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Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years — ADDM network, 16 Sites, United States, 2022
CDC ^ | April 17, 2025 | Kelly A. Shaw, PhD ; Susan Williams; Mary E. Patrick, MPH ; Miguel Valencia-Prado

Posted on 04/16/2025 2:20:16 PM PDT by ransomnote

ransomnote: I posted the abstract below, the rest of the study with graphics and sources is at the link.

ransomnote: I posted the abstract below, the rest of the study with graphics and sources is at the link.

Complete List of Authors:

Kelly A. Shaw, PhD ; Susan Williams ; Mary E. Patrick, MPH ; Miguel Valencia-Prado, MD ; Maureen S. Durkin, PhD ; Ellen
M. Howerton, PhD ; Christine M. Ladd-Acosta, PhD ; Elise T. Pas, PhD ; Amanda V. Bakian, PhD ; Paige Bartholomew,
MPH ; Nancy Nieves-Muñoz, EdM ; Kate Sidwell ; Amy Alford, MEd ; Deborah A. Bilder, MD ; Monica DiRienzo, MA ;
Robert T. Fitzgerald, PhD ; Sarah M. Furnier, PhD ; Allison E. Hudson ; Olivia M. Pokoski, MPH ; Lindsay Shea, DrPH ;
Sarah C. Tinker, PhD ; Zachary Warren, PhD ; Walter Zahorodny, PhD ; Hilcon Agosto-Rosa, MS ; Joshua Anbar, DrPH ;
Katheleen Y. Chavez, MS ; Amy Esler, PhD ; Allison Forkner, MPH ; Andrea Grzybowski, MS ; Azza Hagel Agib ; Libby
Hallas, MS ; Maya Lopez, MD ; Sandy Magaña, PhD ; Ruby H.N. Nguyen, PhD ; Jaylaan Parker, MBA ; Karen Pierce,
PhD ; Tyra Protho, MS ; Hilda Torres, MSW ; Sandra B. Vanegas, PhD ; Alison Vehorn, MS ; Minyu Zhang, PhD ;
Jennifer Andrews, PhD ; Felicia Greer, MPH ; Jennifer Hall-Lande, PhD ; Dedria McArthur, MPH ; Madison Mitamura ;
Angel J. Montes, DHCA ; Sydney Pettygrove, PhD ; Josephine Shenouda, DrPH ; Carolyn Skowyra, MPH ; Anita
Washington, MPH ; Matthew J. Maenner, PhD (VIEW AUTHOR AFFILIATIONS )

Description of System: The Autism and Developmental Disabilities Monitoring Network is an active surveillance program that estimates prevalence and characteristics of ASD and monitors timing of ASD identification among children aged 4 and 8 years. In 2022, a total of 16 sites (located in Arizona, Arkansas, California, Georgia, Indiana, Maryland, Minnesota, Missouri, New Jersey, Pennsylvania, Puerto Rico, Tennessee, Texas [two sites: Austin and Laredo], Utah, and Wisconsin) conducted surveillance for ASD among children aged 4 and 8 years and suspected ASD among children aged 4 years. Surveillance included children who lived in the surveillance area at any time during 2022. Children were classified as having ASD if they ever received 1) an ASD diagnostic statement in a comprehensive developmental evaluation, 2) autism special education eligibility, or 3) an ASD International Classification of Diseases, Ninth Revision (ICD-9) code in the 299 range or International Classification of Diseases, Tenth Revision (ICD-10) code of F84.0, F84.3, F84.5, F84.8, or F84.9. Children aged 4 years were classified as having suspected ASD if they did not meet the case definition for ASD but had an evaluator’s suspicion of ASD documented in a comprehensive developmental evaluation.

