Journal of Autism and Developmental Disorders

, Volume 42, Issue 7, pp 1491–1497 | Cite as

The Prevalence of Autism Spectrum Disorders in Toddlers: A Population Study of 2-Year-Old Swedish Children

  • Gudrun NygrenEmail author
  • Mats Cederlund
  • Eva Sandberg
  • Fredrik Gillstedt
  • Thomas Arvidsson
  • I. Carina Gillberg
  • Gunilla Westman Andersson
  • Christopher Gillberg
Original Paper


Autism Spectrum Disorder (ASD) is more common than previously believed. ASD is increasingly diagnosed at very young ages. We report estimated ASD prevalence rates from a population study of 2-year-old children conducted in 2010 in Gothenburg, Sweden. Screening for ASD had been introduced at all child health centers at child age 21/2 years. All children with suspected ASD were referred for evaluation to one center, serving the whole city of Gothenburg. The prevalence for all 2-year-olds referred in 2010 and diagnosed with ASD was 0.80%. Corresponding rates for 2-year-olds referred to the center in 2000 and 2005 (when no population screening occurred) were 0.18 and 0.04%. Results suggest that early screening contributes to a large increase in diagnosed ASD cases.


Autism Autism spectrum disorder Prevalence Early detection Screening Diagnostic instruments 


