Many children are living with autism spectrum disorder (ASD), and they need services and support, now and as they grow into adolescence and adulthood. More can be done to ensure that children with ASD are evaluated as soon as possible after developmental concerns are recognized. Read on to learn more about CDC’s data on ASD.
Findings from CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network help us understand more about the number of children with autism spectrum disorder (ASD), the features of those children, and the age at which these children are first evaluated and diagnosed. These findings are critical for
- Promoting early identification of children with ASD;
- Planning services for children and families living with ASD and trainings for the professionals who provide those services;
- Guiding future ASD research; and
- Informing policies that promote improved outcomes in health care and education for individuals with ASD.
The highlights below come from the most recent ADDM Network report, and they are based on information collected from the health and special education (if available) records of 8-year-old children who lived in communities in Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin during 2014.
Five Facts to Know
1. The estimated percentage of children with ASD was higher in 2014 than it was in previous ADDM Network reports.
About 1.7% or 1 in 59 children were identified with ASD, based on data reported from 11 communities across the United States in 2014. Previous estimates from the ADDM Network ranged from 1 in 150 (or 0.66%) to 1 in 68 (or 1.5%).
- This is not a representation of autism in the United States as a whole, but is instead an in-depth look at the 11 communities in the ADDM Network.
- The percentage of children identified with ASD ranged widely by community—five communities reported lower estimates in a very close range (1.3% to 1.4%), while six communities reported higher estimates, with the highest approaching 3% for an area of New Jersey.
CDC will continue to track ASD over time in order to better understand whether the percentage of children identified with ASD is staying the same or changing.
2. The percentage of ASD among black and Hispanic children is approaching the percentage in white children.
As in past years, a higher percentage of white children were identified with ASD compared to black children, and even more so compared to Hispanic children. However, these differences are narrowing, which may account for some of the change in percentage since the previous ADDM Network report.
- This finding could indicate that communities are better able to identify ASD in minority groups. It may also be due to more effective outreach directed to minority communities and efforts to have all children screened for ASD.
- Continued efforts are needed to ensure that all children with autism are identified and receive the care and services they need.
3. Children identified with ASD are not receiving comprehensive developmental evaluations as early as they could be.
Most children identified with ASD had concerns about their development noted in their records by age 3 years. Yet, fewer than half of children with ASD received a comprehensive developmental evaluation by this same age. The earlier a child is evaluated for developmental delays, the earlier he or she can be connected to services to address those delays, even if the child has not yet received a diagnosis of autism. Therefore, a lag between first concern and first comprehensive developmental evaluation may affect when children are being connected to the services they need.
4. Children identified with ASD also are not being diagnosed as early as they could be.
Fewer than half of children identified with ASD received their first diagnosis by age 4 years, yet most had concerns about their development noted in their records before age 3 years. In some communities, many children were diagnosed much earlier. This suggests that regional differences in diagnostic practices and access to services continue.
5. Recent changes in the diagnostic criteria for autism had little impact on the percentage of school-aged children identified as having ASD by ADDM Network surveillance.
In 2013, the American Psychiatric Association changed the criteria for making a diagnosis of ASD. Beginning in 2014, the ADDM Network incorporated a new ASD surveillance case definition based on these revised criteria. Estimates of the percentage of children identified with ASD based on the old and new surveillance case definitions were similar, especially among children with an existing ASD diagnosis or eligibility for autism special education services. It may be too soon to determine the long-term impact of the changes in the diagnostic criteria on ASD prevalence and characteristics. CDC will continue to monitor this in the next ADDM Network report.
What Can Concerned Parents Do?
Parents should take two important steps if they suspect their child might have ASD:
- Talk to their child’s healthcare provider about their concerns.
- Call their local early intervention program or school system for a free evaluation of their child.
CDC’s new free Milestone Tracker app makes it easy for parents to track, support, and discuss their young child’s development with their child’s healthcare provider. Many children with a developmental disability are not identified until after starting school. Early intervention (before school age) can have a significant impact on a child’s ability to learn new skills as well as reduce the need for costly interventions over time.
Parents should remember, it is never too late to get help for their child, and an ASD diagnosis from a doctor is not necessary for a child to begin receiving some types of services. For more tips about what parents and others can do when there is a concern, visit CDC’s If You’re Concerned website.
A comprehensive developmental evaluation is a thorough review of how a child plays, learns, communicates, acts, and moves, and whether those characteristics have changed over time. A range of professionals, including teachers, social workers, nurses, psychologists, doctors, and speech-language pathologists, can conduct developmental evaluations. Specialists, such as developmental pediatricians, often use the results of a developmental evaluation to determine if a child has ASD.