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Sunday, April 15, 2018

Differences Among States in Autism Prevalence

In The Politics of Autism, I discuss the uncertainty surrounding estimates of autism prevalence

At The Journal of Autism and Developmental Disorders, R. Christopher Sheldrick and Alice S. Carter have an article titled" State-Level Trends in the Prevalence of Autism Spectrum Disorder (ASD) from 2000 to 2012: A Reanalysis of Findings from the Autism and Developmental Disabilities Network." The abstract:
Since 2000, the Autism and Developmental Disabilities Network (ADDM) has published detailed prevalence estimates for autism spectrum disorder (ASD) among 8 year-olds, which are widely interpreted as the U.S. national prevalence of ASD. Although differences in state-level ASD prevalence has been reported, state-level heterogeneity has not been explored systematically. We analyzed state-level estimates and trends in ASD prevalence from 2000 to 2012 using secondary data from bi-annual ADDM reports. Heterogeneity among state-level ASD prevalence estimates were apparent in 2000 and grew between 2000 and 2012. Findings highlight the need for greater understanding of how children with ASD are identified by the medical and educational systems, which has significant implications for the state-level resources required to effectively manage ASD.
New Jersey has the highest prevalence, Alabama the lowest.  Why?

From the article:
Consideration of such differences is important for at least two reasons. First, a large proportion of service delivery for ASD is managed at the state level. Strong differences in ASD prevalence at the state level therefore have implications for the resources required to provide adequate services (Wise et al. 2010). Second, improved understanding of the causes of observed changes in ASD prevalence may depend on a
more detailed understanding of heterogeneity. For example, the ADDM and others have speculated that trends in ASD prevalence over time may be attributable either to changes
in the true prevalence of ASD, for example resulting from trends in exposure to risk factors such as environmental toxins, or changes in the ascertainment of ASD, for example attributable to increased awareness of or sensitivity to ASD symptoms (Blumberg et al. 2013; Centers for Disease Control and Prevention 2014; Hansen et al. 2015; Idring et al. 2015). 
  • Blumberg, S. J., Bramlett, M. D., Kogan, M. D., Schieve, L. A., Jones, J. R., & Lu, M. C. (2013). Changes in prevalence of parent-reported autism spectrum disorder in school-aged U. S. children: 2007 to 2011–2012. National Health Statistics Reports, 65, 1–11.Google Scholar
  • Centers for Disease Control and Prevention. (2014). Prevalence of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2010. MMWR, 63(SS-2), 1–21.Google Scholar
  • Hansen, S. N., Schendel, D. E., Parner, E. T. (2015). Explaining the increase in the prevalence of autism spectrum disorders. JAMA Pediatrics, 169(1), 56. Scholar
  • Idring, S., Lundberg, M., Sturm, H., Dalman, C., Gumpert, C., Rai, D., … Magnusson, C. (2015). Changes in prevalence of autism spectrum disorders in 2001–2011: Findings from the Stockholm youth cohort. Journal of Autism and Developmental Disorders, 45(6), 1766–1773. Scholar
  • Wise, M. D., Little, A. A., Holliman, J. B., Wise, P. H., & Wang, C. J. (2010). Can state early intervention programs meet the increased demand of children suspected of having autism spectrum disorders? Journal of Developmental and Behavioral Pediatrics, 31(6), 469–476. Scholar