Tian Jia

Northwest University First Hospital, China

Title: Trends and Cross-Country Inequalities in the Global Burden of Neurodevelopmental Disorders Among Children Aged 0–14 from 1990 to 2021

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Biography

Tian Jia is a deputy chief physician in the Department of Child Healthcare at Northwest University First Hospital, Xi'an, China. Her clinical and research interests focus on childhood neurodevelopmental disorders, including autism spectrum disorder, attention-deficit/hyperactivity disorder, developmental delay, and tic disorders. She has published research in both Chinese and international journals. As the first author of the present study, she contributed to the study design, data analysis, interpretation of the findings, and manuscript preparation. Her work emphasizes the integration of clinical practice and scientific research to advance the assessment, management, and care of children with neurodevelopmental disorders

Abstract

Background: Neurodevelopmental disorders (NDDs) are major contributors to childhood disability and impose unequal burdens across countries. This study evaluated temporal trends, cross-country inequalities, and future changes in autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and idiopathic developmental intellectual disability (IDID) among children aged 0–14 years.

Methods: Prevalence estimates and 95% uncertainty intervals for 204 countries and territories from 1990 to 2021 were obtained from the Global Burden of Disease 2021 study. Joinpoint regression was used to estimate average annual percentage changes (AAPCs). Absolute and relative inequalities across Sociodemographic Index levels were assessed using the slope index of inequality and concentration index. The Nordpred model was applied to project prevalence through 2046.

Results: From 1990 to 2021, global prevalence increased slightly for ASD (AAPC 0.09, 95% CI 0.08–0.09) but decreased for ADHD (?0.08, ?0.12 to ?0.04) and IDID (?0.86, ?0.88 to ?0.84). In 2021, prevalence rates per 100,000 children were 857.14 for ASD, 1,661.61 for ADHD, and 1,626.30 for IDID. Cross-country inequalities persisted: ASD and ADHD were disproportionately concentrated in higher-SDI countries and territories, whereas IDID was concentrated in lower-SDI settings. By 2046, age-standardized prevalence rates were projected to decrease slightly for ASD and ADHD and increase slightly for IDID.

Conclusion: The three NDDs demonstrated distinct long-term trends and contrasting socioeconomic distributions. Disorder-specific public health strategies, strengthened early identification and intervention, and equitable allocation of child mental health and developmental services are needed, particularly in resource-limited settings.

Keywords: neurodevelopmental disorders; autism spectrum disorder; attention-deficit/hyperactivity disorder; intellectual disability; health inequality; Global Burden of Disease