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Abstract
Autism spectrum disorders (ASDs) are a group of developmental disabilities characterized by impairments in social interaction and communication, and by restricted, repetitive, and stereotyped patterns of behavior. Symptoms typically are apparent before age three years. Aim: To determine the prevalence of ASD amongst children along ethno-religious lines, where differences might point to potential trigger factors in its causation in a middle to highincome country. Methods: Point prevalence and diagnostic trends of ASD over the past 18 years were examined over a wide geographical area of central Israel, encompassing a database of 331,169 children, aged 3-18 years. Special importance was attached to statistics from different religious and ethno-cultural groups as potentially reflecting discrepancies in diagnosis, reporting, and possible environmentally- related factors in the presentation of a genetically determined syndrome. Results: Overall prevalence was 0.004 (1/250 live births), well below figures from other similar studies abroad and in Israel. Prevalence figures for the ultra-orthodox Jewish community were the lowest (0.0022), when compared with the general population and Israeli Arabs (0.0033). Time trends indicated a surge in diagnosis of ASD among Israeli Arabs between the years 2008 and 2011, in contrast with a general flattening of figures for the orthodox community (P < 0.01). Conclusions: Results indicated that besides discrepancies in diagnosis and reporting factors, there exists a possible relation between clinical expression of ASD genetic predisposition and socioeconomic/cultural status as impacting on the epigenetic factors in the causality of autism. Our prevalence rates are currently lower than those of ASD in Europe and the USA.
Keywords: Autism, autism spectrum disorder, Arabs, Jews, prevalence
Introduction
The aim of our study was to determine whether the different socioeconomic and cultural environments in which children are raised, as dictated by social prohibitions and attitudes inherent in religious or ethnic cultural lifestyles, have an impact on either the trigger mechanism causality of ASD, or, at least, the willingness of parents to diagnose and treat ASD within the public health care system. The study elaborated on recently published established epidemiological trends for ASD in Israel.
We examined the prevalence and diagnostic trends over time of ASD in Israel, which straddles the definition of a middle to high income country, among three strikingly different pediatric population groups, divided along ethno-religious lines:...