# Mapping Autism in Armenia Among Children and Adolescents Aged 0–18 Years: Population-Based Insights into Prevalence and Its Geographical Differences

## TL;DR

This study is the first to map autism prevalence in Armenia, finding higher rates in urban areas and among males, which could help improve healthcare planning.

## Contribution

The first nationwide, population-based estimate and geographic mapping of autism spectrum disorder (ASD) prevalence in Armenia.

## Key findings

- ASD prevalence was higher among males, in urban areas, and in Yerevan, with a mean diagnosis age of 4.5 years.
- The overall ASD prevalence in Armenia was 2.3 per 1000 children, with the highest rate in Yerevan at 3.7 per 1000.
- ASD prevalence was significantly higher in urban compared to rural areas.

## Abstract

What are the main findings?
This study provides the first nationwide, population-based estimate and geographic mapping of autism spectrum disorder (ASD) prevalence among children and adolescents in the Republic of Armenia.ASD prevalence was higher among males, in urban areas, and in the capital city, Yerevan, with a mean age at diagnosis of 4.5 years.

This study provides the first nationwide, population-based estimate and geographic mapping of autism spectrum disorder (ASD) prevalence among children and adolescents in the Republic of Armenia.

ASD prevalence was higher among males, in urban areas, and in the capital city, Yerevan, with a mean age at diagnosis of 4.5 years.

What are the implications of the main findings?
The observed geographic and urban–rural differences suggest variation in ASD detection and diagnosis, likely related to healthcare access and service availability.These findings establish a national baseline to support health policy development, service planning, and future epidemiological, etiological, and biologically informed research, potentially contributing to more targeted and personalized approaches to ASD care.

The observed geographic and urban–rural differences suggest variation in ASD detection and diagnosis, likely related to healthcare access and service availability.

These findings establish a national baseline to support health policy development, service planning, and future epidemiological, etiological, and biologically informed research, potentially contributing to more targeted and personalized approaches to ASD care.

Background/Objectives: This study aimed to estimate the prevalence of autism spectrum disorder (ASD) among children and adolescents aged 0–18 years in the Republic of Armenia (RA), characterize geographic and sex-specific variations, and determine the mean age at diagnosis. These data are essential for informing health system planning, evaluating potential disparities in access to diagnostic services, and generating hypotheses regarding the biological and healthcare-related factors underlying geographic variation in ASD prevalence. Methods: A cross-sectional study was conducted using administrative records from outpatient medical facilities serving children and adolescents across all ten marzes of RA and the city of Yerevan in 2021. ASD prevalence was estimated at the national and regional levels and stratified by urban and rural residence. The male-to-female prevalence ratio and the mean age at ASD diagnosis were also calculated. Results: The overall prevalence of ASD in RA was 2.3 per 1000 children (95% CI: 2.1–2.4). The highest prevalence was observed in Yerevan (3.7 per 1000). The mean age at diagnosis was 4.5 ± 2.5 years. Males exhibited a 5.1-fold higher prevalence compared to females. ASD prevalence was significantly higher in urban areas than in rural settings. Conclusions: ASD prevalence in RA demonstrates marked geographic and sex disparities, with significantly higher rates in urban regions and among males. These findings underscore the importance of continued ASD prevalence monitoring in RA to identify trends, explore potential biological and healthcare-related contributors to geographic variation, and improve healthcare system planning and management. In turn, improved understanding of regional differences in ASD prevalence may help inform more targeted and personalized approaches to care. The results may also support national and regional policymakers in health, education, and related sectors in developing and strengthening services for children and adolescents with ASD and their families.