Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 8, pp 1301–1308 | Cite as

Autism awareness and attitudes towards treatment in caregivers of children aged 3–6 years in Harbin, China

  • Jia Wang
  • Xue Zhou
  • Wei Xia
  • CaiHong Sun
  • LiJie WuEmail author
  • JianLi Wang
Original Paper



To (1) estimate the proportion of people in the community who could correctly recognize autism spectrum disorders (ASD); (2) describe the attitudes towards various treatments for ASD; and (3) identify factors associated with ASD recognition.


A population-based cross-sectional survey was conducted in Harbin, China (n = 4,947). We estimated the proportions of participants who were at different levels of knowledge about ASD and of their attitudes towards mental health service use. Multivariate logistic regression modeling was used to identify factors associated with the recognition of ASD.


Overall, 2,786 (57.8%) of the respondents could recognize the ASD. Recognition of autism depended on gender, residing areas, age and educational levels. With respect to the attitudes towards mental health service use for ASD, 4,007 respondents (84.6%) chose to visit a health organization for treatment; 2,470 (68.2%) made the choice of consulting a psychotherapist.


There is a large room for improvement in awareness about ASD and treatment in the Chinese communities. Insufficient knowledge about ASD and inappropriate attitudes towards mental health service use may impede the efforts of early identification and intervention. Health education and promotion are needed to improve people’s knowledge about ASD and available mental health services.


Awareness Attitudes Autism spectrum disorders Caregivers 



Autism spectrum disorders


Odds ratio


Confidence interval



We thank the Harbin Women and Children’s Hospital and Health Institute as well as all the collaborating institutions. We also thank all of the people who participated in the study.

Conflict of interest

The authors have no conflict of interest to declare.


