Disability and Health Journal
Volume 3, Issue 3 , Pages 186-201 , July 2010

Changes in autism spectrum disorder prevalence in 4 areas of the United States

  • Catherine Rice, Ph.D.

      Affiliations

    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
    • Corresponding Author InformationCorresponding author: 1600 Clifton Road, MS E86. Fax: (404) 498-0792.
  • ,
  • Joyce Nicholas, Ph.D.

      Affiliations

    • College of Medicine, Medical University of South Carolina, Charleston South Caralina 29403, USA
  • ,
  • Jon Baio, Ed.S.

      Affiliations

    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
  • ,
  • Sydney Pettygrove, Ph.D.

      Affiliations

    • College of Public Health (SP) and Department of Pediatrics (CC and FJM), University of Arizona, Tucson 85724, USA
  • ,
  • Li-Ching Lee, Ph.D.

      Affiliations

    • Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA
  • ,
  • Kim Van Naarden Braun, Ph.D.

      Affiliations

    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
  • ,
  • Nancy Doernberg, B.A.

      Affiliations

    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
  • ,
  • Chris Cunniff, M.D.

      Affiliations

    • College of Public Health (SP) and Department of Pediatrics (CC and FJM), University of Arizona, Tucson 85724, USA
  • ,
  • Craig Newschaffer, Ph.D.

      Affiliations

    • School of Public Health, Drexel University, Philadelphia, PA 19102, USA
  • ,
  • F. John Meaney, Ph.D.

      Affiliations

    • College of Public Health (SP) and Department of Pediatrics (CC and FJM), University of Arizona, Tucson 85724, USA
  • ,
  • Jane Charles, M.D.

      Affiliations

    • College of Medicine, Medical University of South Carolina, Charleston South Caralina 29403, USA
  • ,
  • Anita Washington, M.P.H.

      Affiliations

    • Research Triangle Institute International, Atlanta, GA 30341, USA
  • ,
  • Lydia King, Ph.D.

      Affiliations

    • College of Medicine, Medical University of South Carolina, Charleston South Caralina 29403, USA
  • ,
  • Maria Kolotos, M.S.

      Affiliations

    • Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA
  • ,
  • Kristen Mancilla, B.A.

      Affiliations

    • College of Public Health (SP) and Department of Pediatrics (CC and FJM), University of Arizona, Tucson 85724, USA
  • ,
  • Cynthia A. Mervis, M.P.H.

      Affiliations

    • Department of Applied Medical Sciences, University of Southern Maine, Portland, ME 04104, USA
  • ,
  • Laura Carpenter, Ph.D.

      Affiliations

    • College of Medicine, Medical University of South Carolina, Charleston South Caralina 29403, USA
  • ,
  • Marshalyn Yeargin-Allsopp, M.D.

