Prevalence of autism spectrum disorder in Georgia (country): a two-phase population-based study among 8–10-year-olds

Purpose Autism spectrum disorder (ASD) was rarely diagnosed in Georgia, a middle-income European country, prior to the early 2000s, with essentially no documented data on affected children. This study aims to provide the first prevalence estimates of ASD in Georgia by evaluating its occurrence among 8–10 years old children. Design/methodology/approach Using a two-phase, population-based approach, the study screened third-grade students aged 8–10 years during 2019–2020 and conducted diagnostic assessments in 2020–2021. Screening tools included the Autism Spectrum Screening Questionnaire and Strengths and Difficulties Questionnaire. Diagnostic assessments used standardized measures such as the Autism Diagnostic Observation Schedule-II, Autism Diagnostic Interview-Revised, Test of Nonverbal Intelligence, Fourth Edition, Schedule for Affective Disorders and Schizophrenia for School-Age Children, Vineland Adaptive Behavior Scales-II, supplemented by speech, language and communication tests. Screening data were obtained for 16,348 children (72.3% response rate; 50.1% females), with full diagnostic evaluations for 300 (mean age = 10.2 years; 31.7% females). Findings The estimated prevalence was 4.25% (95% confidence interval [CI]: 3.95%–4.55%), with higher rates among males (6.13%; 95% CI: 5.61%–6.65%) compared to females (1.52%; 95% CI: 1.25%–1.78%); the male-to-female diagnosis ratio was found to be 4:1. Social implications High prevalence of autism in Georgia points to the urgent need for actions targeting especially early identification, diagnosis and treatment for individuals with ASD in Georgia, mainly through resource allocation, with a particular focus on enhancing professional training. Originality/value This study estimated for the first the prevalence of ASD in Georgia (country) of 4.25% among 8–10 years old children, with a male-to-female diagnosis ratio of 4:1. The findings underscore the urgent need for early identification, diagnosis and treatment of ASD, suggesting resource allocation and enhanced professional training are critical.