Rates of autism spectrum disorder (ASD) have risen slightly in the United States, which may be because of to improved detection among minority populations, the US Centers for Disease Control and Prevention (CDC) said today.
According to the latest estimates, 1 in 59 children aged 8 years (16.8 per 1000) were diagnosed with ASD in 2014, up from 1 in 68 (14.6 per 1000) in 2012.
The latest estimates appear in the April 27 issue of the Morbidity and Mortality Weekly Report.
They stem from the CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network, a tracking system that provides estimates of the prevalence and characteristics of ASD among 8-year-old children in 11 communities in Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin. The latest estimates are based on data from a total population of 325,483 children aged 8 years, which represents 8% of the total US population of 8-year-olds.
Some of the uptick in ASD prevalence could be due to improved identification in minority populations, the CDC said. Although the disorder is still more likely to be identified in white children, autism prevalence among black and Hispanic children is “approaching that of white children,” Stuart Shapira, MD, PhD, associate director for science at the CDC’s National Center on Birth Defects and Developmental Disabilities, said in a news release.
“The higher number of black and Hispanic children now being identified with autism could be due to more effective outreach in minority communities and increased efforts to have all children screened for autism so they can get the services they need,” Shapira said.
In the latest estimates, ASD prevalence was fourfold higher in boys than girls (26.6 vs 6.6 per 1000).
Among nine ADDM sites with sufficient data on intellectual ability, 31% of children with ASD were classified as having intellectual disability (IQ ≤70), 25% were in the borderline range (IQ 71–85), and 44% had IQ scores in the average to above average range (IQ >85).
Need for ASD Services Remains High
Overall ASD prevalence varied widely among the 11 communities, ranging from 13.1 per 1000 in Arkansas to 29.3 per 1000 in New Jersey. Some of the regional differences in ASD prevalence estimates among the 11 communities could be due to differences in how ASD is diagnosed and documented, the CDC said.
Because ADDM sites do not provide a representative sample of the entire United States, these prevalence data can’t be generalized to all US children aged 8 years, the CDC said. However, on the basis of these estimates, “the need for behavioral, educational, residential, and occupational services remains high, as does the need for increased research on both genetic and nongenetic risk factors for ASD,” write Jon Baio, EdS, from the National Center on Birth Defects and Developmental Disabilities at the CDC, and colleagues.
A top priority remains identifying children with ASD at a younger age and referring them to early intervention. According to the CDC, fewer than half of the children identified in the ADDM Network were diagnosed by the time they were 4 years old. And although for 85% of children with ASD, concerns about development were noted in their health records by age 3 years, only 42% received a developmental evaluation by that age. This lag between first concern and first evaluation may cause delays in children receiving services.
“Parents can track their child’s development and act early if there is a concern. Healthcare providers can acknowledge and help parents act on those concerns. And those who work with or on behalf of children can join forces to ensure that all children with autism get identified and connected to the services they need as early as possible,” Shapira said in the release.
The CDC’s Learn the Signs. Act Early program provides parents, childcare professionals, and healthcare providers free resources, in English and Spanish, for monitoring children’s development. The program offers parent-friendly, research-based milestone checklists for children as young as 2 months of age. The program also offers information about what to do if there is a developmental concern and whom to contact for assistance.
The next report from the ADDM Network will add data for children who were 8 years old in 2016. It will provide a clearer picture of whether ASD prevalence is changing and whether improvements are being made in early identification of autism.
MMWR Morb Mortal Wkly Rep. 2018:67;1-28. Abstract
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