Results: Among children aged 8 years in 2022, ASD prevalence was 32.2 per 1,000 children (one in 31) across the 16 sites, ranging from 9.7 in Texas (Laredo) to 53.1 in California. The overall observed prevalence estimate was similar to estimates calculated using Bayesian hierarchical and random effects models. ASD was 3.4 times as prevalent among boys (49.2) than girls (14.3). Overall, ASD prevalence was lower among non-Hispanic White (White) children (27.7) than among Asian or Pacific Islander (A/PI) (38.2), American Indian or Alaska Native (AI/AN) (37.5), non-Hispanic Black or African American (Black) (36.6), Hispanic or Latino (Hispanic) (33.0), and multiracial children (31.9). No association was observed between ASD prevalence and neighborhood median household income (MHI) at 11 sites; higher ASD prevalence was associated with lower neighborhood MHI at five sites.

Record abstraction was completed for 15 of the 16 sites for 8,613 children aged 8 years who met the ASD case definition. Of these 8,613 children, 68.4% had a documented diagnostic statement of ASD, 67.3% had a documented autism special education eligibility, and 68.9% had a documented ASD ICD-9 or ICD-10 code. All three elements of the ASD case definition were present for 34.6% of children aged 8 years with ASD.

Among 5,292 (61.4% of 8,613) children aged 8 years with ASD with information on cognitive ability, 39.6% were classified as having an intellectual disability. Intellectual disability was present among 52.8% of Black, 50.0% of AI/AN, 43.9% of A/PI, 38.8% of Hispanic, 32.7% of White, and 31.2% of multiracial children with ASD. The median age of earliest known ASD diagnosis was 47 months and ranged from 36 months in California to 69.5 months in Texas (Laredo).

Cumulative incidence of ASD diagnosis or eligibility by age 48 months was higher among children born in 2018 (aged 4 years in 2022) than children born in 2014 (aged 8 years in 2022) at 13 of the 15 sites that were able to abstract records. Overall cumulative incidence of ASD diagnosis or eligibility by age 48 months was 1.7 times as high among those born in 2018 compared with those born in 2014 and ranged from 1.4 times as high in Arizona and Georgia to 3.1 times as high in Puerto Rico. Among children aged 4 years, for every 10 children meeting the case definition of ASD, one child met the definition of suspected ASD.

Children with ASD who were born in 2018 had more evaluations and identification during ages 0–4 years than children with ASD who were born in 2014 during the 0–4 years age window, with an interruption in the pattern in early 2020 coinciding with onset of the COVID-19 pandemic.

Overall, 66.5% of children aged 8 years with ASD had a documented autism test. Use of autism tests varied widely across sites: 24.7% (New Jersey) to 93.5% (Puerto Rico) of children aged 8 years with ASD had a documented autism test in their records. The most common tests documented for children aged 8 years were the Autism Diagnostic Observation Schedule, Autism Spectrum Rating Scales, Childhood Autism Rating Scale, Gilliam Autism Rating Scale, and Social Responsiveness Scale.

Interpretation: Public Health Action: Increased identification of autism, particularly among very young children and previously underidentified groups, underscores the increased demand and ongoing need for enhanced planning to provide equitable diagnostic, treatment, and support services for all children with ASD. The substantial variability in ASD identification across sites suggests opportunities to identify and implement successful strategies and practices in communities to ensure all children with ASD reach their potential.

ransomnote: End of Abstract. The rest of the study is at the link.



TOPICS: Miscellaneous
KEYWORDS: childrenwithasd; positivefeedback
This is the Autism study upon which HHS chief RFK Jr. based his remarks.
1 posted on 04/16/2025 2:20:16 PM PDT by ransomnote
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To: ransomnote

I have studied this quite a lot.

Researchers have been busy pinning down genetic causes but that cannot possibly be the whole story.

Yes certain genes are definitely associated with autism. But you cannot have a genetic epidemic that causes one specific disease.

If it were a mutagen one would expect all sorts of deformities, not just autism, to be manifest.

Something(s) in the environment have to be behind this, possibly making compensating mechanisms unable to work.

One clue (but definitely not the whole story) is increase in autism among Somalis in Minnesota (low sunlight) and the amount of time kids spend indoors (1994-1995 with the advent of the Hypertext Markup Language and widespread internet usage). Both implicate vitamin D playing perhaps a protective role.


