Prevalence and early signs of autism spectrum disorder (ASD) among 18-36 month-old children of Tianjin in China.

OBJECTIVE: The aim of this study is to estimate the prevalence of autism spectrum disorder (ASD) among 18-36 month old children in the Tianjin Municipality of China, and to identify early signs of autistic children and the predictability of each individual symptom. METHODS: A total of 8 000 children were screened to do a questionnaire based on CHAT modified to include more early signs of autism at the age of 18-36 months. Then the at-risk children were reexamined 1.5 years later and ASD children were identified based on DSM-IV. Early signs of autism were analyzed retrospectively by using discriminant function analysis performed among ASD children, children not followed up and children followed up but failing to meet ASD criteria. RESULTS: Three hundred and sixty seven children were screened as being at-risk to ASD, and 22 of them were identified as having ASD in the subsequent diagnosis. The prevalence of ASD was 27.5 per 10 000 in Tianjin of China with a male to female ratio of 4:1. Items addressing social interactions and communications had higher predictability than other items to distinguish autistic children from non-autistic ones. Pretend play, functional play, showing and reading parents' facial expressions distinguished autistic children from those not followed up, nevertheless those followed up but failing to meet ASD criteria were not included. CONCLUSION: The prevalence of ASD found in our study was lower than that reported in some studies by western researchers. Autism has its specific symptoms, such as deficits in social awareness, social relatedness, and social referencing.

Development of Time-location Weighted Spatial Measures Using Global Positioning System Data

OBJECTIVES: Despite increasing availability of global positioning system (GPS), no research has been conducted to analyze GPS data for exposure opportunities associated with time at indoor and outdoor microenvironments. We developed location-based and time-weighted spatial measures that incorporate indoor and outdoor time-location data collected by GPS. METHODS: Time-location data were drawn from 38 female subjects in California who wore a GPS device for seven days. Ambient standard deviational ellipse was determined based on outdoor locations and time duration, while indoor time weighted standard deviational ellipse (SDE) was developed to incorporate indoor and outdoor times and locations data into the ellipse measure. RESULTS: Our findings indicated that there was considerable difference in the sizes of exposure potential measures when indoor time was taken into consideration, and that they were associated with day type (weekday/weekend) and employment status. CONCLUSIONS: This study provides evidence that time-location weighted measure may provide better accuracy in assessing exposure opportunities at different microenvironments. The use of GPS likely improves the geographical details and accuracy of time-location data, and further development of such location-time weighted spatial measure is encouraged.