Prevalence of pervasive developmental disorders among children at the English Montreal School Board

Abstract

Objectives: The prevalence of pervasive developmental disorders (PDDs) has increased. There has been speculation regarding a role of thimerosal-containing vaccines (TCVs) in this trend. Our objectives were to determine prevalence rates of PDDs among school-aged children, and to evaluate the impact of discontinuation of thimerosal use in 1996 in routine childhood vaccines on PDD rates. Method: Children ( n = 23 635) attending kindergarten to Grade 11 were surveyed in 71 schools from the English Montreal School Board. For children with PDD, information was obtained about their diagnostic subtype, age, sex, grade, and school. Prevalence rates were calculated for the entire school population and for each grade. Prevalence rates were also compared for children born before or after 1996. Results: Students ( n = 187; male to female ratio: 5.4:1) with PDD were identified, corresponding to a prevalence of 79.1/10 000 (95% CI 67.8 to 90.4/10 000). The prevalence was 25.4, 43.6, 9.7, and 0.4 for autistic disorder, PDD not otherwise specified, Asperger syndrome, and childhood disintegrative disorder, respectively. During the study period, there was a significant linear increase in prevalence (OR 1.17 per year; 95% CI 1.12 to 1.23). The trend in prevalence of PDDs was unrelated to the discontinuation of TCVs. Conclusion: Our study provides additional evidence that the PDD rate is close to 1%. We estimate that at least 11 500 Canadian children aged 2 to 5 years suffer from a PDD. The reasons for the upward trend in prevalence could not be determined with our methods. Discontinuation of thimerosal use in vaccines did not modify the risk of PDD.