Brief Report: Cumulative Incidence of Autism Spectrum Disorder Before School Entry in a Thoroughly Screened Population


The present study aimed to identify the cumulative incidence of autism spectrum disorder (ASD) in a thoroughly screened population and to examine the behavioral and motor characteristics observed in children with ASD at the age of 18 months. Subjects were 1067 children who underwent a screening assessment for ASD at the routine 18-months health checkup. By the age of 6 years, 3.1% (4.3% of boys and 2.0% of girls) were diagnosed as having ASD by their attending pediatricians. Higher rate of difficulties in motor skills and social and communication skills had been reported in children with ASD at 18 months of age. This study showed that careful community-based screening system may be helpful in detecting ASD at early age.

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The authors would like to thank all the members of our research group, especially Ms. Emi Hirabayashi, Ms. Hiromi Momose, Ms. Haruka Yamada, Ms. Naoko Takahashi, Ms. Miyuki Kuwata, Mr. Susumu Chino, Mr. Hiroyuki Yamaguchi, and Mr. Toshihiro Imai for support and guidance throughout the study.


This study was supported by Promotion Project of Education, Research, and Medical Care from Shinshu University Hospital (D.S.), Grant-in-Aid for Scientific Research from the Ministry of Health, Labour and Welfare (H30-shintai-ippan-002), and a grant from Meiji Yasuda Mental Health Foundation (2015).

Author information




All authors contributed to the study conception and design. Material preparation was performed by DS, TK, WK, NK, TN, and HH. Data collection was performed by DS, TK, and WK. Analysis was performed by DS and HH. The first draft of the manuscript was written by DS. RK, NK, SW, and HH supervised the writing of the paper and gave critical comments on the manuscript. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Daimei Sasayama.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Ethics Committee of Shinshu University School of Medicine, reference numbers 3297, 3614, and 3905) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

The ethics review committee (Ethics Committee of Shinshu University School of Medicine) determined that informed consent was not required due to the nature of the study. Caregivers of the study subjects were informed of their option to opt out via our institutional website and posters posted in the city hall of Okaya-shi.

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Sasayama, D., Kudo, T., Kaneko, W. et al. Brief Report: Cumulative Incidence of Autism Spectrum Disorder Before School Entry in a Thoroughly Screened Population. J Autism Dev Disord (2020).

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  • Autism spectrum disorder
  • Epidemiology
  • Incidence
  • Mass screening