.

Conclusion: The results echo Swedish findings indicating a reversal of risk gradient in children of parents from developing countries, specifically a decreased risk for high-functioning and increased risk for low-functioning autism.

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Autistic Disorder / epidemiology
  • Child
  • Child Development Disorders, Pervasive / diagnosis*
  • Child Development Disorders, Pervasive / epidemiology*
  • Cohort Studies
  • Comorbidity
  • Emigrants and Immigrants / statistics & numerical data*
  • Family Health / statistics & numerical data*
  • Female
  • Humans
  • Incidence
  • Male
  • Netherlands / epidemiology
  • Registries / statistics & numerical data
  • Risk Factors
  • Sex Distribution