Community-based Screening for Autism Spectrum Disorder Among Children in Pondicherry: A Cross-sectional Study

Background: Most Indian studies on Autism Spectrum Disorder (ASD) are hospital-based, and community-level data using standardized screening tools remain limited. Community screening can help identify children at risk and generate hypotheses regarding associated factors. The main objective of the study was to screen for ASD among children in Pondicherry and to identify associated factors. Methods: A community-based cross-sectional screening study was conducted in rural and urban areas of Pondicherry between September 2023 and February 2024. Children aged 18 months to 14 years ( n = 272) were screened using the AIIMS-modified INCLEN diagnostic tool for ASD. Participants were recruited using convenience sampling. Socio-demographic details and information on perinatal, familial, environmental, and behavioral factors were collected through parental interviews. Environmental variables such as ventilation and overcrowding were self-reported. The proportion of screen-positive ASD was calculated. Associations between screen-positive ASD and various factors were explored using Fisher’s exact test and Mann–Whitney U test. Results: Seven children were found to be screen-positive for ASD, yielding a proportion of 2.57% (95% CI: 1.03%-5.26%) in this screened sample. Screen-positive ASD showed significant associations with male gender ( P = .006), age group 5–10 years ( P = .04), late preterm birth ( P = .013), respiratory distress at birth ( P = .015), and reduced time spent in outdoor play ( P = .033). Other socio-demographic, familial, and environmental variables did not show significant associations. These findings represent unadjusted exploratory associations. Conclusion: This community-based screening study identified a small proportion of children who screened positive for ASD and highlighted several factors that showed exploratory associations. The findings underscore the importance of community screening and the need for larger, methodologically robust studies to estimate the proportion and evaluate risk factors for ASD in the Indian context.