Abdolreza Yavari
1 
, Maryam Zamanian
2 , Mahdi Panahian
3* , Akram Valizadeh
1 1 Department of Speech Therapy, School of Rehabilitation, Arak University of Medical Sciences, Arak, Iran
2 Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
3 Department of Audiology, School of Rehabilitation, Arak University of Medical Sciences, Arak, Iran
Abstract
Background. Many people with high-functioning autism are not diagnosed and treated until pre-school or early school years. This study aimed to investigate the prevalence of high-functioning autism spectrum disorder in students aged 7-12 from Arak city in order to identify these students and protect them against further harm by early intervention.
Methods. This cross-sectional analytical study was conducted to investigate 2864 male and female students having an IQ of 70 or higher and completing their first to sixth grades in primary schools located in Arak between October 2017 and June 2018, by using the ASSQ questionnaire. This questionnaire had been designed to screen the autism spectrum, and its validity and reliability had been confirmed by Kasechi at the University of Social Welfare Sciences in 2013 in Tehran. Individuals scoring 22 or higher on the questionnaire were identified as having high-functioning autism spectrum disorder.
Results. A total of 2864 elementary school students with an average age of 9.16 years (minimum 7 years and maximum 12 years) and completing the first to sixth grades were evaluated. According to the results, 1.7% of students had high-functioning autism spectrum disorder. The age variable with P-value=0.003 (the highest prevalence (3.1%) was recorded for the age group of 7 years and the lowest prevalence (0.7%) was found for the age group of 8 and 9 years) and the gender variable with P=0.002 (1.1% of male students and 2.3% of female students) made significant difference in the prevalence of this disorder. Moreover, the prevalence of the disorder was higher in girls than boys.
Conclusion. High-functioning autism spectrum disorder was a latent disorder with a relatively high prevalence, which was higher in girls than boys. Furthermore, the prevalence was not age-related, and there was a possibility for the occurrence of this disorder’s symptoms at any age.
Extended Abstract
Background
Autism Spectrum Disorder (ASD) is a serious developmental neurological disorder in which people lose their ability to communicate and interact with others. Autism spectrum disorder is currently classified into two modes: High-functioning autism and Low-functioning autism. People with high-functioning autism have near-normal communication skills, normal intelligence, and slight learning difficulties. Although the symptoms of this spectrum of autism disorder appear in the first and second years of life, many of these people are not identified and treated until pre-school age or in the early years of school. In the present study, the prevalence of high-functioning autism in primary school children aged 7-12 years was investigated.
Methods
The study population of this cross-sectional analytical study consisted of all male and female students aged 7-12 years and completing their first to sixth grades in all primary schools located in Arak in the academic year 2017-2018. The sample was selected randomly based on the alphabetical list and according to educational grade, age and gender. The total number of samples from all primary schools of Arak was 3058 students. However, a total of 2864 students were included in the study according to the inclusion criteria (i.e., the age range of 7 to 12 years and IQ of 70 or higher) and the exclusion criteria (i.e., unwillingness to cooperate), out of which 1506 were girls and 1358 were boys.Then ASSQ questionnaire was used to assess the included students. This questionnaire screens autism spectrum, and its validity and reliability had been confirmed by Kasechi at the University of Social Welfare Sciences in 2013 in Tehran. Individuals scoring 22 or higher on the questionnaire were identified as having high-functioning autism spectrum disorder.After the completion of questionnaires by students, the data obtained from this study were entered into SPSS software, and the general prevalence of high-functioning autism spectrum was obtained based on gender and age. Independent t-test and analysis of variance were also used to compare the variables.
Results
A total of 2864 elementary school students with an average age of 9.16 years (minimum 7 years and maximum 12 years) and completing their first to sixth grades were evaluated. According to our results, 20% of the participants were 7, 20.2% were 8, 19.4% were 9, 16.8% were 10, 12.3% were 11, and 11.3% were 12 years old. Furthermore, 47.4% of the participants were boys and 52.6% of them were girls.The most important variable of this study was the prevalence of high-functioning autism spectrum disorder. Our study results showed that 49 students suffered from high-functioning autism spectrum disorder. In other words, the proportion of students with high-functioning autism spectrum disorder in primary schools in Arak in the 2017-2018 academic year was 1.7%.Another variable evaluated in this study was the prevalence of high-functioning autism in different genders. Our results revealed that 15 male students had high-functioning autism spectrum disorder, while 34 female students had this disorder. In other words, 1.1% of male students and 2.3% of female students in primary schools in Arak suffered from autism spectrum disorder with high performance; the rate of this variable was statistically significant in the two groups (P-value= 0.002).The third variable examined in this study was the association of the prevalence of high-functioning autism spectrum disorder with age. According to the results, the highest prevalence was recorded for the age group of 7 years with a prevalence of 3.1%, and the lowest prevalence was found for the age group of 8 and 9 years with a prevalence of 0.7%. Comparing the prevalence of high-functioning autism spectrum disorder in different age groups showed a statistically significant difference (P-value=0.003).
Conclusion
High-functioning autism spectrum disorder was a latent disorder with a relatively high prevalence, which was higher in girls than boys. Moreover, this prevalence was not age-related, and there was a possibility of the occurrence of this disorder’s symptoms at any age. Therefore, it was recommended that an early screening should be performed in order to facilitated the rapid diagnosis and intervention of high-functioning autism and prevent further social harm.