2 posted on 04/16/2025 2:38:31 PM PDT by packagingguy
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To: ransomnote
This study looked at disorders in the "spectrum" not just severe cases. A big weakness I see is that while they list the specific codes in the diagnosis, they do not show the distribution of those codes in the data.

They looked for those diagnosed with codes F84.0, F84.3, F84.5, F84.8, or F84.9, which you can look up at the link below:

https://www.icd10data.com/ICD10CM/Codes/F01-F99/F80-F89/F84-

So they don't indicate something like x number had code 84.0 (the severe autism we'd all recognize) vs code 84.5 Asperger's, which is a bit weaker. All are lumped together to create the stats.

The other codes are more general impairment of social interaction along with some type of repetitive behavior or interest.

Importantly, the ages of those kids along with the time (2022) are on the heels of two years of forced COVID isolation thanks to the wonderful teacher's unions. No surprise to see reduced social development there.

At one point they refer to a big difference showing much higher rates in CA vs TX. This could point to a test-bias where CA is more likely to have lefty programs that provide free health screening for the poor etc..

I have to admit I did not spend hours pouring over this so can't say I have reviewed it in depth. If you can find where they differentiate by specific codes, please let me know.

For now, the only "environmental threat" I can imagine based on this is that you should keep your kids away from public schools (where the testers are) and make them play w/kids in your hood (off the phone). That last would be helped by not having child protective services seize your kids for being by themselves out of sight of the house.

3 posted on 04/16/2025 3:03:45 PM PDT by fruser1
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To: packagingguy

It’s interesting that wildlife doesn’t have autism. So, whatever is causing it is unique to humans.


4 posted on 04/16/2025 3:09:29 PM PDT by jacknhoo (Luke 12:51; Think ye, that I am come to give peace on earth? I tell you, no; but separation.)
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To: ransomnote
Video TRANSCRIPT of Kennedy Jr's press release is linked below.

WATCH LIVE: RFK Jr. holds news briefing for CDC findings on the increase of autism prevalence [TRANSCRIPT OF RFK Jr's remarks from VIDEO]
YOUTUBE ^ | 04/16/2025 | PBS NewsHour, Robert F Kennedy Jr.

Posted on 4/16/2025, 5:13:24 PM by ransomnote


5 posted on 04/16/2025 3:19:05 PM PDT by ransomnote (IN GOD WE TRUST)
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To: ransomnote

The incidence of autism is directly proportional to the amount of money shoveled into the diagnosis and treatment of it. If chapped hands got you on Medicaid with a primary physician, individualized counseling, and lots of sympathy, you’d see a dramatic increase in the number of chapped hands cases being reported.


6 posted on 04/16/2025 3:22:11 PM PDT by SpaceBar
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To: ransomnote

Thanks for posting, ‘note. BTTT


7 posted on 04/16/2025 3:23:10 PM PDT by PGalt (Past Peak Civilization?)
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To: SpaceBar

Sure it is.


8 posted on 04/16/2025 3:24:58 PM PDT by SoConPubbie (Trump has all the right enemies, DeSantis has all the wrong friends.)
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To: ransomnote

I’m on the Spectrum, very high functioning. It was much more rare in the 80’s, and they didn’t know how to clasify it.


9 posted on 04/16/2025 3:38:02 PM PDT by cowboyusa
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To: cowboyusa

Me too. I am “elderly”, as they say, and female. I have been “masking” all my life, and as we age, we lose those who “get” and understand us.

Loniless increases as we lose our spouses and loved ones as these are very hard to replace.

“Neurotypicals” have a hard time appreciating our intense interests and focus - and it gets harder as we age to fit in easily to social situations. Bingo and card games are no substitute for the work we used to love when we had to “retire”.

I appreciate your post and just wanted you to thank for posting your observation. My best to you and yours...


10 posted on 04/16/2025 4:26:11 PM PDT by jacquej (“You cannot have a conservative government with a liberal culture." (Mark Steyn))
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To: ransomnote

Average age of the father? Number of hours kids under 2 spend looking at iPads and TVs?

Those are the first things I’d check.


11 posted on 04/16/2025 4:58:11 PM PDT by proxy_user
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