Are Autism Spectrum Conditions More Prevalent in an Information-Technology Region? A School-Based Study of Three Regions in the Netherlands

  • Martine T. Roelfsema
  • Rosa A. Hoekstra
  • Carrie Allison
  • Sally Wheelwright
  • Carol Brayne
  • Fiona E. Matthews
  • Simon Baron-CohenEmail author
Original paper


We tested for differences in the prevalence of autism spectrum conditions (ASC) in school-aged children in three geographical regions in the Netherlands. Schools were asked to provide the number of children enrolled, the number having a clinical diagnosis of ASC and/or two control neurodevelopmental conditions. Prevalence was evaluated by negative binomial regression and adjustments were made for non-response and size of the schools. The prevalence estimates of ASC in Eindhoven was 229 per 10,000, significantly higher than in Haarlem (84 per 10,000) and Utrecht (57 per 10,000), whilst the prevalence for the control conditions were similar in all regions. Phase two is planned to validate school-reported cases using standardized diagnostic methods and to explore the possible causes for these differences.


Autism spectrum conditions Prevalence Regional differences Hyper-systemizing theory 



This study was conducted in association with the NIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation Trust. This work was supported by grants to SBC from the Medical Research Council UK, Target Autism Genome, and the Nancy Lurie Marks Family Foundation. During this work, MTR was supported by scholarships from the Erasmus fund, the Bekker la Bastide fund and the University of Amsterdam and RAH was supported by the Netherlands Organisation for Scientific Research (NWO Rubicon). FM is also supported by the MRC UK (MRC.MC_US_A030_0031.). We gratefully acknowledge the schools for their participation in this project, Geertje Anderson for her contribution to the data collection, and Patrick Wiercx, Marjolijn Weijmans, Ger Maassen, Annelies Spek and Rutger Jan van der Gaag for valuable discussion.