      Affiliations

    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA

References 

  1. Yeargin-Allsopp M, Rice C, Karapurkar T, et al. Prevalence of autism in a US metropolitan area. JAMA. 2003;289:49–55
  2. California Department of Developmental Services. Changes in the population of persons with autism and pervasive developmental disorders in California's Developmental Services System: 1987 through 1998. A report to the legislature. Sacramento, CA: CA Department of Developmental Services; 1999;
  3. California Department of Developmental Services. Changes in the CA caseload: an update 1999 through 2002. Sacramento, CA: CA Department of Developmental Services; 2003;
  4. Newschaffer CJ, Falb MD, Gurney JG. National autism prevalence trends from United States special education data. Pediatrics. 2005;115:277–282
  5. Blaxill MF. What's going on? The question of time trends in autism. Public Health Rep. 2004;119:536–551
  6. Charman T. The prevalence of autism spectrum disorders: recent evidence and future challenges. Eur Child Adolesc Psychiatry. 2002;11:249–256
  7. Fombonne E. Is there an epidemic of autism?. Pediatrics. 2001;107:411–412
  8. Fombonne E. Epidemiology of pervasive developmental disorders. Pediatr Res. 2009;[Epub ahead of print]
  9. Gernsbacher MA, Dawson M, Goldsmith HH. Three reasons not to believe in an autism epidemic. Curr Direct Psychol Sci. 2005;14:55–58
  10. Rutter M. Incidence of autism spectrum disorders: changes over time and their meaning. Acta Paediatr. 2005;94:2–15
  11. Wing L, Potter D. The epidemiology of autistic spectrum disorders: is the prevalence rising?. Ment Retard Dev Disabil Res Rev. 2002;8:151–161
  12. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association; 2000;
  13. World Health Organization. International classification of disease. 10th ed. Geneva: Author; 1990;
  14. Centers for Disease Control and Prevention. Prevalence of autism spectrum disorders—autism and developmental disabilities monitoring network, six sites, United States, 2000. Morb Mortal Wkly Rep Surveill Summ. 2007;56:1–11
  15. Centers for Disease Control and Prevention. Prevalence of autism spectrum disorders—autism and developmental disabilities monitoring network, 14 sites, United States, 2002. Morb Mortal Wkly Rep Surveill Summ. 2007;56:12–28
  16. Baird G, Simonoff E, Pickles A, et al. Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP). Lancet. 2006;368:210–215
  17. Honda H, Shimizu Y, Imai M, et al. Cumulative incidence of childhood autism: a total population study of better accuracy and precision. Dev Med Child Neurol. 2005;47:10–18
  18. Kadesjo B, Gillberg C, Hagberg B. Brief report: autism and Asperger syndrome in seven-year-old children: a total population study. J Autism Dev Disord. 1999;29:327–331
  19. Posserud MB, Lundervold AJ, Gillberg C. Autistic features in a total population of 7-9-year-old children assessed by the ASSQ (Autism Spectrum Screening Questionnaire). J Child Psychol Psychiatry. 2006;47:167–175
  20. Laidler JR. US Department of Education data on “autism” are not reliable for tracking autism prevalence. Pediatrics. 2005;116:e120–e124
  21. Barbaresi WJ, Katusic SK, Colligan RC, et al. The incidence of autism in Olmsted County, Minnesota, 1976-1997: results from a population-based study. Arch Pediatr Adolesc Med. 2005;159:37–44
  22. Chakrabarti S, Fombonne E. Pervasive developmental disorders in preschool children. JAMA. 2001;285:3093–3099
  23. Gillberg C, Cederlund M, Lamberg K, et al. Brief report: “the autism epidemic.” The registered prevalence of autism in a Swedish urban area. J Autism Dev Dis. 2006;36:429–435
  24. Honda H, Shimizu Y, Rutter M. No effect of MMR withdrawal on the incidence of autism: a total population study. J Child Psychol Psychiatry. 2005;46:572–579
  25. Karapurkar T, Lee N, Kresch Curran L, et al. The epidemiology of autism and autism spectrum disorders. In:  Gupta VB editors. Pediatric habilitation: autistic spectrum disorders in children. vol 12:New York: Marcel Dekker; 2004;p. 17–42
  26. Parner E, Schendel D, Thorsen P. Autism prevalence trends over time in Denmark: changes in prevalence and age at diagnosis. Arch Pediatr Adolesc Med. 2008;162:1150–1156
  27. Hertz-Picciotto E, Delwiche L. The rise in autism and the role of age at diagnosis. Epidemiology. 2009;20:84–90
