Progress and Disparities in Early Identification of Autism Spectrum Disorder: Autism and Developmental Disabilities Monitoring Network, 2002–2016

Details

• Alternative Title:
  J Am Acad Child Adolesc Psychiatry
• Personal Author:
  Shaw, Kelly A. ; McArthur, Dedria ; Hughes, Michelle M. ; Bakian, Amanda V. ; Lee, Li-Ching ; Pettygrove, Sydney ; Maenner, Matthew J.
• Description:
  Objective:
  
  Early identification can improve outcomes for children with autism spectrum disorder (ASD). We sought to assess changes in early ASD identification over time and by co-occurring intellectual disability (ID) and race/ethnicity.
  
  Method:
  
  Using data for 2002–2016 from a biennial population-based ASD surveillance program among 8-year-old children in the United States, we defined identification as a child’s earliest recorded ASD diagnosis or special education eligibility. Unidentified children had characteristics meeting the ASD surveillance case definition but no recorded identification by age 8 years. We calculated median age at identification among identified children, median age at identification including unidentified children, and cumulative incidence of identification by age 48 months.
  
  Results:
  
  ASD identification by age 48 months was 4 times (95% CI: 3.6–4.3) as likely in 2016 as in 2002, with the largest increases among children without ID. Median age at ASD identification among identified children decreased 3 months during this time. Children of every race/ethnicity were more likely to be identified over time. There were racial disparities stratified by ID: in 2016, Black and Hispanic children without ID were less likely to be identified with ASD than were White children (both groups risk ratio: 0.7; 95% CI: 0.5–0.8), but Black children were 1.5 times (95% CI: 1.3–1.9) as likely as White children to be identified with ASD and ID.
  
  Conclusion:
  
  Substantial progress has been made to identify more children with ASD early, despite minimal decrease in median age at diagnosis. Considerable disparities remain in early ASD identification by race/ethnicity and co-occurring intellectual disability.
  
  
• Subjects:
  Autism Spectrum Disorder Autistic Disorder Child Child, Preschool Developmental Disabilities Humans Intellectual Disability Prevalence United States
• Keywords:
  Autism Spectrum Disorder Epidemiology Health Status Disparities Intellectual Disability
• Source:
  J Am Acad Child Adolesc Psychiatry. 61(7):905-914
• Pubmed ID:
  34838692
• Pubmed Central ID:
  PMC9353949
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  61
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:0d4c17ef1ee21910727ca3d3da132d4f8c186641b5999b6cb793f895770344cd8d7cbd9135ae9a59461283cb38146150123262ede35cd3f6735c453843d300e6
• Download URL:
  https://stacks.cdc.gov/view/cdc/120008/cdc_120008_DS1.pdf
• File Type:
  [PDF - 464.17 KB ]