  1. 1.
    Geschwind DH (2008) Autism: many genes, common pathways? Cell 135(3):391–395PubMedCrossRefGoogle Scholar
  2. 2.
    World Health Organization (2007) Pervasive developmental disorders. F84Google Scholar
  3. 3.
    Karande S (2006) Autism: a review for family physicians. Indian J Med Sci 60(5):205–215PubMedCrossRefGoogle Scholar
  4. 4.
    Fombonne E (2009) Epidemiology of pervasive developmental disorders. Pediatr Res 65(6):591–598PubMedCrossRefGoogle Scholar
  5. 5.
    Kogan MD, Blumberg SJ, Schieve LA, Boyle CA, Perrin JM, Ghandour RM, Singh GK, Strickland BB, Trevathan E, van Dyck PC (2009) Prevalence of parent-reported diagnosis of autism spectrum disorder among children in the US, 2007. Pediatrics 124(5):1395–1403Google Scholar
  6. 6.
    (2009) Prevalence of autism spectrum disorders. Autism and Developmental Disabilities Monitoring Network, United States, 2006. MMWR Surveill Summ 58(10):1–20Google Scholar
  7. 7.
    Baird G, Simonoff E, Pickles A, Chandler S, Loucas T, Meldrum D, Charman T (2006) Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP). Lancet 368(9531):210–215PubMedCrossRefGoogle Scholar
  8. 8.
    Baron-Cohen S, Scott FJ, Allison C, Williams J, Bolton P, Matthews FE, Brayne C (2009) Prevalence of autism-spectrum conditions: UK school-based population study. Br J Psychiatry 194(6):500–509PubMedCrossRefGoogle Scholar
  9. 9.
    Brugha TS, McManus S, Bankart J, Scott F, Purdon S, Smith J, Bebbington P, Jenkins R, Meltzer H (2011) Epidemiology of autism spectrum disorders in adults in the community in England. Arch Gen Psychiatry 68(5):459–465PubMedCrossRefGoogle Scholar
  10. 10.
    Kim YS, Leventhal BL, Koh YJ, Fombonne E, Laska E, Lim EC, Cheon KA, Kim SJ, Kim YK, Lee H, Song DH, Grinker RR (2011) Prevalence of autism spectrum disorders in a total population sample. Am J Psychiatry 168(9):904–912PubMedCrossRefGoogle Scholar
  11. 11.
    Russell G, Kelly S, Golding J (2009) A qualitative analysis of lay beliefs about the aetiology and prevalence of autistic spectrum disorders. Child Care Health Dev 36(3):431–436PubMedCrossRefGoogle Scholar
  12. 12.
    Zaroff CM, Uhm SY (2011) Prevalence of autism spectrum disorders and influence of country of measurement and ethnicity. Soc Psychiatry Psychiatr Epidemiol. doi: 10.1007/s00127-011-0350-3
  13. 13.
    Posserud M, Lundervold AJ, Lie SA, Gillberg C (2010) The prevalence of autism spectrum disorders: impact of diagnostic instrument and non-response bias. Soc Psychiatry Psychiatr Epidemiol 45(3):319–327PubMedCrossRefGoogle Scholar
  14. 14.
    Liu J, Yang X-L, Jia M-X, Qu C-Y, Shi J-L, Liu G, Wang X-H, Shao C-X (2007) Survey on pervasive developmental disorder in 2–6 year-old children in Beijing. Chin Ment Health J 05:290–293Google Scholar
  15. 15.
    Wang W-H, Zhai L-W, Zheng L, Zhu J, Qu X-Y, Feng Q-M, Ma D, Wu Y-N, Wang X-D (2003) Epidemiological investigation on autism children of Jiangsu Province. Chin J Behav Med Sci 12(02):173–175Google Scholar
  16. 16.
    Zhang X, Ji C-Y, Li J-S, Sun J-L (2004) The investigation of autism in children aged 2 to 6 years old in Tianjin. Chin J Reprod Health 15(4):206–208Google Scholar
  17. 17.
    Yu C, Xia Wei, Sun C-H, Zhou Y-J, Liu L, Zhou X, Wu L-J (2010) Survey on autistic spectrum disorder in 2 to 6 years old children in Harbin City. Chin J Child Health Care 18(10):750–753Google Scholar
  18. 18.
    Wu B-L, Zou X-B, Xu X (2008) Autism: from genomics to clinical practice. Chin J Evid Based Pediatr 04:241–246Google Scholar
  19. 19.
    Howlin P, Asgharian A (1999) The diagnosis of autism and Asperger syndrome: findings from a survey of 770 families. Dev Med Child Neurol 41(12):834–839PubMedCrossRefGoogle Scholar
  20. 20.
    Helt M, Kelley E, Kinsbourne M, Pandey J, Boorstein H, Herbert M, Fein D (2008) Can children with autism recover? If so, how? Neuropsychol Rev 18(4):339–366PubMedCrossRefGoogle Scholar
  21. 21.
    Filipek PA, Accardo PJ, Ashwal S, Baranek GT, Cook EH Jr, Dawson G, Gordon B, Gravel JS, Johnson CP, Kallen RJ, Levy SE, Minshew NJ, Ozonoff S, Prizant BM, Rapin I, Rogers SJ, Stone WL, Teplin SW, Tuchman RF, Volkmar FR (2000) Practice parameter: screening and diagnosis of autism: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology 55(4):468–479PubMedCrossRefGoogle Scholar
  22. 22.
    Planche P, Lazartigues A, Lemoniier E (2004) Identification of the early signs of autism spectrum disorder: Age at detection and conjectures about development. In: Ryaskin OT (ed) Focus on autism research. Nova Biomedical Books, New York, pp 103–123Google Scholar
  23. 23.
    Howlin P, Moore A (1997) Diagnosis in autism: a survey of over 1200 parents. Autism 1:135–162CrossRefGoogle Scholar
  24. 24.
    Wang J, Cao M-R, Zhou X, Wang X-L, Sun C-H, Wei X, Wu L-J (2010) Survey on the status of clinic visits and family nursing care for autism children. Chin J Child Health Care 18(10):757–760Google Scholar
  25. 25.
    Jorm AF (2000) Mental health literacy. Public knowledge and beliefs about mental disorders. Br J Psychiatry 177:396–401PubMedCrossRefGoogle Scholar
  26. 26.
    Andersen R, Newman JF (1973) Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc 51(1):95–124PubMedCrossRefGoogle Scholar
  27. 27.
    Heidgerken AD, Geffken G, Modi A, Frakey L (2005) A survey of autism knowledge in a health care setting. J Autism Dev Disord 35(3):323–330PubMedCrossRefGoogle Scholar
  28. 28.
    Bakare MO, Ebigbo PO, Agomoh AO, Menkiti NC (2008) Knowledge about childhood autism among health workers (KCAHW) questionnaire: description, reliability and internal consistency. Clin Pract Epidemiol Ment Health 4:17PubMedCrossRefGoogle Scholar
  29. 29.
    Koyama T, Tachimori H, Sawamura K, Koyama A, Naganuma Y, Makino H, Takeshima T (2009) Mental health literacy of autism spectrum disorders in the Japanese general population. Soc Psychiatry Psychiatr Epidemiol 44(8):651–657PubMedCrossRefGoogle Scholar
  30. 30.
    Lian WB, Ho SK, Yeo CL, Ho LY (2003) General practitioners’ knowledge on childhood developmental and behavioural disorders. Singap Med J 44(8):397–403Google Scholar
  31. 31.
    Olafsdottir S, Pescosolido BA (2011) Constructing illness: how the public in eight Western nations respond to a clinical description of “schizophrenia”. Soc Sci Med 73(6):929–938PubMedCrossRefGoogle Scholar
  32. 32.
    Fan Y-B, Jie X-F, Zou X-B (2008) Prevalence of autism: a systematic review. Chin J Child Health Care 16(4):439–441Google Scholar
  33. 33.
    Mandell DS, Novak M (2005) The role of culture in families’ treatment decisions for children with autism spectrum disorders. Ment Retard Dev Disabil Res Rev 11(2):110–115PubMedCrossRefGoogle Scholar
  34. 34.
    Harrington JW, Patrick PA, Edwards KS, Brand DA (2006) Parental beliefs about autism: implications for the treating physician. Autism 10(5):452–462PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Jia Wang
    • 1
  • Xue Zhou
    • 1
  • Wei Xia
    • 1
  • CaiHong Sun
    • 1
  • LiJie Wu
    • 1
    Email author
  • JianLi Wang
    • 2
  1. 1.Department of Children’s and Adolescent HealthPublic Health College of Harbin Medical UniversityHarbinPeople’s Republic of China
  2. 2.Departments of Psychiatry and of Community Health Sciences, Faculty of MedicineUniversity of CalgaryCalgaryCanada

Personalised recommendations