Autism In China Research Articles

QUALITATIVE RESEARCH ON LIVING STATUS OF OLDER AUTISTIC FAMILIES IN JIAXING CITY, CHINA

Objective: It aimed to learn the living status of older autistic children and to put forward countermeasures and suggestions to improve the quality of life of older autistic children and family members. Methods: Literature analysis method was used to understand the related research and policy of older autism in China. Deep interview was conducted with older autistic families. The contents of the interviews were recorded after informed consent, and the recordings were transformed into text materials. Text analysis was carried out. One family was given a six-month psychological intervention. Results: All the 6 cases cannot go out independently and seek emergency help. Only 1 case has self-care ability. The main psychological stress of family member is warrying about children’s future. 5 cases pointed out that adolescent emotional and behavioral problems are urgent problems for parents. Conclusion: It is necessary to apply psychological lectures and counseling for emotional and behavioral management to autism family members. It is important to develop employment policy and caring services. Which are helpful to improve the living status of older autism and family members.

Culturally Relevant Special Education Curriculum for Children With Autism in China

Special education schools in China and other developing countries are increasingly adapting curricula and approaches developed in Western countries to serve young children with disabilities. Yet no...

A Systematic Review of Applied Behavior Analytic Interventions for Children with Autism in Mainland China

Applied behavior analysis (ABA)-based intervention is typically utilized to support children with autism spectrum disorders (ASD), which has been widely used across the world. However, little is known about the current extent of the utilization of applied behavior analysis for children with autism in China. This paper provides a systematic review on the ABA-based intervention studies conducted in Mainland China. Studies published in Chinese and English journals were included, and 35 empirical studies qualified for the selection criteria were analyzed. The results suggest that the Chinese ABA-based programs are generally effective. Among the overall publications on the ABA-based intervention, there is a limited number of empirical studies, but this type of studies increases in recent years. In addition, one characteristic of the Chinese programs is that parental involvement is emphasized. The review also reveals the wide use of non-behavioral eclectic methods and the limit in the experimental design in some Chinese studies. The implications of these findings for research and practice are discussed.

Autism in China: Progress and challenges in addressing the needs of children and families

ABSTRACTOver the past decade there has been a substantial increase in research addressing the needs of children in China who have an autism spectrum disorder (ASD). Despite the fact the country has the largest educational system in the world and has numerous policies to ensure all children’s rights to an education, opportunities are limited for children with disabilities. Recent revisions to China’s Regulations Educating Students with Disabilities that mandate inclusion (www.cdpf.org/cn/english/law/content/2008-04/10/content_84949.htm) may help, however, effective education requires more than a policy and a desk in a classroom; it requires thoughtful plans, teacher preparation, adequate resource allocation, and administrative commitment. This article describes the progress that China has made in addressing the needs of children with ASD, and the challenges it still faces. Whereas some local governments have recently increased funding to families caring for a child with ASD, most have not. Hopefully, the fact the central government has invested millions of yuan in an epidemiological study on autism and is participating in one of the most ambitious investigations ever conducted on the genetics of autism is a signal that autism is now a priority of China’s and greater resources will be provided to ensure affordable treatment and appropriate educational options.

