Prevalence and determinants of autism spectrum disorder in children in Saudi Arabia in comparison to developed countries: a systematic review and meta-analysis

Abstract

This study addressed the prevalence and determinants of autism spectrum disorder (ASD) in children, with an aim to provide a comprehensive overview of global trends in ASD prevalence, considering the challenges posed by methodological variations, diverse definitions of autism, and varying diagnostic criteria among different nations. A systematic literature search yielded 3,457 studies, narrowed down to 1,834 after eliminating duplicates. The screening process, involved a meticulous review of titles, abstracts, and full-text articles, resulted in the exclusion of 870 studies that did not meet the inclusion criteria. Quality assessment identified and removed seven low-quality studies. The final meta-analysis incorporated 25 studies, presenting a diverse snapshot of ASD prevalence in developed countries. The selected studies spanned the years 2015 to 2023, ensuring a contemporary representation. The meta-analysis revealed a global prevalence of ASD in children at 0.51%, with a 95% confidence interval ranging from 0.4% to 1%. Regional variations were observed, with Saudi Arabia exhibiting a prevalence of 1.33%, surpassing the global average. Gender disparity was consistent, with males having a higher representation, reflecting a global trend. Differences in the definition of autism, screening tools, and diagnostic criteria presented challenges in cross-country comparisons, emphasizing the need for standardized approaches in future research. This study contributed valuable insights into the global prevalence of ASD, highlighting regional variations, gender disparities, and methodological challenges. The elevated prevalence in Saudi Arabia underscores the importance of tailored interventions, while the methodological differences emphasize the need for standardization in ASD research.