  1. American Academy of Pediatrics, C.o.C.w.D., Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children With Special Needs Project Advisory Committee (2006). Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics 118, 405–420. doi: 10.1542/peds.2006-1231.
  2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (text revision), 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
  3. Arvidsson, T., Holmberg, L., Reuter, A., & Strömbom, A. (2010). Barnhälsovårdsrapport verksamhetsåret 2010 Västragötalandsregionen. Göteborg.Google Scholar
  4. Baird, G., et al. (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, 210–215. doi: 10.1016/S0140-6736(06)69041-7.PubMedCrossRefGoogle Scholar
  5. Baron-Cohen, S., et al. (2009). Prevalence of autism-spectrum conditions: UK school-based population study. British Journal of Psychiatry, 194, 500–509. doi: 10.1192/bjp.bp.108.059345.PubMedCrossRefGoogle Scholar
  6. Chawarska, K., Klin, A., Paul, R., Macari, S., & Volkmar, F. (2009). A prospective study of toddlers with ASD: Short-term diagnostic and cognitive outcomes. Journal of Child Psychology and Psychiatry and Allied Disciplines, 50, 1235–1245. doi: 10.1111/j.1469-7610.2009.02101.x.CrossRefGoogle Scholar
  7. Coleman, M., & Gillberg, C. (2011). The autisms. Oxford University Press (in press).Google Scholar
  8. De Giacomo, A., & Fombonne, E. (1998). Parental recognition of developmental abnormalities in autism. European Child and Adolescent Psychiatry, 7, 131–136.PubMedCrossRefGoogle Scholar
  9. Dealberto, M. J. (2011). Prevalence of autism according to maternal immigrant status and ethnic origin. Acta Psychiatrica Scandinavica, 123, 339–348. doi: 10.1111/j.1600-0447.2010.01662.x.PubMedCrossRefGoogle Scholar
  10. Eaves, L. C., & Ho, H. H. (2004). The very early identification of autism: Outcome to age 4 1/2–5. Journal of Autism and Developmental Disorders, 34, 367–378.PubMedCrossRefGoogle Scholar
  11. Fernell, E., & Gillberg, C. (2010). Autism spectrum disorder diagnoses in Stockholm preschoolers. Research in Developmental Disabilities, 31, 680–685. doi: 10.1016/j.ridd.2010.01.007.PubMedCrossRefGoogle Scholar
  12. Fombonne, E. (2009). Epidemiology of pervasive developmental disorders. Pediatric Research, 65, 591–598. doi: 10.1203/PDR.0b013e31819e7203.PubMedCrossRefGoogle Scholar
  13. Gillberg, C. (1983). Perceptual, motor and attentional deficits in Swedish primary school children. Some child psychiatric aspects. Journal of Child Psychology and Psychiatry and Allied Disciplines, 24, 377–403.CrossRefGoogle Scholar
  14. Gillberg, C. (1984). On the relationship between epidemiological and clinical samples. Journal of Autism and Developmental Disorders, 14, 214–217.PubMedCrossRefGoogle Scholar
  15. Gillberg, C. (1990). Infantile autism: Diagnosis and treatment. Acta Psychiatrica Scandinavica, 81, 209–215.PubMedCrossRefGoogle Scholar
  16. Gillberg, C., Cederlund, M., Lamberg, K., & Zeijlon, L. (2006). Brief report: “the autism epidemic”. The registered prevalence of autism in a Swedish urban area. Journal of Autism and Developmental Disorders, 36, 429–435. doi: 10.1007/s10803-006-0081-6.PubMedCrossRefGoogle Scholar
  17. Gillberg, C., Steffenburg, S., & Schaumann, H. (1991). Is autism more common now than ten years ago? British Journal of Psychiatry, 158, 403–409.PubMedCrossRefGoogle Scholar
  18. Gillberg, C., et al. (1990). Autism under age 3 years: A clinical study of 28 cases referred for autistic symptoms in infancy. Journal of Child Psychology and Psychiatry and Allied Disciplines, 31, 921–934.CrossRefGoogle Scholar
  19. Johnson, S., Hollis, C., Hennessy, E., Kochhar, P., Wolke, D., & Marlow, N. (2011). Screening for autism in preterm children: Diagnostic utility of the Social Communication Questionnaire. Archives of Disease in Childhood, 96, 73–77. doi: 10.1136/adc.2010.194795.PubMedCrossRefGoogle Scholar
  20. Johnson, C. P., & Myers, S. M. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120, 1183–1215. doi: 10.1542/peds.2007-2361.PubMedCrossRefGoogle Scholar
  21. Kadesjo, B., Gillberg, C., & Hagberg, B. (1999). Brief report: Autism and Asperger syndrome in seven-year-old children: A total population study. Journal of Autism and Developmental Disorders, 29, 327–331.PubMedCrossRefGoogle Scholar
  22. Kleinman, J. M., et al. (2008). The modified checklist for autism in toddlers: A follow-up study investigating the early detection of autism spectrum disorders. Journal of Autism and Developmental Disorders, 38, 827–839. doi: 10.1007/s10803-007-0450-9.PubMedCrossRefGoogle Scholar
  23. Lord, C. (1995). Follow-up of two-year-olds referred for possible autism. Journal of Child Psychology and Psychiatry and Allied Disciplines, 36, 1365–1382.CrossRefGoogle Scholar
  24. Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63, 694–701. doi: 10.1001/archpsyc.63.6.694.PubMedCrossRefGoogle Scholar
  25. Lord, C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.PubMedCrossRefGoogle Scholar
  26. Lotter, V. (1966). Epidemiology of autistic conditions in young children. Prevalence. Social Psychiatry, 1, 163–173.CrossRefGoogle Scholar
  27. Nicholas, J. S., Carpenter, L. A., King, L. B., Jenner, W., & Charles, J. M. (2009). Autism spectrum disorders in preschool-aged children: Prevalence and comparison to a school-aged population. Annals of Epidemiology, 19, 808–814. doi: 10.1016/j.annepidem.2009.04.005.PubMedCrossRefGoogle Scholar
  28. Norberg, L., Tingwall, V., & Ahlin-Åkerman, B. (1980). Standardisering av Griffiths utvecklingsskala för åldern 2–8 år. Stockholm: Högskolan för lärarutbildning, Institutionen för pedagogik.Google Scholar
  29. Nygren, G., Hagberg, B., Billstedt, E., Skoglund, A., Gillberg, C., & Johansson, M. (2009). The Swedish version of the Diagnostic Interview for Social and Communication Disorders (DISCO-10). Psychometric properties. Journal of Autism and Developmental Disorders, 39, 730–741. doi: 10.1007/s10803-008-0678-z.PubMedCrossRefGoogle Scholar
  30. Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The modified checklist for autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31, 131–144.PubMedCrossRefGoogle Scholar
  31. Siegel, B., Pliner, C., Eschler, J., & Elliott, G. R. (1988). How children with autism are diagnosed: Difficulties in identification of children with multiple developmental delays. Journal of Developmental and Behavioral Pediatrics, 9, 199–204.PubMedCrossRefGoogle Scholar
  32. Sparrow, S., Balla, D., & Cicchetti, D. (1984). The Vineland Adaptive Behavior Scales. Circle Pines, MN: American Guidance Service.Google Scholar
  33. Statistics Sweden. (2010). Statistiska Centralbyrån/Statistics Sweden. Google Scholar
  34. Steffenburg, S., & Gillberg, C. (1986). Autism and autistic-like conditions in Swedish rural and urban areas: A population study. British Journal of Psychiatry, 149, 81–87.PubMedCrossRefGoogle Scholar
  35. Wing, L., Leekam, S. R., Libby, S. J., Gould, J., & Larcombe, M. (2002). The diagnostic interview for social and communication disorders: Background, inter-rater reliability and clinical use. Journal of Child Psychology and Psychiatry and Allied Disciplines, 43, 307–325.CrossRefGoogle Scholar
  36. Wing, L., Yeates, S. R., Brierley, L. M., & Gould, J. (1976). The prevalence of early childhood autism: Comparison of administrative and epidemiological studies. Psychological Medicine, 6, 89–100.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Gudrun Nygren
    • 1
    Email author
  • Mats Cederlund
    • 1
  • Eva Sandberg
    • 1
  • Fredrik Gillstedt
    • 1
  • Thomas Arvidsson
    • 1
  • I. Carina Gillberg
    • 1
  • Gunilla Westman Andersson
    • 1
  • Christopher Gillberg
    • 1
  1. 1.Gillberg Neuropsychiatry Centre, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden

Personalised recommendations