Autism prevalence in China is comparable to Western prevalence

BackgroundAutism prevalence in the West is approximately 1% of school age children. Autism prevalence in China has been reported to be lower than in the West. This is likely due to at least two reasons: (1) most studies in China only included the special school population, overlooking the mainstream school population; and (2) most studies in China have not used contemporary screening and diagnostic methods. To address this, we tested total autism prevalence (mainstream and special schools) in Jilin City, and mainstream school autism prevalence in Jiamusi and Shenzhen cities.MethodsThe study included a three-step process: (1) screening; (2) clinical assessment of ‘screen positives’ plus controls; and (3) research diagnostic assessment of those meeting clinical threshold for concerns at step 2. Prevalence estimates per 10,000 children aged 6–10 years old were weighted for study design using diagnostic criteria applied at the research assessment stage.ResultsIn Jilin City, 77 cases of autism were identified from a total population of 7258, equating to a prevalence of 108 per 10,000 (95% confidence interval (CI) 89, 130). In Shenzhen City: 21,420 children were screened and 35 cases of autism were identified, resulting in a mainstream prevalence of 42 per 10,000 (95% CI 20–89). In Jiamusi City, 16,358 children were screened, with 10 autism cases being identified, with a mainstream prevalence of 19 per 10,000 (95% CI 10–38).ConclusionsResults from Jilin City, where both mainstream and special school data were available, revealed a similar prevalence of autism in China to the West, at around 1%. Results from Shenzhen and Jiamusi cities, where only mainstream data were available, prevalence is also in line with Western estimates. In all three cities, new cases of autism were identified by the study in mainstream schools, reflecting current under-diagnosis. Non-significant variation across different cities is seen indicating the need to explore potential variation of autism across diverse Chinese regions with large sample sizes to achieve a fully robust national picture.

Deconstructing the employment problem of adult autism spectrum disorders from the Strength Perspective

The data show that the prevalence of autism in China is on the rise. As autistic patients grow up, their employment problems are highlighted. The current employment situation of older autistic groups is not ideal. This paper breaks away from the original “problem perspective” and “defect perspective” and introduces the “ strength perspective “ into the employment problem of adult autism spectrum disorders. After analyzing the contradiction between action and self-awareness in the plan, personal superiority and social discrimination, and the contradiction between membership and social security, from the perspective of superiority, the expectations and suggestions that are conducive to the employment of adult autism spectrum disorders are proposed.

The Application of the First Year Inventory for ASD Screening in China

PurposeThe First Year Inventory (FYI) is a parent-report instrument, and is developed to assess behaviors of 12-month-old infants that could suggest risk for an eventual diagnosis of autism. This study was designed to examine the application of the FYI in the Chinese community. Design and methodsFYIs were completed at a community health center by 541 families during the child's physical examination at 12 months of age from 2013 to 2015. The weighted risk scores used in this study were based on US norms, and compared the FYI differences between China and the U.S. ResultsThe total risk scores ranged from 5 to 42 points; the 95th percentile cutoff was 27.00(9.8 points higher than the 95th percentile cutoff in the US), the 98th percentile cutoff was 29.66(7.04 points higher than the 98th percentile cutoff in the US), and the 99th percentile cutoff was 31.83. Higher risk scores were found for boys than girls. Mothers with a junior college education reported significantly higher FYI risk scores than other three groups including high school, college graduates and post-graduates. ConclusionsThere were no significant effects of birth parity, investigator, or investigation year on risk scores. Large-scale longitudinal research is encouraged in the future to develop an early detection model of autism in China.

Effects of PECS on the Emergence of Vocal Mands and the Reduction of Aggressive Behavior Across Settings for a Child With Autism

Effective strategies to address communication and behavior challenges are critical in early intervention programs. The purpose of this study was to investigate the effects of the Picture Exchange Communication System (PECS) on vocal mands and aggressive behavior displayed by a child with autism in China. One 4-year-old boy with autism participated in this study. The experimental design was a multiple baseline across three settings. The PECS intervention involved the first three phases described in the PECS manual. The results indicated that PECS effectively increased vocal mands and decreased aggressive behavior maintained by access to preferred items in all three settings. The results also suggested that vocal mands were potentially controlled by pictures in the PECS book. One week following the completion of the intervention, the child maintained the PECS exchanges at a high level with increased vocal mands. His aggressive behavior remained at almost zero occurrences. Results of this study have important implications to early intervention educators working with children with autism.

