Many countries may be underestimating the number of children who need autism-related support services, according to a new global review that could inform future healthcare, education, and early screening policies.
Published in Osong Public Health and Research Perspectives, the study analyzed data from 66 studies involving more than 21.3 million children across multiple continents. The researchers estimated that 0.77% of children worldwide are diagnosed with autism spectrum disorder (ASD), roughly 1 in 130 children. Among boys, the estimated prevalence was 1.14%.
ASD is a neurodevelopmental condition that can affect communication, behavior, sensory processing, and social interaction. Early identification can help children and families access services sooner, such as speech therapy, behavioral support, educational planning, and family counseling.
The researchers say the new findings may be especially useful for governments and health systems as they plan future child development services.
“Reliable prevalence estimates help countries understand the likely scale of need and prepare support systems sooner,” said corresponding author Kurvatteppa Halemani. “Without clear data, services may be developed too late or at an insufficient scale.”
The review found substantial regional differences. Higher reported prevalence was more common in several high-income countries, whereas many low- and middle-income countries reported lower rates. The authors say these gaps may partly reflect differences in awareness, screening programs, specialist availability, and healthcare access rather than lower true prevalence alone.
“In some settings, lower reported numbers may indicate that children are being missed or diagnosed later, rather than fewer children being affected,” Halemani said.
The study identified Australia among the countries with the highest pooled prevalence estimates in the review, while rates varied across continents and countries. Researchers note that broader awareness, improved surveillance, and evolving diagnostic criteria over recent decades have likely increased case identification worldwide.
The findings come as many countries expand child mental health and developmental services while facing shortages of trained specialists. The authors say prevalence data can help guide planning for screening programs, teacher training, specialist clinics, inclusive education, and long-term support into adulthood. Experts often compare public health data to a map: when needs become visible, systems can respond more effectively. For ASD, this may mean shorter wait times for diagnosis and earlier access to support during key developmental years.
The study was a systematic review and meta-analysis, which combined results from previously published studies rather than evaluating new patients directly. The authors note that differences in diagnostic methods, study design, and healthcare systems across countries may affect direct comparisons. Still, the review provides one of the most up-to-date global summaries of childhood autism prevalence and serves as a practical benchmark for future planning.