  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (text revision) (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  2. Baird, G., Simonoff, E., Pickles, A., Chandler, S., Loucas, T., Meldrum, D., 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.PubMedCrossRefGoogle Scholar
  3. Baron-Cohen, S. (2006). The hyper-systemizing, assortative mating theory of autism. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 30, 865–872.PubMedCrossRefGoogle Scholar
  4. Baron-Cohen, S. (2008). Autism, hypersystemizing, and truth. Quarterly Journal of Experimental Psychology, 61, 64–75.CrossRefGoogle Scholar
  5. Baron-Cohen, S., & Hammer, J. (1997). Parents of children with Asperger syndrome: what is the cognitive phenotype? Journal of Cognitive Neuroscience, 9, 548–554.CrossRefGoogle Scholar
  6. Baron-Cohen, S., Wheelwright, S., Stott, C., Bolton, P., & Goodyer, I. (1997). Is there a link between engineering and autism? Autism, 1, 153–163.CrossRefGoogle Scholar
  7. Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The autism-spectrum quotient (AQ): evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31, 5–17.PubMedCrossRefGoogle Scholar
  8. Baron-Cohen, S., Richler, J., Bisarya, D., Gurunathan, N., & Wheelwright, S. (2003). The systemizing quotient: an investigation of adults with Asperger syndrome or high-functioning autism, and normal sex differences. Philosophical Transactions of the Royal Society London, 358, 361–374.CrossRefGoogle Scholar
  9. Baron-Cohen, S., Ring, H., Chitnis, X., Wheelwright, S., Gregory, L., Williams, S., et al. (2006). fMRI of parents of children with Asperger syndrome: a pilot study. Brain and Cognition, 61, 122–130.PubMedCrossRefGoogle Scholar
  10. Baron-Cohen, S., Wheelwright, S., Burtenshaw, A., & Hobson, E. (2007). Mathematical talent is linked to Autism. Human Nature, 18, 125–131.CrossRefGoogle Scholar
  11. Baron-Cohen, S., Scott, F. J., Allison, C., Williams, J., Bolton, P., Matthews, F. E., et al. (2009). Autism spectrum prevalence: a school-based UK population study. British Journal of Psychiatry, 194, 500–509.PubMedCrossRefGoogle Scholar
  12. Begeer, S., Bouk, S. E., Boussaid, W., Terwogt, M. M., & Koot, H. M. (2009). Underdiagnosis and referral bias of autism in ethnic minorities. Journal of Autism and Developmental Disorders, 39, 142–148.PubMedCrossRefGoogle Scholar
  13. Bölte, S., & Poustka, F. (2006). The broader cognitive phenotype of autism in parents: how specific is the tendency for local processing and executive dysfunction? Journal of Child Psychology and Psychiatry, 47, 639–645.PubMedCrossRefGoogle Scholar
  14. Fombonne, E. (1999). The epidemiology of autism: a review. Psychological Medicine, 29, 769–786.PubMedCrossRefGoogle Scholar
  15. Happé, F., Briskman, J., & Frith, U. (2001). Exploring the cognitive phenotype of autism: weak “central coherence” in parents and siblings of children with autism: I. Experimental tests. Journal of Child Psychology and Psychiatry, 42, 299–307.PubMedCrossRefGoogle Scholar
  16. Hoekstra, R. A., Bartels, M., Cath, D. C., & Boomsma, D. I. (2008). Factor structure, reliability and criterion validity of the autism-spectrum quotient (AQ): A study in Dutch population and patient groups. Journal of Autism and Developmental Disorders, 38, 1555–1566.PubMedCrossRefGoogle Scholar
  17. Jolliffe, T., & Baron-Cohen, S. (1997). Are people with autism or Asperger’s syndrome faster than normal on the embedded figures task? Journal of Child Psychology and Psychiatry, 38, 527–534.PubMedCrossRefGoogle Scholar
  18. LISA. (2010). Netherlands (Database of all employer business establishments in the Netherlands). Available at
  19. Liu, K., King, M., & Bearman, P. (2010). Social influence and the autism epidemic. The American Journal of Sociology, 115, 1387–1434.CrossRefGoogle Scholar
  20. Lotter, V. (1966). Epidemiology of autistic conditions in young children: 1. Prevalence. Social Psychiatry, 1, 124–137.CrossRefGoogle Scholar
  21. Piven, J., Palmer, P., Jacobi, D., Childress, D., & Arndt, S. (1997). Broader autism phenotype: evidence from a family history study of multiple-incidence autism families. American Journal of Psychiatry, 154, 185–190.PubMedGoogle Scholar
  22. Rice, C. (2009). Prevalence of autism spectrum disorders—Autism and developmental disabilities monitoring network, United States, 2002. Surveillance Summaries, 58, 1–20.Google Scholar
  23. Ronald, A., & Hoekstra, R. A. (2011). Autism spectrum disorders and autistic traits: A decade of new twin studies. American Journal of Medical Genetics Part B, 156, 255–274.CrossRefGoogle Scholar
  24. Rutter, M. (2005). Genetic influences and autism. In F. R. Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism, pervasive developmental disorders (3rd ed.). New York: Wiley.Google Scholar
  25. Scott, F. J., Baron-Cohen, S., Bolton, P., & Brayne, C. (2002). The CAST (Childhood Asperger Syndrome Test): Preliminary development of a UK screen for mainstream primary-school-age children. Autism, 6, 9–31.PubMedCrossRefGoogle Scholar
  26. Shah, A., & Frith, U. (1983). An islet of ability in autistic children: A research note. Journal of Child Psychology and Psychiatry, 24, 613–620.PubMedCrossRefGoogle Scholar
  27. Statistics Netherlands: Central Bureau of Statistics (CBS) (2008). Available at
  28. Volkmar, F., Lord, C., Bailey, A., Schultz, R., & Klin, A. (2004). Autism and pervasive developmental disorders. Journal of Child Psychology and Psychiatry, 45, 135–170.PubMedCrossRefGoogle Scholar
  29. Wakabayashi, A., Baron-Cohen, S., Wheelwright, S., & Tojo, Y. (2006). The autism-spectrum quotient (AQ) in Japan: A cross-cultural comparison. Journal of Autism and Developmental Disorders, 36, 263–270.PubMedCrossRefGoogle Scholar
  30. Wheelwright, S., Baron-Cohen, S., Goldenfeld, N., Delaney, J., Fine, D., Smith, R., et al. (2006). Predicting Autism Spectrum Quotient (AQ) from the Systemizing Quotient-Revised (SQ-R) and Empathy Quotient (EQ). Brain Research, 1079, 47–56.PubMedCrossRefGoogle Scholar
  31. Wiercx, P. (2009). ZO-Brabant worstelt met autisme. Eindhovens Dagblad. Available at (GGZ Eindhoven):
  32. Windham, G. C., Fessel, K., & Grether, J. K. (2009). Autism spectrum disorders in relation to parental occupation in technical fields. Autism Research, 2, 183–191.PubMedCrossRefGoogle Scholar
  33. Wing, L., & Potter, D. (2002). The epidemiology of autistic spectrum disorders: Is the prevalence rising? Mental Retardation and Developmental Disabilities Research Reviews, 8, 151–161.PubMedCrossRefGoogle Scholar
  34. World Health Organization. (1993). The ICD–10 classification of mental and behavioural. Disorders: Diagnostic criteria for research. Geneva: WHO.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Martine T. Roelfsema
    • 1
  • Rosa A. Hoekstra
    • 1
    • 2
  • Carrie Allison
    • 1
  • Sally Wheelwright
    • 1
    • 5
  • Carol Brayne
    • 3
  • Fiona E. Matthews
    • 4
  • Simon Baron-Cohen
    • 1
    Email author
  1. 1.Autism Research Centre, Department of PsychiatryUniversity of CambridgeCambridgeUK
  2. 2.Department of Life SciencesThe Open UniversityMilton KeynesUK
  3. 3.Department of Public Health and Primary Care, Institute of Public HealthUniversity of CambridgeCambridgeUK
  4. 4.MRC Biostatistics Unit, Institute of Public HealthCambridgeUK
  5. 5.University Surgical Unit, Southampton General HospitalSouthamptonUK

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