An Emotional Skills Intervention for Elementary Children with Autism in China: A Pilot Study

The purpose of this pilot study was to examine the effects of an emotional skills intervention on behavioral and emotional competence, as well as on communication for children with autism in China. Eight children (seven boys and one girl), aged 7 to 8, participated in this study. We used a pre and posttest group design. The intervention consisted of 10 group sessions and four individual sessions. Each group session had two or three children. The intervention curriculum consisted of emotion recognition, emotion recognition within context, self-expression of emotions, seeking help when encountering problems, and techniques for emotion regulation. Results indicated that the intervention significantly improved children’s emotional skills, behavioral and emotional competence, and communication. The potential implications of this study for elementary children with autism in China are also discussed.

Gut microbiota and autism

Autism spectrum disorder (ASD) is one of the most severe neurodevelopmental disorders in the world, and it has brought tremendous burden for family and society. However, there is still no effective method clinically to cure this disorder. The morbidity of the disorder has increased rapidly in recent decades, which does not correspond with Hardy-Weinberg Equilibrium, indicating the disorder is more involved in some environmental factors than genes. Maternal disturbances, poor diet, and leaky gut are remarkable risk factors for autism, all of which can induce gut microbiota dysbiosis. More and more studies have indicated that autism is closely related to imbalanced gut microbiota and abnormal gut-brain axis. Autistic children have different gut microbiota including bacteria and fungi from healthy children, and gut microbiota modulation using either antibiotics, probiotics, or fecal microbiota transplantation may change autistic symptoms. Due to the synchronization of gut brain development and brain development, factors that affect the gut microbiota development of infants during the critical period will increase the incidence rate of autism. Gut microbiota can influence brain development and brain function like behavior and cognition through gut-brain axis/microbiota-gut-brain axis. The microbiota-gut-brain axis mainly include four pathways, which are metabolism, immune system, neuroendocrine system, and vagus nervous system. Abnormal microbiota can increase the harmful metabolites including 3-(3-hydroxyphenyl)-3-hydroxypropionic acid (HPHPA) and 4-ethylphenylsulfate (4EPS) to induce autistic-like behaviors. Gut microbiota regulates the development and function of immune system, and microbiota dysbiosis can result in chronic inflammation to impair the normal development of brain and mentality. Abnormal microbiota can induce autistic symptoms through neuroendocrine pathway, it probably disturbs the development and function of hypothalamus-pituitary-adrenal (HPA) axis, influence the activity of serotonergic system and oxytocin system, and increase the content of harmful gas neurotransmitters such as hydrogen sulfide (H2S) and ammonia (NH3). Microbiota dysbiosis can also lead to autistic-like behaviors through vagus nervous system. Gut microbiota dysbiosis will possibly be the effective target of autism treatment. Increasing studies have shown that gut microbiota restoration including probiotics supplementation alleviates autism symptoms. Certain beneficial microbial strains can recover normal microbiota, prevent pathogen infection, alleviate gut barrier leakiness, prompt gastrointestinal function, and improve behavior and cognition development. These beneficial bacteria probably alleviate autism through regulating the microbiota-gut-brain axis function. They can improve brain function via vagus nervous systems, alleviate brain inflammation through immune response regulation, and restore normal brain neurotransmitters and neurogenesis through HPA function recovery and neurotransmitters metabolism regulation. The new intervention is different from traditional interventions which usually focus on one or two symptoms of autism, it not only restores normal gut microbiota but also improve the whole microbiota-gut-brain axis function including the gut brain and the great brain. Certain symbiotic microorganism intervention will probably become promising auxiliary treatment for autism. In the present paper, we review and summarize some valuable related researches between autism and gut microbiota, to provide an important reference for comprehensive prevention and treatment of autism in China.

The prevalence of autism spectrum disorders in China: a comprehensive meta-analysis.