  28. Rice CE, Baio J, Van Naarden Braun K, et al. A public health collaboration for the surveillance of autism spectrum disorders. Paediatr Perinat Epidemiol. 2007;21:179–190
  29. Bertrand J, Mars A, Boyle C, et al. Prevalence of autism in a United States population: the Brick Township, New Jersey, investigation. Pediatrics. 2001;108:1155–1161
  30. Van Naarden Braun K, Pettygrove S, Daniels J, et al. Evaluation of a methodology for a collaborative multiple source surveillance network for autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2002. Morb Mortal Wkly Rep Surveill Summ. 2007;56:29–40
  31. Selvin S. Statistical power and sample size calculations. In: Statistical analysis of epidemiologic data. 2nd ed. New York: Oxford University Press; 1996;
  32. National Center for Health Statistics. Estimates of the July 1, 2000-July 1, 2004, United States resident population from the vintage 2006 postcensal series by year, county, age, sex, race, and Hispanic origin. Available at: http://www.cdc.gov/nchs/about/major/dvs/popbridge/datadoc.htm.
  33. National Center for Education Statistics. Estimates of the population of students by school district. Available at: http://nces.ed.gov/ccd/bat/.
  34. Szklo M, Nieto FJ. Epidemiology: beyond the basics. 2nd ed. Sudbury, MA: Jones and Bartlett Publishers; 2007;
  35. Shattuck P. The contribution of diagnostic substitution to the growing administrative prevalence of autism in US special education. Pediatrics. 2006;117:1028–1037
  36. Croen LA, Grether JK, Selvin S. Descriptive epidemiology of autism in a California population: who is at risk?. J Autism Dev Disord. 2002;32:217–224
  37. Schieve LA, Rice CE, Boyle C, et al. Parental report of diagnosed autism in children aged 4-17 years—United States, 2003-2004. Morb Mortal Wkly Rep. 2006;55:481–486
  38. Centers for Disease Control and Prevention. Prevalence of autism spectrum disorders (ASDs)—an update from the Autism and Developmental Disabilities Monitoring (ADDM) Network, 2004 and 2006. Morb Mortal Wkly Rep Surveill Summ. [in press].
  39. Lazarus C, Autry A, Baio J, et al. Impact of postcensal versus intercensal population estimates on prevalence of selected developmental disabilities—metropolitan Atlanta, Georgia, 1991-1996. Am J Ment Retard. 2007;112:462–466
  40. Constantino JN, Todd RD. Autistic traits in the general population: a twin study. Arch Gen Psychiatr. 2003;60:524–530
  41. Atladóttir H, Parner E, Schendel D, et al. Time trends in reported diagnoses of childhood neuropsychiatric disorders: a Danish cohort study. Arch Pediatr Adolesc Med. 2007;161:193–198
  42. Pallapies D. Trends in childhood disease. Mutat Res. 2006;608:100–111
  43. Van Den Hazel P, Zuurbier M, Babisch W, et al. Today's epidemics in children: possible relations to environmental pollution and suggested measures. Acta Paediatr. 2006;95(Suppl 453):18–25

 Financial disclosure: Dr. Rice conducts a limited number of training sessions to professionals on the diagnosis of the autism spectrum disorders as an approved outside activity separate from employment with the Federal government. The other authors report no conflicts of interest. The authors acknowledge the collaborative work of the Autism and Developmental Disabilities Monitoring (ADDM) Network dedicated project staff who contributed to the data collection for this manuscript. The participation and support from the many educational and clinical programs and data sources have been invaluable. Catherine Lord, Ph.D. (University of Michigan), Gail McGee, Ph.D., and Michael Morrier, Ph.D. (Emory University) provided expertise related to the case definition. Diana Schendel, Coleen Boyle, Esther Sumartojo, Ed Trevathan, and Carole Craft reviewed the manuscript and gave editorial assistance. Sydney Pettygrove, Catherine Rice, Jon Baio, Li-Ching Lee, and Joyce Nicholas had full access to all of the data in their study site and take responsibility for the integrity of the data and the accuracy of the data analysis. These projects were funded by the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. For additional information on these projects, see http://www.cdc.gov/autism.

PII: S1936-6574(09)00192-7

doi: 10.1016/j.dhjo.2009.10.008

Disability and Health Journal
Volume 3, Issue 3 , Pages 186-201 , July 2010