Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA.
Pediatrics. 2010 Nov;126(5):e1018-25. doi: 10.1542/peds.2010-1023. Epub 2010 Oct 25.
The goal was to determine whether the increasing prevalence of autism, on the basis of educational data, in Wisconsin between 2002 and 2008 was uniform in all school districts or was greatest in districts with lower baseline (2002) prevalence.
Special education counts were obtained for all Wisconsin elementary school districts from 2002 through 2008. The annual prevalence of children being served under the autism category was calculated for each district, districts were grouped into 8 categories (octiles) according to their baseline prevalence, and prevalence trends were plotted according to octile.
The overall prevalence of use of the autism category in Wisconsin elementary schools increased from 4.9 to 9.0 cases per 1000 children between 2002 and 2008. The magnitude of this increase was not uniform across districts and was inversely associated with baseline prevalence. Prevalence in the lowest octile increased from 0.5 cases per 1000 students in 2002 to 7.0 cases per 1000 students in 2008 (P < .0001), whereas no significant trend was seen for the octile with the highest baseline prevalence (range: 11.2-12.3 cases per 1000 students; P = .11). The highest-octile/lowest-octile prevalence ratio decreased from 24.6 (95% confidence interval: 16.2-37.3) in 2002 to 1.8 (95% confidence interval: 1.6-2.1) in 2008.
The prevalence of use of the autism special education category in Wisconsin seems to be leveling off in the school districts with the highest prevalence rates, at ∼12 cases per 1000 students, whereas the gap in prevalence between districts overall has narrowed.
基于教育数据，确定 2002 年至 2008 年期间威斯康星州自闭症的患病率是否在所有学区都呈上升趋势，或者在基线患病率较低（2002 年）的学区上升幅度最大。
从 2002 年至 2008 年，我们获得了威斯康星州所有小学学区的特殊教育人数。计算了每个学区自闭症儿童的年度患病率，根据基线患病率将学区分为 8 个类别（十分位数），并根据十分位数绘制了患病率趋势图。
2002 年至 2008 年间，威斯康星州小学自闭症类别使用率从每千名儿童 4.9 例上升至 9.0 例。这种增长的幅度在学区之间并不均匀，与基线患病率呈负相关。最低十分位数的患病率从 2002 年的每千名学生 0.5 例增加到 2008 年的每千名学生 7.0 例（P<0.0001），而基线患病率最高的十分位数则没有明显趋势（范围：每千名学生 11.2-12.3 例；P=0.11）。最高十分位数/最低十分位数的患病率比从 2002 年的 24.6（95%置信区间：16.2-37.3）下降到 2008 年的 1.8（95%置信区间：1.6-2.1）。
威斯康星州自闭症特殊教育类别的使用率在患病率最高的学区似乎趋于平稳，约为每千名学生 12 例，而总体上学区之间的患病率差距已经缩小。