There are conflicting prevalence estimates of autism spectrum disorders (ASDs) in mainland China (China thereafter). This study is a comprehensive meta-analysis of the pooled prevalence of ASDs in the general population in China. Study investigators independently conducted a systematic literature search of the following databases: PubMed, EMBASE, PsycINFO, China National Knowledge Infrastructure, Chinese biomedical literature service system, and Wan Fang. Studies reporting prevalence of ASDs and autism in Chinese population were identified and analysed using the Comprehensive Meta-Analysis program with the random effects model. Forty-four studies were included in the meta-analysis comprising 2,337,321 subjects of whom 46.66 % were females. The mean age of subjects ranged from 1.6 to 8 years. Based on diagnostic criteria the pooled prevalence of ASDs was 39.23 per 10,000 (95% CI: 28.44-50.03 per 10,000, I2=89.2%); specifically, the prevalence of autism was 10.18 per 10,000 (95% CI: 8.46-11.89 per 10,000, I2=92.5%). Subgroup analyses revealed significant difference in the prevalence of ASDs between genders (72.77 per 10,000 in males vs. 16.45 per 10,000 in females). In conclusion, the prevalence of ASDs and autism in China was found generally lower than those reported in other countries. Further studies are needed to clarify the variation in prevalence.

The stigma of autism in china: an analysis of newspaper portrayals of autism between 2003 and 2012

Autism is a highly stigmatized developmental disability in many societies, and the media are major contributors to such stigma. Presented here is the first systematic analysis of Chinese newspapers’ coverage of autism for stigma-causing content. More specifically, this analysis examines the age of autistic people reported, the image of autistic people, and the use of stigma cues (in terms of peril, mark, and shame) and challenge cues (in terms of personification, hope, and fight) in five leading newspapers in China between 2003 and 2012. It finds that while the reportage of autism increases over time, which might contribute to the public’s heightened awareness of the condition, such reportage is often biased. The most common stereotypes about autism in Chinese newspapers are autistic people as children, as patients, or as savants. The most often-used challenge cues are personification and hope, but their uses significantly decrease in percentage from 2003 to 2012. The most often used stigma cues are peril and mark. The use of the shame cue is relatively less frequent, but it increases significantly over the 10-year period. Theoretically, this article provides an application of stigma communication theory in a non-Western context. Practically, it not only contributes to the current knowledge about media representation of autism in China, but also suggests that it is important for media agencies and health care professionals to promote media guidelines and train health journalists for reporting disability issues in a nonstigmatizing way.

Addressing the Needs of Students with Autism and Other Disabilities in China: Perspectives from the Field

Autism is a developmental disability that has gained increasing attention during the past several decades in China. The two case studies presented in this article examined the perspectives of two school leaders on educating students with autism in China. Two school principals, one from a public school and one from a private school, were interviewed during this study using 10 open-ended questions. Responses generated the following areas of discussion: teacher recruitment and training, curriculum and teaching methodology, parental involvement, and factors that contribute to success and present challenges. This study provides the readers with an update from the perspectives of two school leaders on the school system in China for children with disabilities, particularly for students with autism. Implications of the study and further suggestions for future research are also discussed.

Representation of Autism in Leading Newspapers in China: A Content Analysis

The public’s lack of understanding and the public’s misconceptions about autism in China contribute to the underdiagnosis and undertreatment of the disorder and the stigma associated with it. Mass media are the primary channel through which people learn about autism. This article examines how leading newspapers in China covered autism in the 10-year period of 2003 through 2012 through a framing analysis. It finds that while autism has received increased media attention, it is increasingly framed as a family problem—family members are cited or quoted more than any other sources and the responsibility of dealing with autism is ultimately assigned to families. Autistic people are largely silenced unless they are autistic savants with special talents. The use of the scientific discourse and the human-interest discourse both decrease over time in percentage, while the use of other discourses such as the public relations discourse becomes more dominant.

