Bayesian prevalence of autism and unmet special education needs in Chile in a sample of three million school-age children
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Date
2025
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Abstract
Autism spectrum disorder prevalence estimates in Latin America have been limited by a lack of reliable data. This cohort study aimed to estimate autism spectrum disorder prevalence in Chile by linking school registries with electronic health records. Probabilistic data linking was conducted between the 2021 Chilean school registry and 2003−2015 health records from the Araucania Sur Health Service. Bayesian prevalence estimation was used, considering variables such as age, sex, immigration status, ethnicity and rurality. Autism spectrum disorder prevalence across 29 health services was analysed for students aged 6 to 18 years. Regression models assessed unmet needs for special education services, validated using Araucania Sur Health Service health records. The study included 3,056,306 pupils (51.34% boys; mean age 11.6 years), with 14,549 having autism spectrum disorder. The national standardized school prevalence was 0.46%. Boys had 6 times higher odds of receiving special education services support than girls. In Araucania Sur Health Service, the adjusted clinical prevalence from health records was 1.22%. The Bayesian projected national autism spectrum disorder prevalence was 1.31%. This study, the largest of its kind in Latin America, revealed a higher autism spectrum disorder prevalence than previously reported, with one in 76 children affected. Disparities were observed across sex, ethnicity and health services.
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Keywords
ASD prevalence, Bayesian methods, Chile, Latin America, Special education needs