Autism in a Family in China: An investigation and ethical consideration of sibling issues

Having a child with autism in China raises challenges for families. Some are similar to those of families in western countries, but others are unique. This study sought to understand one aspect—the dilemmas of having a second child in a country where having only one child is the norm, and where social welfare services are not developed. This study examined the experiences of one family from the time when the family were considering having a second child through to the time when the younger child was a teenager. The most salient issues were the changing perspectives on the sibling’s role, and the responsibility and future burden of the sibling due to this responsibility. We use three ethical theories as a framework for analysis. The data suggested several benefits of having a second child and the possibilities for promoting opportunities and well-being, and not just responsibility and worry, in the second child. Areas of future research to expand this study are considered.

Prevalence of autism-caused disability among Chinese children: A national population-based survey

Few articles in English have discussed the prevalence of autism in China. The work described here was aimed at estimating the prevalence rate of autism-caused disability among Chinese children and exploring family environmental factors associated with autism based on a national population sample. Data for this study were derived from the Second China National Sample Survey on Disability. A weighted number of 77,301 disabled children affected by autism were identified, yielding a prevalence rate of 2.38/10,000. A history of mental disorders in adults was strongly associated with autism. The prevalence of autism in Chinese children was underestimated, and the lack of qualified professionals able to identify and diagnose autism was the main reason. Countermeasures are warranted to obtain a more precise overview of autism in China.

Erratum to: Prenatal and Perinatal Risk Factors for Autism in China

Erratum to: Prenatal and Perinatal Risk Factors for Autism in China

Prenatal and Perinatal Risk Factors for Autism in China

We conducted a case–control study using 190 Han children with and without autism to investigate prenatal and perinatal risk factors for autism in China. Cases were recruited through public special education schools and controls from regular public schools in the same region (Tianjin), with frequency matching on sex and birth year. Unadjusted analyses identified seven prenatal and seven perinatal risk factors significantly associated with autism. In the adjusted analysis, nine risk factors showed significant association with autism: maternal second-hand smoke exposure, maternal chronic or acute medical conditions unrelated to pregnancy, maternal unhappy emotional state, gestational complications, edema, abnormal gestational age (<35 or >42 weeks), nuchal cord, gravidity >1, and advanced paternal age at delivery (>30 year-old).

中国における自閉症の早期診断・発見システム構築の課題 : 医療機関の医師へのニーズ調査から

The present paper examines the requirements for an early diagnosis and detection system for autism that was proposed by doctors engaged in diagnosis and medical treatment for children with autism in Chinese medical institutions, in an attempt to clarify challenges for establishing an early diagnosis and detection system for autism in China. In questionnaire results from 185 doctors, including pediatricians and psychiatrists, at 9 hospitals in 4 major cities in Liaoning Province, China, although 93% of the doctors answered "Yes" to the question as to whether they knew about autism, only 62.7% of the doctors had studied about autism, and just 27.6% of the doctors had had medical care experience related to autism. These results suggest that many doctors in Liaoning Province must have insufficient knowledge about autism. Nearly all of the respondents indicated that an early detection system for autism had not been developed in China. Most of the clinical doctors suggested that an ideal screening system for detecting autism in China would be one in which doctors or public health nurses performed screening tests that included items related to the early detection of autism as part of the general health check system.

Effects of a Parent Training Program on the Interactive Skills of Parents of Children with Autism in China

Abstract This study evaluated the effects of a parent training program on the interactive skills of parents of children with autism in the People's Republic of China. Twenty‐seven families of children with autism in a northeastern city of China were randomly assigned to either the training or the control group. Parents received a total of 20 h of training in a format that included both group and individual sessions. Parents’ interactive skills during free play with their children with autism were examined using videotaped observations at their homes and analyzed using the Maternal Behavior Rating Scales. One‐way analysis of covariance indicated that following the training, parents in the training group, compared with those in the control group, were more sensitive to their children's interests, responded to their children's behavior more appropriately, were more accepting of their children and their behavior, showed more enjoyment of interacting with their children, and expressed more warmth toward their children throughout the free play interactions. More research is needed to investigate whether parental responsiveness and affect promote more active engagement by their children in their interactions.